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Procedural Coding Guidelines

Utilizing CPT, HCPCS and CDT
I. INTRODUCTION AMA revises and publishes CPT codes biannually. Each
new edition is made available in mid-November for the
This paper discusses procedure coding, using the Current
following year, with mid-year updates available on the
Procedural Terminology (CPT), Health Care Common
AMA website. Currently CPT contains over 7,000 codes.
Procedural Coding System (HCPCS), and Current Dental
It is imperative that you purchase an updated copy of the
Terminology (CDT) systems. Subsequent papers of this
CPT codes each year to assure that you are reporting the
series address diagnostic coding and coding for specific
procedures accurately. Using deleted codes will unnec-
areas of OMS (e.g., TMJ surgery, implants, dentoalveolar
essarily delay your reimbursement. CDT is revised and
surgery, etc.)
published by the American Dental Association (ADA)
These coding guidelines have been developed by the every year. The most current publication of CDT is CDT
AAOMS Committee on Health Care and Advocacy 2013, which became available December 2012 and effec-
(CHCA) to assist you in your use of these coding systems. tive January 1, 2013. CPT became effective January 1,
In no way are the guidelines a substitute for a working 2013 and must be used for claims submitted commencing
knowledge of the coding books and systems. January 1, 2013.
The American Medical Association (AMA) CPT codes
are a listing of descriptive terms and numeric codes for
II. USING CPT TO CODE OMS PROCEDURES
reporting medical services and procedures. The purpose of It is essential that you also understand CPT coding guide-
the terminology is to provide a uniform language that will lines, symbols, instructions, and format in order to accu-
accurately describe medical, surgical, and diagnostic ser- rately reflect the level of service of the procedure being
vices, and thereby provide an effective means for reliable reported.
nationwide communication among doctors, patients, and
CPT BOOK INTRODUCTION
third parties.
The “introduction” to the AMA CPT book provides the
Both CPT procedural and ICD-9-CM (International
basis for CPT coding and basic instruction in the use of the
Classification of Diseases Ninth Revision Clinical Mod-
book, its sections, and CPT in general.
ification) diagnostic coding involve transforming verbal
descriptors of patient care into code numbers for reporting SECTION GUIDELINES
to insurance companies. The more familiar you become
In addition to the general guidelines that appear in the
with the terminology and the guidelines of the various
“Introduction,” section-specific guidelines also appear
coding systems, the easier it will become to file accurate
at the beginning of each of the six sections listed below.
and complete claims.
To understand this more clearly, open your CPT book to
CHCA serves in an advisory capacity to the American the beginning of the Surgery Section (codes ranging from
Medical Association (AMA) CPT Editorial Panel and the 10021 to 69990) and note that the guidelines addressed
American Dental Association (ADA) Code Maintenance here are applicable to only the surgery codes. The informa-
Committee (CMC), striving for more appropriate language tion here relates to issues such as the surgical package and
and treatment codes for the practice of the specialty. In ad- what it includes: follow-up care, materials over and above
dition, CHCA consults with the National Center for Health those usually included in the service, multiple procedures,
Statistics ICD-9-CM Coordination and Maintenance Com- and modifiers.
mittee to obtain better clarification of diagnostic codes.

