Procedural Cross Coder

Essential links from ICD-9-CM volume 3 procedure codes to CPT® and HCPCS Level II codes

2016 Contents

Introduction...... i Operations on the Cardiovascular System (35–39) ...... 95 Operations on the Hemic and Lymphatic Systems (40–41) ...... 134 Operations on the Digestive System (42–54) ...... 140 Operations on the Urinary System (55–59) ...... 186 Operations on the Male Genital Organs (60–64) ...... 201 Procedures and Interventions NEC (00) ...... 1 Operations on the Female Genital Organs Operations on the Nervous System (01–05) ...... 9 (65–71) ...... 211 Operations on the Endocrine System (06–07) ...... 28 Obstetrical Procedures (72–75) ...... 230 Operations on the Eye (08–16) ...... 33 Operations on the Musculoskeletal Other Miscellaneous Diagnostic and System (76–84) ...... 237 Therapeutic Procedures (17.1–17.81) ...... 56 Operations on the Integumentary Operations on the Ear (18–20) ...... 60 System (85–86) ...... 315 Operations on the Nose, Mouth, and Miscellaneous Diagnostic and Therapeutic Pharynx (21–29) ...... 67 Procedures (87–99)...... 334 Operations on the Respiratory System (30–34)..... 84 Glossary ...... 419 Introduction

Current Procedural Terminology

Organization Procedural Cross Coder

Procedural Cross Coder

History

Format Procedural Cross Coder

© 2015 American Medical Association. All Rights Reserved. i Procedural Cross Coder 0BQ43ZZ 0BQ10ZZ 0BQ30ZZ Repair Trachea, Open Approach Repair Right Main Bronchus, Open Approach CPT Codes 32501 Resection and repair of portion of bronchus (bronchoplasty) when 31750 Tracheoplasty; cervical performed at time of lobectomy or segmentectomy (List separately in 31755 Tracheoplasty; tracheopharyngeal fistulization, each stage addition to code for primary procedure) 31760 Tracheoplasty; intrathoracic 32815 Open closure of major bronchial fistula 31800 Suture of tracheal wound or injury; cervical 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula 31805 Suture of tracheal wound or injury; intrathoracic 31820 Surgical closure tracheostomy or fistula; without plastic repair 0BQ33ZZ 0BQ13ZZ Repair Right Main Bronchus, Percutaneous Approach Repair Trachea, Percutaneous Approach CPT Codes CPT Codes 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 31750 Tracheoplasty; cervical addition to code for primary procedure) 31755 Tracheoplasty; tracheopharyngeal fistulization, each stage 32815 Open closure of major bronchial fistula 31760 Tracheoplasty; intrathoracic 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 0BQ14ZZ bronchopleural fistula Repair Trachea, Percutaneous Endoscopic Approach 0BQ34ZZ CPT Codes Repair Right Main Bronchus, Percutaneous Endoscopic Approach 31750 Tracheoplasty; cervical CPT Codes 31755 Tracheoplasty; tracheopharyngeal fistulization, each stage 32501 Resection and repair of portion of bronchus (bronchoplasty) when 31760 Tracheoplasty; intrathoracic performed at time of lobectomy or segmentectomy (List separately in 0BQ17ZZ addition to code for primary procedure) 32815 Open closure of major bronchial fistula Repair Trachea, Via Natural or Artificial Opening 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of CPT Codes bronchopleural fistula 31899 Unlisted procedure, trachea, bronchi 0BQ37ZZ 0BQ18ZZ Repair Right Main Bronchus, Via Natural or Artificial Opening Repair Trachea, Via Natural or Artificial Opening Endoscopic CPT Codes CPT Codes 31899 Unlisted procedure, trachea, bronchi 31615 Tracheobronchoscopy through established tracheostomy incision 0BQ38ZZ 31899 Unlisted procedure, trachea, bronchi Repair Right Main Bronchus, Via Natural or Artificial Opening Endoscopic 0BQ20ZZ CPT Codes Repair Carina, Open Approach 31660 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when CPT Codes performed; with bronchial thermoplasty, 1 lobe 31766 Carinal reconstruction 31661 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes 0BQ23ZZ 0BQ40ZZ Repair Carina, Percutaneous Approach CPT Codes Repair Right Upper Lobe Bronchus, Open Approach CPT Codes 31766 Carinal reconstruction 32501 Resection and repair of portion of bronchus (bronchoplasty) when 0BQ24ZZ performed at time of lobectomy or segmentectomy (List separately in addition to code for primary procedure) Repair Carina, Percutaneous Endoscopic Approach 32815 Open closure of major bronchial fistula CPT Codes 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 31766 Carinal reconstruction bronchopleural fistula 0BQ27ZZ 0BQ43ZZ Repair Carina, Via Natural or Artificial Opening Repair Right Upper Lobe Bronchus, Percutaneous Approach CPT Codes CPT Codes 31899 Unlisted procedure, trachea, bronchi 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 0BQ28ZZ addition to code for primary procedure) Repair Carina, Via Natural or Artificial Opening Endoscopic 32815 Open closure of major bronchial fistula CPT Codes 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 31615 Tracheobronchoscopy through established tracheostomy incision bronchopleural fistula 31899 Unlisted procedure, trachea, bronchi