PAGE 1 Procedural Coding Guidelines Utilizing CPT, HCPCS and CDT

 Coding Paper
CPT CONTAINS SIX SECTIONS
CPT is composed of six separate sections. The section
numbers and their sequence are as follows:
Sections Code Ranges
Evaluation and Management 99201 to 99499
Anesthesiology 00100 to 01999
99143 to 99150 IDENTIFYING DELETED CODES
Surgery 10021 to 69990 Deleted codes are identified in CPT by parenthetical notes
in the location where the code had previously been locat-
Radiology (including Nuclear
ed. Many times, the notation will also include a code or
Medicine & Diagnostic Ultrasound) 70010 to 79999
codes to use in its place (e.g., “99141, 99142 have been
Pathology and Laboratory 80048 to 89356 deleted. To report, see 99143-99145”). Occasionally, the
Medicine (except Anesthesiology) 90281 to 99602 deleted code will have the recommended notation that
another medical encounter should be selected (e.g., “21493
In addition to the six major sections, surgery in particular
and 21494 have been deleted. To report, use the applica-
is divided into subsections related to specific body sys-
ble Evaluation and Management code”). The notation is
tems: integumentary, musculoskeletal, respiratory, cardio-
removed the year following the year the deletion became
vascular, hemic and lymphatic systems, mediastinum and
effective.
diaphragm, digestive, urinary, male genital, female genital,
maternity care and delivery, endocrine, nervous, eye and STARRED PROCEDURES
ocular adnexa, and auditory.
Effective with CPT 2004, starred procedures were elimi-
OMS PROCEDURES IN CPT nated.
Most OMS procedures are listed in the Musculoskeletal INDENTED PROCEDURES AND THE
System (20000-29999) and the Digestive System (40490- IMPORTANCE OF A SEMICOLON
49999). Within the Musculoskeletal System, most OMS IN CPT CODING
codes appear under “General” (20000-20999) and “Head”
Some of the codes in CPT are indented to avoid repeat-
(21010-21499). In addition, applicable codes for OMS
ing a portion of a descriptor listed in a preceding code. It
may be found in the integumentary, respiratory, and ner-
is important to note in these instances the location of the
vous system sections.
semicolon “;”. All portions of the descriptors up to the
SYMBOLS IN CPT semicolon also apply to the portion of the selected descrip-
tor that is indented.
Understanding the symbols that appear next to a code
in CPT is necessary to identify additions, deletions, and Example:
revisions. New procedures added to that year’s edition are 12011 Simple repair of superficial wounds of face, ears,
identified throughout the book with the “●” symbol ap- eyelids, nose, lips, and/or mucous membranes;
pearing before the code number. The symbol “▲” is used 2.5 cm or less
to indicate that a code has been revised or there has been a
12013 2.6 cm to 5.0 cm
substantial alteration to the procedure. Effective in 1999,
two more symbols were added: “+” reflects an add-on code 12014 5.1 cm to 7.5 cm
and the symbol “W” indicates the code is exempt to mod- Presume that we are coding for the above repair for lacera-
ifier –51. In CPT 2005, a symbol resembling a bulls-eye tions of 3.5 cm. It would not be appropriate to code 12011
“8” was added to the book to identify procedures in which and 12013 together. The correct way to correctly report
conscious sedation is considered an inherent component. this procedure would be:
UNLISTED SERVICE CODES 12013 Simple repair of superficial wounds of face, ears,
eyelids, nose, lips, and/or mucous membranes;
Codes for unlisted services are also provided in the guide-
2.6 cm to 5.0 cm
lines preceding some sections of CPT.

PAGE 2 Procedural Coding Guidelines Utilizing CPT, HCPCS and CDT

CPT INDEX
Unlike the ICD-9-CM Index, which encompasses the
whole of Book 2, the CPT Index is located in the back of
the CPT book.
Coding Paper
There are four primary classes of entry:
1. Procedure or service (e.g., arthrocentesis, orthopanto-
gram) ACCURATE INFORMATION ASSURES
2. Organ or other anatomic site (e.g., mandible, sinus, ACCURATE CODING
salivary gland) In the example cited, based upon the information in the
operative report, 29804 accurately identifies the surgical
3. Condition (e.g., abscess, fracture)
arthroscopic procedure performed. (Note that 29800 de-
4. Synonyms, eponyms, and abbreviations (e.g., Abbe-Es- scribes TMJ arthroscopy performed for diagnostic purpos-
tlander Procedure, LeFort 1, EKG) es with or without a synovial biopsy, and 29804 represents
a TMJ arthroscopy performed for surgical purposes-i.e.,
LOCATING PROCEDURAL CODES IN CPT
lysis of adhesions, cartilage manipulation, lavage, etc.).
Open the CPT book to the Index in the back of the book. It should be noted that when a diagnostic arthroscopy is
Carefully study the use of the Index, then find the prin- performed and surgical treatment is carried out after the
ciple procedure (e.g., “Temporomandibular Joint (TMJ) problem has been located, a separate code for a diagnostic
Arthroscopy”) relating to the principle diagnosis (“524.63 arthroscopy cannot be submitted. CPT guidelines at the
articular disc disorder”). As demonstrated in this example, beginning of the arthroscopy section clearly state a surgi-
the procedure codes for TMJ arthroscopy can be either cal arthroscopy always includes a diagnostic arthroscopy;
29800 or 29804, according to the Index. Without looking 29800 is only to be used when no surgical services are
at the actual descriptors for CPT codes, 29800 and 29804, provided other than the diagnostic arthroscopy, with or
it would not be possible to identify from the CPT Index without synovial biopsy.
which arthroscopy code truly reflects the services provid-
ed. Just as you should never code from the ICD-9-CM MODIFIERS
diagnosis code index, you should never select a CPT code Modifiers are additional two-digit numbers added to a code
from the CPT Index without fully reviewing the complete to indicate special circumstances not otherwise apparent
descriptor. In CPT, as in ICD-9-CM, even if only one code when reporting the procedural code(s) alone. After the pro-
is identified, you must refer to the actual code to assure cedural codes have been obtained, attention should turn to
accuracy. the possible need for modifiers to make the carrier aware
of services or procedures performed that may vary from
CPT AND ICD-9-CM CODES MUST CORRESPOND
the basic code because of a specific circumstance (e.g., re-
After determining the diagnosis or diagnoses, use the porting of bilateral procedures, indicating a procedure was
principle diagnosis and demonstrate what was done to treat performed more than once, reporting the assistant surgeon
the problem and then relate the treatment procedures to the for the reported procedure, etc.). It may be necessary to
diagnosis. The ICD-9-CM diagnosis code must be appro- support the modified code by submitting additional docu-
priate for procedures performed as reflected by the CPT mentation to clarify the modification being reported.
codes. Recent work by Medicare as well as the “Correct
Modifiers may be added to any CPT code. A general de-
Coding Initiative” attempts to directly link CPT and ICD-
scription of modifiers appears in the front of the CPT book
9-CM codes. Codes that do not match will result in denial
as part of the “Introduction” section. A complete listing of
of the claim.
modifiers is contained in Appendix A (before the “Index”
in the rear of the book). The listings of modifiers pertinent
to evaluation and management services, medicine, anes-
thesia, surgery, radiology, and pathology are located in the
guidelines for each of these sections.

PAGE 3 Procedural Coding Guidelines Utilizing CPT, HCPCS and CDT

 Coding Paper
Although many procedures are considered to be inherently
bilateral (e.g., 21193-21196), it may be necessary with oth-
ers to specify bilaterality by utilizing the “-50” modifier.
The correct method of reporting the modifier is to add the
hyphenated two-digit modifier to the five-digit procedural
code for the second procedure (e.g., 29804-50). The first
procedure should be identified only by the 29804 code.
Note that the alternative five-digit modifier codes (i.e., The CPT definitions for utilizing codes 21050 and 21060
09950) were eliminated from CPT in 2003. specifically state “separate procedure” and therefore
If you need to use more than one modifier for a procedure, should not be used when arthroplasty codes 21240 and
add “99” to the procedural code to indicate that multiple 21242 are used.
modifiers will be utilized, and then list the additional mod- EVALUATION AND MANAGEMENT (E/M) CODES
ifiers (e.g., 21453-99 52/51).
Evaluation and Management Codes (visits and consulta-
When more than one procedure (other than E/M services) tions) were extensively revised and redefined to conform
is performed at the same session by the same provider, the to the new Medicare Payment Schedule in 1992. This
primary procedure or service may be reported as listed. change significantly affected coding and documentation
The additional procedure(s) or service(s) would be report-
of what was previously simple consultative or office visit
ed for reimbursement, with the “-51” modifier added to services. The most current E/M Documentation Guidelines
indicate multiple surgical procedures at the same operative may be found at http://www.cms.gov/Outreach-and-Edu-
session. cation/Medicare-Learning-Network-MLN/MLNProducts/
It is acceptable to use CPT modifiers with HCPCS codes. downloads//MASTER1.pdf
Likewise, HCPCS modifiers can be used on CPT codes. The categories and subcategories of codes available for
However, the American Dental Association presently does reporting E/M services are as follows:
not approve the use of any modifiers with CDT codes sub-
mitted to dental carriers. Category/Subcategory Code Numbers
Office or Other Outpatient Services
UNBUNDLING OF SURGICAL PROCEDURES
New Patient 99201-99205
Unbundling of services refers to the practice whereby one
essentially maintains the usual fee for a specific proce- Established Patient 99211-99215
dure, but one or more components of that procedure are Hospital Observation Services
segregated from the surgical package and given a separate Observation Care Discharge Services 99217
fee. Unquestionably, some surgeons have successfully
increased their income under this guise, which they refer Initial Observation Care 99218-99220
to as “creative billing.” However, it is more appropriate to Hospital Inpatient Services
describe this practice as unethical or fraudulent billing. Initial Hospital Care 99221-99223
Temporomandibular joint arthroplasty is perhaps the most Subsequent Hospital Care 99231-99233
frequently cited example of unbundling in OMS. The basic
question is what components of the procedure are inher- Observation or Inpatient Care Services 99234-99236
ent in its routine completion and what, if any, ancillary Hospital Discharge Services 99238-99239
procedures would constitute separate procedures. Clearly, Consultations
autografts and allografts are specifically addressed in the
Office Consultations 99241-99245
coding definitions of 21240 and 21242 of the CPT manual,
but what about condylar shaves and/or meniscus surgery? Inpatient Consultations 99251-99255
Are these procedures germane to completion of the ar- Emergency Department Services
throplasty, or do they constitute procedures that should be
New or Established Patient 99281-99285
charged for individually by utilizing CPT codes 21050 and
21060?