0BQ44ZZ 31661 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when Repair Right Upper Lobe Bronchus, Percutaneous Endoscopic Approach performed; with bronchial thermoplasty, 2 or more lobes CPT Codes 0BQ60ZZ 32501 Resection and repair of portion of bronchus (bronchoplasty) when Repair Right Lower Lobe Bronchus, Open Approach performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 32815 Open closure of major bronchial fistula 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of addition to code for primary procedure) bronchopleural fistula 32815 Open closure of major bronchial fistula 0BQ47ZZ 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of Repair Right Upper Lobe Bronchus, Via Natural or Artificial Opening bronchopleural fistula CPT Codes 0BQ63ZZ 31899 Unlisted procedure, trachea, bronchi Repair Right Lower Lobe Bronchus, Percutaneous Approach 0BQ48ZZ CPT Codes Repair Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 31660 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 32815 Open closure of major bronchial fistula performed; with bronchial thermoplasty, 1 lobe 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 31661 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when bronchopleural fistula performed; with bronchial thermoplasty, 2 or more lobes 0BQ64ZZ 0BQ50ZZ Repair Right Lower Lobe Bronchus, Percutaneous Endoscopic Approach Repair Right Middle Lobe Bronchus, Open Approach CPT Codes CPT Codes 32501 Resection and repair of portion of bronchus (bronchoplasty) when 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in performed at time of lobectomy or segmentectomy (List separately in addition to code for primary procedure) addition to code for primary procedure) 32815 Open closure of major bronchial fistula 32815 Open closure of major bronchial fistula 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula bronchopleural fistula 0BQ67ZZ 0BQ53ZZ Repair Right Lower Lobe Bronchus, Via Natural or Artificial Opening Repair Right Middle Lobe Bronchus, Percutaneous Approach CPT Codes CPT Codes 31899 Unlisted procedure, trachea, bronchi 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 0BQ68ZZ addition to code for primary procedure) Repair Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 32815 Open closure of major bronchial fistula CPT Codes 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula 31660 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe 0BQ54ZZ 31661 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when Repair Right Middle Lobe Bronchus, Percutaneous Endoscopic Approach performed; with bronchial thermoplasty, 2 or more lobes CPT Codes 0BQ70ZZ 32501 Resection and repair of portion of bronchus (bronchoplasty) when Repair Left Main Bronchus, Open Approach performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 32815 Open closure of major bronchial fistula 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of addition to code for primary procedure) bronchopleural fistula 32815 Open closure of major bronchial fistula 0BQ57ZZ 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of Repair Right Middle Lobe Bronchus, Via Natural or Artificial Opening bronchopleural fistula CPT Codes 0BQ73ZZ 31899 Unlisted procedure, trachea, bronchi Repair Left Main Bronchus, Percutaneous Approach 0BQ58ZZ CPT Codes Repair Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 31660 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 32815 Open closure of major bronchial fistula performed; with bronchial thermoplasty, 1 lobe 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula

0BQ74ZZ 31661 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when Repair Left Main Bronchus, Percutaneous Endoscopic Approach performed; with bronchial thermoplasty, 2 or more lobes CPT Codes 0BQ90ZZ 32501 Resection and repair of portion of bronchus (bronchoplasty) when Repair Lingula Bronchus, Open Approach performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 32815 Open closure of major bronchial fistula 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of addition to code for primary procedure) bronchopleural fistula 32815 Open closure of major bronchial fistula 0BQ77ZZ 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of Repair Left Main Bronchus, Via Natural or Artificial Opening bronchopleural fistula CPT Codes 0BQ93ZZ 31899 Unlisted procedure, trachea, bronchi Repair Lingula Bronchus, Percutaneous Approach 0BQ78ZZ CPT Codes Repair Left Main Bronchus, Via Natural or Artificial Opening Endoscopic 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 31660 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 32815 Open closure of major bronchial fistula performed; with bronchial thermoplasty, 1 lobe 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 31661 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when bronchopleural fistula performed; with bronchial thermoplasty, 2 or more lobes 0BQ94ZZ 0BQ80ZZ Repair Lingula Bronchus, Percutaneous Endoscopic Approach Repair Left Upper Lobe Bronchus, Open Approach CPT Codes CPT Codes 32501 Resection and repair of portion of bronchus (bronchoplasty) when 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in performed at time of lobectomy or segmentectomy (List separately in addition to code for primary procedure) addition to code for primary procedure) 32815 Open closure of major bronchial fistula 32815 Open closure of major bronchial fistula 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula bronchopleural fistula 0BQ97ZZ 0BQ83ZZ Repair Lingula Bronchus, Via Natural or Artificial Opening Repair Left Upper Lobe Bronchus, Percutaneous Approach CPT Codes CPT Codes 31899 Unlisted procedure, trachea, bronchi 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 0BQ98ZZ addition to code for primary procedure) Repair Lingula Bronchus, Via Natural or Artificial Opening Endoscopic 32815 Open closure of major bronchial fistula CPT Codes 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula 31660 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe 0BQ84ZZ 31661 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when Repair Left Upper Lobe Bronchus, Percutaneous Endoscopic Approach performed; with bronchial thermoplasty, 2 or more lobes CPT Codes 0BQB0ZZ 32501 Resection and repair of portion of bronchus (bronchoplasty) when Repair Left Lower Lobe Bronchus, Open Approach performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 32815 Open closure of major bronchial fistula 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of addition to code for primary procedure) bronchopleural fistula 32815 Open closure of major bronchial fistula 0BQ87ZZ 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of Repair Left Upper Lobe Bronchus, Via Natural or Artificial Opening bronchopleural fistula CPT Codes 0BQB3ZZ 31899 Unlisted procedure, trachea, bronchi Repair Left Lower Lobe Bronchus, Percutaneous Approach 0BQ88ZZ CPT Codes Repair Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic 32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in CPT Codes addition to code for primary procedure) 31660 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 32815 Open closure of major bronchial fistula performed; with bronchial thermoplasty, 1 lobe 32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula

0QS004Z device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral Reposition Lumbar Vertebra with Internal Fixation Device, Open Approach cannulation, inclusive of all imaging guidance; lumbar 22515 Percutaneous vertebral augmentation, including cavity creation (fracture CPT Codes reduction and bone biopsy included when performed) using mechanical 22325 Open treatment and/or reduction of vertebral fracture(s) and/or device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral dislocation(s), posterior approach, 1 fractured vertebra or dislocated cannulation, inclusive of all imaging guidance; each additional thoracic segment; lumbar or lumbar vertebral body (List separately in addition to code for primary 22328 Open treatment and/or reduction of vertebral fracture(s) and/or procedure) dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (List 0QS04ZZ separately in addition to code for primary procedure) Reposition Lumbar Vertebra, Percutaneous Endoscopic Approach 22840 Posterior non-segmental instrumentation (eg, Harrington rod technique, CPT Codes pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in 22511 Percutaneous vertebroplasty (bone biopsy included when performed), 1 addition to code for primary procedure) vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral 22842 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List 22512 Percutaneous vertebroplasty (bone biopsy included when performed), 1 separately in addition to code for primary procedure) vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body 22843 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with (List separately in addition to code for primary procedure) multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure) 0QS0XZZ 22844 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments Reposition Lumbar Vertebra, External Approach (List separately in addition to code for primary procedure) CPT Codes 22315 Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring 0QS00ZZ casting or bracing, with and including casting and/or bracing by Reposition Lumbar Vertebra, Open Approach manipulation or traction CPT Codes 0QS104Z 22325 Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated Reposition Sacrum with Internal Fixation Device, Open Approach segment; lumbar CPT Codes 22328 Open treatment and/or reduction of vertebral fracture(s) and/or 27218 Open treatment of posterior pelvic bone fracture and/or dislocation, for dislocation(s), posterior approach, 1 fractured vertebra or dislocated fracture patterns that disrupt the pelvic ring, unilateral, includes internal segment; each additional fractured vertebra or dislocated segment (List fixation, when performed (includes ipsilateral ilium, sacroiliac joint separately in addition to code for primary procedure) and/or sacrum) 0QS034Z 0QS10ZZ Reposition Lumbar Vertebra with Internal Fixation Device, Percutaneous Approach Reposition Sacrum, Open Approach CPT Codes CPT Codes 22514 Percutaneous vertebral augmentation, including cavity creation (fracture 27218 Open treatment of posterior pelvic bone fracture and/or dislocation, for reduction and bone biopsy included when performed) using mechanical fracture patterns that disrupt the pelvic ring, unilateral, includes internal device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral fixation, when performed (includes ipsilateral ilium, sacroiliac joint cannulation, inclusive of all imaging guidance; lumbar and/or sacrum) 22515 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical 0QS134Z device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral Reposition Sacrum with Internal Fixation Device, Percutaneous Approach cannulation, inclusive of all imaging guidance; each additional thoracic CPT Codes or lumbar vertebral body (List separately in addition to code for primary procedure) 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral 0QS03ZZ (includes ipsilateral ilium, sacroiliac joint and/or sacrum) Reposition Lumbar Vertebra, Percutaneous Approach 0QS13ZZ CPT Codes Reposition Sacrum, Percutaneous Approach 22511 Percutaneous vertebroplasty (bone biopsy included when performed), 1 CPT Codes vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or 22512 Percutaneous vertebroplasty (bone biopsy included when performed), 1 dislocation, for fracture patterns that disrupt the pelvic ring, unilateral vertebral body, unilateral or bilateral injection, inclusive of all imaging (includes ipsilateral ilium, sacroiliac joint and/or sacrum) guidance; each additional cervicothoracic or lumbosacral vertebral body 0QS144Z (List separately in addition to code for primary procedure) Reposition Sacrum with Internal Fixation Device, Percutaneous Endoscopic 0QS044Z Approach Reposition Lumbar Vertebra with Internal Fixation Device, Percutaneous CPT Codes Endoscopic Approach 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or CPT Codes dislocation, for fracture patterns that disrupt the pelvic ring, unilateral 22514 Percutaneous vertebral augmentation, including cavity creation (fracture (includes ipsilateral ilium, sacroiliac joint and/or sacrum) reduction and bone biopsy included when performed) using mechanical