PAGE 4 Procedural Coding Guidelines Utilizing CPT, HCPCS and CDT

Effective with CPT 2006, the Follow-Up Inpatient Con-
sultation codes (99261-99263) and the Confirmatory
Consultation codes (99271-99275) have been deleted.
Follow-up visits to an initial consultation are now report-
ed with Subsequent Hospital Care codes 99231-99233
when performed in the inpatient setting, and Office or
Other Outpatient Established Patient codes 99212-99215
when performed in the office or other outpatient setting. would be classified as it would have been by the doctor
Confirmatory (second opinion) Consultations performed who is not available. There is no distinction between new
in the facility setting, meeting consultation requirements, and established patients treated in the emergency room.
will be reported using Initial Inpatient Consultation codes Under this E/M coding system, codes in each subcategory
99251-99255, and those performed in the office or other are identified by number only and are defined in terms of
outpatient setting will be reported with Office or Other seven components: history, examination, medical deci-
Outpatient Services codes 99201-99205 for new patients sion-making, counseling, coordination of care, nature of
and 99212-99215 for established patients. Note the above presenting problem, and time. The first three components,
applies to the CPT manual in general and not any specific history, examination, and medical decision-making, are
carrier or Medicare policy. considered the key components in selecting a level of
In addition to these standard E/M services, numerous other evaluation and management services. An exception to this
such services are added yearly to this category; Preventive would be cases in which the patient visit consists predom-
Medicine, Critical Care Services, Nursing Facility Assess- inantly of counseling and/or coordination of care. In those
ment and Care, Home Services, etc. instances, if time involved in “face to face” discussion
The evaluation and management codes define all visits with the patient and/or family constitutes more than 50%
(consultations, office and hospital visits) and delineate of the total time spent with the patient, time can be the sole
levels of service. The levels of evaluation and management factor in determining level of service. However, it is essen-
services encompass the wide variations in skill, effort, tial that the time is documented in the patient record.
time, responsibility, and knowledge required for the pre- Medical decision-making refers to the complexity of estab-
vention, or diagnosis and treatment, of illness or injury. In lishing a diagnosis and/or selecting a management option.
making the revisions, the AMA placed primary emphasis Four types of medical decision-making are recognized.
on the content of the services provided in determining the These include: straight forward, low complexity, moder-
appropriate level of service. ate complexity, and high complexity. The type of deci-
The new coding system differs significantly from previous sion-making is determined by the number of diagnoses or
coding practices. The definitions of evaluation and man- management options, amount and/or complexity of data to
agement (visit) codes now vary among subcategories. As be reviewed, and the risk of complications and/or morbidi-
indicated previously, the new codes are divided into cate- ty and mortality.
gories such as location of service delivery, and subcatego- When reporting the E/M code, refer to the complete set of
ries to indicate whether the patient is new or established. guidelines that precedes all of the evaluation and manage-
(A new patient is one who has not received any profession- ment codes in the CPT book and the specific instructions
al services from the physician/qualified health care profes- in each category or subcategory. In addition, examples
sional, or another physician/qualified health care profes- pertinent to specific specialties are provided in the E/M
sional of the exact same specialty and subspecialty who section, as well as in Appendix C – Clinical Examples
belongs to the same group practice, within the past three Supplement, located in the back of the CPT book.
years. An established patient is one who has received pro- Under the new Medicare Payment Schedule, “cognitive
fessional services from the physician/qualified health care skill” is weighted more heavily, thus the value of E/M ser-
professional, or another physician/qualified health care vices is greater. It is important that oral and maxillofacial
professional of the exact same specialty and subspecialty surgeons familiarize themselves with and correctly utilize
who belongs to the same group practice, within the past the new codes to ensure they receive proper reimburse-
three years.) When an oral and maxillofacial surgeon is on ment. If the correct codes are not used, carriers are not
call or covering for another doctor, the patient’s encounter obligated to pay claims.