254 © 2015 Optum360, LLC © 2015 American Medical Association. All Rights Reserved. Procedural Cross Coder 0QS305Z 0QS14ZZ 0QS23ZZ Reposition Sacrum, Percutaneous Endoscopic Approach Reposition Right Pelvic Bone, Percutaneous Approach CPT Codes CPT Codes 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum) (includes ipsilateral ilium, sacroiliac joint and/or sacrum) 0QS1XZZ 0QS244Z Reposition Sacrum, External Approach Reposition Right Pelvic Bone with Internal Fixation Device, Percutaneous CPT Codes Endoscopic Approach 20999 Unlisted procedure, musculoskeletal system, general CPT Codes 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or 0QS204Z dislocation, for fracture patterns that disrupt the pelvic ring, unilateral Reposition Right Pelvic Bone with Internal Fixation Device, Open Approach (includes ipsilateral ilium, sacroiliac joint and/or sacrum) CPT Codes 29999 Unlisted procedure, arthroscopy 27217 Open treatment of anterior pelvic bone fracture and/or dislocation for 0QS245Z fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis and/or ipsilateral Reposition Right Pelvic Bone with External Fixation Device, Percutaneous superior/inferior rami) Endoscopic Approach 27218 Open treatment of posterior pelvic bone fracture and/or dislocation, for CPT Codes fracture patterns that disrupt the pelvic ring, unilateral, includes internal 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or fixation, when performed (includes ipsilateral ilium, sacroiliac joint dislocation, for fracture patterns that disrupt the pelvic ring, unilateral and/or sacrum) (includes ipsilateral ilium, sacroiliac joint and/or sacrum) G0414 Open treatment of anterior pelvic bone fracture and/or dislocation for 29999 Unlisted procedure, arthroscopy fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis 0QS24ZZ and/or superior/inferior rami) Reposition Right Pelvic Bone, Percutaneous Endoscopic Approach 0QS205Z CPT Codes Reposition Right Pelvic Bone with External Fixation Device, Open Approach 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or CPT Codes dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum) 27254 Open treatment of hip dislocation, traumatic, with acetabular wall and 29999 Unlisted procedure, arthroscopy femoral head fracture, with or without internal or external fixation 0QS20ZZ 0QS2XZZ Reposition Right Pelvic Bone, External Approach Reposition Right Pelvic Bone, Open Approach CPT Codes CPT Codes 27193 Closed treatment of pelvic ring fracture, dislocation, diastasis or 27217 Open treatment of anterior pelvic bone fracture and/or dislocation for subluxation; without manipulation fracture patterns that disrupt the pelvic ring, unilateral, includes internal 27194 Closed treatment of pelvic ring fracture, dislocation, diastasis or fixation, when performed (includes pubic symphysis and/or ipsilateral subluxation; with manipulation, requiring more than local anesthesia superior/inferior rami) 27218 Open treatment of posterior pelvic bone fracture and/or dislocation, for 0QS304Z fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint Reposition Left Pelvic Bone with Internal Fixation Device, Open Approach and/or sacrum) CPT Codes 27217 Open treatment of anterior pelvic bone fracture and/or dislocation for 0QS234Z fracture patterns that disrupt the pelvic ring, unilateral, includes internal Reposition Right Pelvic Bone with Internal Fixation Device, Percutaneous Approach fixation, when performed (includes pubic symphysis and/or ipsilateral CPT Codes superior/inferior rami) 27218 Open treatment of posterior pelvic bone fracture and/or dislocation, for 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or fracture patterns that disrupt the pelvic ring, unilateral, includes internal dislocation, for fracture patterns that disrupt the pelvic ring, unilateral fixation, when performed (includes ipsilateral ilium, sacroiliac joint (includes ipsilateral ilium, sacroiliac joint and/or sacrum) and/or sacrum) G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or G0414Open treatment of anterior pelvic bone fracture and/or dislocation dislocation, for fracture patterns which disrupt the pelvic ring, unilateral for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, or bilateral, (includes ilium, sacroiliac joint and/or sacrum) includes internal fixation when performed (includes pubic symphysis 0QS235Z and/or superior/inferior rami) Reposition Right Pelvic Bone with External Fixation Device, Percutaneous Approach 0QS305Z CPT Codes Reposition Left Pelvic Bone with External Fixation Device, Open Approach 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or CPT Codes dislocation, for fracture patterns that disrupt the pelvic ring, unilateral 27254 Open treatment of hip dislocation, traumatic, with acetabular wall and (includes ipsilateral ilium, sacroiliac joint and/or sacrum) femoral head fracture, with or without internal or external fixation

© 2015 Optum360, LLC © 2015 American Medical Association. All Rights Reserved. 255 0QS30ZZ Procedural Cross Coder 0QS30ZZ 0QS3XZZ Reposition Left Pelvic Bone, Open Approach Reposition Left Pelvic Bone, External Approach CPT Codes CPT Codes 27217 Open treatment of anterior pelvic bone fracture and/or dislocation for 27193 Closed treatment of pelvic ring fracture, dislocation, diastasis or fracture patterns that disrupt the pelvic ring, unilateral, includes internal subluxation; without manipulation fixation, when performed (includes pubic symphysis and/or ipsilateral 27194 Closed treatment of pelvic ring fracture, dislocation, diastasis or superior/inferior rami) subluxation; with manipulation, requiring more than local anesthesia 27218 Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal 0QS404Z fixation, when performed (includes ipsilateral ilium, sacroiliac joint Reposition Right Acetabulum with Internal Fixation Device, Open Approach and/or sacrum) CPT Codes 0QS334Z 27226 Open treatment of posterior or anterior acetabular wall fracture, with Reposition Left Pelvic Bone with Internal Fixation Device, Percutaneous Approach internal fixation 27227 Open treatment of acetabular fracture(s) involving anterior or posterior CPT Codes (one) column, or a fracture running transversely across the acetabulum, 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or with internal fixation dislocation, for fracture patterns that disrupt the pelvic ring, unilateral 27228 Open treatment of acetabular fracture(s) involving anterior and posterior (includes ipsilateral ilium, sacroiliac joint and/or sacrum) (two) columns, includes T-fracture and both column fracture with G0413 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or complete articular detachment, or single column or transverse fracture dislocation, for fracture patterns which disrupt the pelvic ring, unilateral with associated acetabular wall fracture, with internal fixation or bilateral, (includes ilium, sacroiliac joint and/or sacrum) 27254 Open treatment of hip dislocation, traumatic, with acetabular wall and 0QS335Z femoral head fracture, with or without internal or external fixation Reposition Left Pelvic Bone with External Fixation Device, Percutaneous Approach 0QS40ZZ CPT Codes Reposition Right Acetabulum, Open Approach 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or CPT Codes dislocation, for fracture patterns that disrupt the pelvic ring, unilateral 27254 Open treatment of hip dislocation, traumatic, with acetabular wall and (includes ipsilateral ilium, sacroiliac joint and/or sacrum) femoral head fracture, with or without internal or external fixation 0QS33ZZ 0QS434Z Reposition Left Pelvic Bone, Percutaneous Approach Reposition Right Acetabulum with Internal Fixation Device, Percutaneous CPT Codes Approach 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or CPT Codes dislocation, for fracture patterns that disrupt the pelvic ring, unilateral 27226 Open treatment of posterior or anterior acetabular wall fracture, with (includes ipsilateral ilium, sacroiliac joint and/or sacrum) internal fixation 0QS344Z 27227 Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, Reposition Left Pelvic Bone with Internal Fixation Device, Percutaneous Endoscopic with internal fixation Approach 27228 Open treatment of acetabular fracture(s) involving anterior and posterior CPT Codes (two) columns, includes T-fracture and both column fracture with 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or complete articular detachment, or single column or transverse fracture dislocation, for fracture patterns that disrupt the pelvic ring, unilateral with associated acetabular wall fracture, with internal fixation (includes ipsilateral ilium, sacroiliac joint and/or sacrum) 27254 Open treatment of hip dislocation, traumatic, with acetabular wall and 29999 Unlisted procedure, arthroscopy femoral head fracture, with or without internal or external fixation 0QS345Z 0QS43ZZ Reposition Left Pelvic Bone with External Fixation Device, Percutaneous Endoscopic Reposition Right Acetabulum, Percutaneous Approach Approach CPT Codes CPT Codes 27254 Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral 0QS444Z (includes ipsilateral ilium, sacroiliac joint and/or sacrum) 29999 Unlisted procedure, arthroscopy Reposition Right Acetabulum with Internal Fixation Device, Percutaneous Endoscopic Approach 0QS34ZZ CPT Codes Reposition Left Pelvic Bone, Percutaneous Endoscopic Approach 27226 Open treatment of posterior or anterior acetabular wall fracture, with CPT Codes internal fixation 27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or 27227 Open treatment of acetabular fracture(s) involving anterior or posterior dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (one) column, or a fracture running transversely across the acetabulum, (includes ipsilateral ilium, sacroiliac joint and/or sacrum) with internal fixation 29999 Unlisted procedure, arthroscopy 27228 Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation

256 © 2015 Optum360, LLC © 2015 American Medical Association. All Rights Reserved. Procedural Cross Coder B02810Z B02000Z B02710Z Computerized Tomography (CT Scan) of Brain using High Osmolar Contrast, Computerized Tomography (CT Scan) of Cisterna using Low Osmolar Contrast, Unenhanced and Enhanced Unenhanced and Enhanced CPT Codes CPT Codes 70460 Computed tomography, head or brain; with contrast material(s) 70460 Computed tomography, head or brain; with contrast material(s) 70470 Computed tomography, head or brain; without contrast material, 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections followed by contrast material(s) and further sections 70482 Computed tomography, orbit, sella, or posterior fossa or outer, middle, B0200ZZ or inner ear; without contrast material, followed by contrast material(s) Computerized Tomography (CT Scan) of Brain using High Osmolar Contrast and further sections CPT Codes B0271ZZ 70460 Computed tomography, head or brain; with contrast material(s) Computerized Tomography (CT Scan) of Cisterna using Low Osmolar Contrast B02010Z CPT Codes Computerized Tomography (CT Scan) of Brain using Low Osmolar Contrast, 70460 Computed tomography, head or brain; with contrast material(s) Unenhanced and Enhanced B027Y0Z CPT Codes Computerized Tomography (CT Scan) of Cisterna using Other Contrast, 70460 Computed tomography, head or brain; with contrast material(s) Unenhanced and Enhanced 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections CPT Codes 70460 Computed tomography, head or brain; with contrast material(s) B0201ZZ 70470 Computed tomography, head or brain; without contrast material, Computerized Tomography (CT Scan) of Brain using Low Osmolar Contrast followed by contrast material(s) and further sections CPT Codes 70482 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) 70460 Computed tomography, head or brain; with contrast material(s) and further sections B020Y0Z B027YZZ Computerized Tomography (CT Scan) of Brain using Other Contrast, Unenhanced Computerized Tomography (CT Scan) of Cisterna using Other Contrast and Enhanced CPT Codes CPT Codes 70460 Computed tomography, head or brain; with contrast material(s) 70460 Computed tomography, head or brain; with contrast material(s) 70470 Computed tomography, head or brain; without contrast material, B027ZZZ followed by contrast material(s) and further sections Computerized Tomography (CT Scan) of Cisterna B020YZZ CPT Codes Computerized Tomography (CT Scan) of Brain using Other Contrast 70480 Computed tomography, orbit, sella, or posterior fossa or outer, middle, CPT Codes or inner ear; without contrast material 76380 Computed tomography, limited or localized follow-up study 70460 Computed tomography, head or brain; with contrast material(s) B020ZZZ B02800Z Computerized Tomography (CT Scan) of Cerebral Ventricle(s) using High Osmolar Computerized Tomography (CT Scan) of Brain Contrast, Unenhanced and Enhanced CPT Codes CPT Codes 70450 Computed tomography, head or brain; without contrast material 70460 Computed tomography, head or brain; with contrast material(s) 76380 Computed tomography, limited or localized follow-up study 70470 Computed tomography, head or brain; without contrast material, B02700Z followed by contrast material(s) and further sections Computerized Tomography (CT Scan) of Cisterna using High Osmolar Contrast, B0280ZZ Unenhanced and Enhanced Computerized Tomography (CT Scan) of Cerebral Ventricle(s) using High Osmolar CPT Codes Contrast 70460 Computed tomography, head or brain; with contrast material(s) CPT Codes 70470 Computed tomography, head or brain; without contrast material, 70460 Computed tomography, head or brain; with contrast material(s) followed by contrast material(s) and further sections 70482 Computed tomography, orbit, sella, or posterior fossa or outer, middle, B02810Z or inner ear; without contrast material, followed by contrast material(s) Computerized Tomography (CT Scan) of Cerebral Ventricle(s) using Low Osmolar and further sections Contrast, Unenhanced and Enhanced B0270ZZ CPT Codes Computerized Tomography (CT Scan) of Cisterna using High Osmolar Contrast 70460 Computed tomography, head or brain; with contrast material(s) CPT Codes 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections 70460 Computed tomography, head or brain; with contrast material(s)