PAGE 5 Procedural Coding Guidelines Utilizing CPT, HCPCS and CDT

III. HCPCS
The Health Care Common Procedure Coding System
(HCPCS), commonly pronounced “hicks-picks,” is some-
times required by CMS and Medicaid carriers for the
reporting of OMS procedures. As the administrator of both
Medicare and Medicaid, HCFA’s (now CMS) intent in
1974, was to establish HCPCS to allow uniform reporting
of physician and non-physician services. This system, up- of medicine, osteopathy and dentistry; e.g., dental exam-
dated annually, also was designed to provide accurate and inations to detect infections prior to certain surgical pro-
more detailed reporting of supplies and equipment, drugs, cedures, treatment of oral infections and interpretations of
and other services not currently specified in CPT. diagnostic X-ray examinations in connection with covered
services. Because the general exclusion of payment for
There are two levels of HCPCS Codes: dental services has not been withdrawn, payment for the
Level 1 contains the same codes and modifiers that appear services of dentists is also limited to those procedures that
in the current CPT Coding System, with the exception of are not primarily provided for the care, treatment, removal
specific anesthesiology codes. When you are reporting or replacement of teeth or structures directly supporting
anesthesia procedures to CMS or Medicaid carriers with the teeth. The coverage or exclusion of any given dental
HCPCS codes, you should use the surgical procedure code service is not affected by the professional designation of
with the appropriate anesthesiology code modifiers. How- “physician” rendering the services; i.e., an excluded dental
ever, CMS does not recognize general anesthesia or deep service remains excluded, and a covered dental service is
sedation by the surgeon and will deny payment for this still covered whether furnished by a dentist or a doctor of
service. Separate payment for moderate conscious sedation medicine or osteopathy.”
by the surgeon can vary by carrier. Medicaid policy for all Medicare regulations prohibit such discrimination under
levels of anesthesia may also vary from state to state. Head the Medicaid Overlap Law enacted in 1987 as part of the
and neck anesthesia codes (00100-00352) are to be used Federal Budget Reconciliation Act. AAOMS recommends
only when a second doctor actually provides the anesthetic that you continue to report the procedure using the most
management. The Level 1 codes are five-digit numeric accurate reporting system (CPT or HCPCS). When the
codes exactly as they are in CPT. most accurate reporting of that procedure is CPT, that
Level II contains codes for physician and non-physician should be the code by which your services are reported,
services that are not contained in CPT. The Level II codes unless that procedure is also changed for all Medicare phy-
are alpha-numeric (e.g., D7111, D7220, D7250). The sicians performing the same services. AAOMS considers
modifiers for Level II codes are mostly double alpha (e.g., it illegal to change the code for only an oral and maxillo-
“-CC” procedure code change). Use “-CC” when the pro- facial surgeon. The following are examples of procedures
cedure code was filed by your office and you are resubmit- more accurately reported by CPT: excisions of lesions
ting the procedure(s) correctly. (both benign and malignant); fractures; and reconstructive
In some cases, carriers may attempt to change all submit- surgery.
ted procedures received from oral and maxillofacial sur- IV. ADA CDT 2013 CODES
geons from CPT codes to HCPCS because of their dental
degree. AAOMS considers this practice in violation of the The American Dental Association (ADA) has revised the
Medicare Federal Regulation relating to the degree of the Code on Dental Procedures and Nomenclature (the Code)
provider. A copy of the Medicare regulation to which you several times since the original code was developed and
address this issue can be obtained from AAOMS. Section published in 1969. The latest revision to the Code, referred
2020.3 of the Medicare Regulation states, “Dentists – a to as CDT 2013, is the result of work by the Code Mainte-
dentist qualifies as a “physician” if he/she is a doctor of nance Committee (CMC), representing interests between
dental surgery or dental medicine who is acting within the the ADA and the Payer sector of the dental community,
scope of his/her license when he/she performs such func- Unlike CDT-2, beginning with CDT-3 in 2000, the codes
tions. Such services include any otherwise covered service now start with “D” instead of “0”. All of the ADA codes
that may legally and alternatively be performed by doctors are contained in CDT 2013, which also provides assistance
to accurately report dental treatment to the carriers.