© 2015 Optum360, LLC © 2015 American Medical Association. All Rights Reserved. 257 B0281ZZ Procedural Cross Coder B0281ZZ B029Y0Z Computerized Tomography (CT Scan) of Cerebral Ventricle(s) using Low Osmolar Computerized Tomography (CT Scan) of Sella Turcica/Pituitary Gland using Other Contrast Contrast, Unenhanced and Enhanced CPT Codes CPT Codes 70460 Computed tomography, head or brain; with contrast material(s) 70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) B028Y0Z 70482 Computed tomography, orbit, sella, or posterior fossa or outer, middle, Computerized Tomography (CT Scan) of Cerebral Ventricle(s) using Other Contrast, or inner ear; without contrast material, followed by contrast material(s) Unenhanced and Enhanced and further sections CPT Codes B029YZZ 70460 Computed tomography, head or brain; with contrast material(s) Computerized Tomography (CT Scan) of Sella Turcica/Pituitary Gland using Other 70470 Computed tomography, head or brain; without contrast material, Contrast followed by contrast material(s) and further sections CPT Codes B028YZZ 70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, Computerized Tomography (CT Scan) of Cerebral Ventricle(s) using Other Contrast or inner ear; with contrast material(s) CPT Codes B029ZZZ 70460 Computed tomography, head or brain; with contrast material(s) Computerized Tomography (CT Scan) of Sella Turcica/Pituitary Gland B028ZZZ CPT Codes Computerized Tomography (CT Scan) of Cerebral Ventricle(s) 70480 Computed tomography, orbit, sella, or posterior fossa or outer, middle, CPT Codes or inner ear; without contrast material 76380 Computed tomography, limited or localized follow-up study 70450 Computed tomography, head or brain; without contrast material 76380 Computed tomography, limited or localized follow-up study B02900Z Computerized Tomography (CT Scan) of Sella Turcica/Pituitary Gland using High Osmolar Contrast, Unenhanced and Enhanced CPT Codes 70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) 70482 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections B0290ZZ Computerized Tomography (CT Scan) of Sella Turcica/Pituitary Gland using High Osmolar Contrast CPT Codes 70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) B02910Z Computerized Tomography (CT Scan) of Sella Turcica/Pituitary Gland using Low Osmolar Contrast, Unenhanced and Enhanced CPT Codes 70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) 70482 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections B0291ZZ Computerized Tomography (CT Scan) of Sella Turcica/Pituitary Gland using Low Osmolar Contrast CPT Codes 70481 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)