PAGE 6 Procedural Coding Guidelines Utilizing CPT, HCPCS and CDT

Dental codes are now divided into 12 categories, which
include:
I. Diagnostic D0100-D0999
II. Preventive D1000-D1999
III. Restorative D2000-D2999
IV. Endodontics D3000-D3999
V. CODING BOOKS
V. Periodontics D4000-D4999
The Physicians’ Current Procedural Terminology (CPT),
VI. Prosthodontics, removable D5000-D5899
the 2013 Current Dental Terminology (CDT 2013), as
VII. Maxillofacial Prosthetics D5900-D5999 well as the CMS Level II current HCPCS code book, are
VIII. Implant Services D6000-D6199 available from Optum. Be sure to order the AMA’s version
of CPT.
IX. Prosthodontics, fixed D6200-D6999
X. Oral and Maxillofacial Surgery D7000-D7999
Note: This paper should not be used as the sole reference in coding.
XI. Orthodontics D8000-D8999
Both diagnosis and treatment codes change frequently, and insurance
XII. Adjunctive General Services D9000-D9999 carriers may differ in their interpretations of the codes.

While the categories appear to be titled by dental specialty, Coding and billing decisions are personal choices to be made by in-
dividual oral and maxillofacial surgeons exercising their own profes-
use of the codes is not restricted to any specific specialty.
sional judgment in each situation. The information provided to you in
Any dental practitioner can use any code found in CDT. this paper is intended for educational purposes only. In no event shall
AAOMS be liable for any decision made or action taken or not taken
SYMBOLS FOR ADA CODES
by you or anyone else in reliance on the information contained in this
Symbols designating new or revised ADA codes are the article. For practice, financial, accounting, legal or other professional
same as those used to denote additional or revised CPT advice, you need to consult your own professional advisers.
codes (see Section II-Symbols in CPT).

UNBUNDLING SURGICAL PROCEDURES This is one in a series of AAOMS papers designed to provide
REPORTED WITH DENTAL CODES information on coding claims for oral and maxillofacial surgery
(OMS). This paper discusses procedural coding guidelines utiliz-
When surgical procedures are reported under the dental
ing CPT, HCPCS and CDT. When indicated, you will be referred
coding system, as in CPT medical reporting, oral and max- to the appropriate area of the coding books where the principles
illofacial surgeons are expected to use the same guidelines of coding illustrated in this paper may be applied.
regarding which components of the procedure are inherent Proper coding provides a uniform language to describe medical,
in that procedure’s routine completion, and which, if any, surgical, and dental services. Diagnostic and procedure codes
ancillary procedures would constitute separate procedures. are continually updated or revised. The AAOMS Committee on
For example, ADA code D7840 (condylectomy) would not Health Care and Advocacy has developed these coding guide-
be listed in addition to D7865 (arthroplasty) as an addi- lines in order to assist the membership to use the coding systems
effectively and efficiently.
tional procedure. The condylectomy would only be re-
ported separately if it were the only procedure performed. © 2013 American Association of Oral and Maxillofacial Surgeons.
Reporting the arthroplasty and the condylectomy as two No portion of this publication may be used or reproduced without
the express written consent of the American Association of Oral
separate procedures constitutes classic “unbundling” since
and Maxillofacial Surgeons.
the condylectomy is a component of a temporomandibular
Revised March 2013
joint arthroplasty and therefore does not warrant a separate
charge.
In many instances in CDT, multiple codes may be indicat-
ed for use in a procedure. CDT will indicate that a code
should be reported “in addition to” other procedure codes.
An example of this would be D7290 (surgical reposition-
ing of teeth), which states in the descriptor, “Grafting
procedure(s) is / are additional.”

PAGE 7 Procedural Coding Guidelines Utilizing CPT, HCPCS and CDT