Modifications: 7/1/2018

No Modified codes for 7/1/2018.

New: 7/1/2014

New codes added 7/1/2014, effective 10/1/2014

175T00000X
 
Under the Other Service Providers Type the Peer Specialist was added:

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Source: National Uniform Claim Committee

246ZX2200X
 
Under the Technologists, Technicians & Other Technical Service Providers and Specialist/Technologist, Other the Orthopedic Assistant was added:

An Orthopaedic Assistant is a person who has been trained to work as a physician extender in both clinical and surgical environments. An Orthopaedic Assistant assists with aspects of patient care as determined by the supervising surgeon including, but not limited to, obtaining patient history, assisting with examinations, injections, recording of office notes, and application/adjustment/removal of splints, casts, and other immobilization devices. Acting as a surgical first assistant for orthopaedic surgery cases includes providing aid in exposure, hemostasis, positioning of the patient, suturing and closure of body planes and skin, application of wound dressings or immobilization devices, and other technical functions that will help the surgeon carry out a safe operation with optimal results for the patient. An Orthopaedic Assistant may be licensed, registered, or certified depending on the state in which the individual practices.
Source: American Society of Orthopaedic Assistants (ASOA), 2014

Additional Resources: National Board for Certification of Orthopaedic Assistants

New: 7/1/2015

New codes added 7/1/2015, effective 10/1/2015

2080B0002X 2083B0002X
 
Under the Pediatrics and Preventive Medicine the following code was added:

Obesity Medicine
A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity.

Source: American Board of Obesity Medicine

Additional Resource: American Society of Bariatric Physicians, www.asbp.org.

207RA0001X
 
Under the Allopathic & Osteopathic Physicians; Internal Medicine the following code was added:

Advanced Heart Failure and Transplant Cardiology
Specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure.

Source: American Board of Internal Medicine, www.abim.org

1835P2201X
 
Under the Pharmacy Service Providers; Pharmacist the following code was added:

Ambulatory Care
A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community.

Source: Board of Pharmacy Specialties, www.bpsweb.org

New: 1/1/2015

New codes added 1/1/2015, effective 4/1/2015

125Q00000X
 
Under the Dental Providers the Oral Medicinist was added:

A dentist with advanced training specializing in the recognition and treatment of oral conditions resulting from the interrelationship between oral disease and systemic health. The Oral Medicinist manages clinical and non-surgical treatment of non-dental pathologies affecting the oral and maxillofacial region, such as cancer, organ transplants, and acute and chronic pain. Activities include provision of interdisciplinary patient care in collaboration with medical specialists and other dentists in hospitals and outpatient medical clinics in the management of patients with complex medical conditions requiring multidisciplinary healthcare intervention.
Source: National Uniform Claim Committee

Additional Resources: American Academy of Oral Medicine

New: 1/1/2016

New codes added 1/1/2016, effective 4/1/2016

207WX0200X
 
Under the Allopathic & Osteopathic Physicians; Ophthalmology the Ophthalmic Plastic and Reconstructive Surgery was added:

Ophthalmic Plastic and Reconstructive Surgery
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.

Source: American Academy of Ophthalmology, 2015

2081P0301X
 
Under the Allopathic & Osteopathic Physicians; Physical Medicine & Rehabilitation the Brain Injury Medicine was added:

Brain Injury Medicine
A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences.

Source: American Board of Physical Medicine and Rehabilitation, 2015

2084P0301X
 
Under the Allopathic & Osteopathic Physicians; Psychiatry & Neurology the Brain Injury Medicine was added:

Brain Injury Medicine
A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences.

Source: American Board of Physical Medicine and Rehabilitation, 2015

405300000X
 
Under the Other Service Providers the Prevention Professional was added:

Prevention Professional
Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work.

Source: National Uniform Claim Committee, 2015

1835C0205X
 
Under the Pharmacy Service Providers; Pharmacist the Critical Care was added:

Critical Care
A licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists, as integral members of interprofessional teams, working to ensure the safe and effective use of medications in critically ill patients.

Source: Board of Pharmacy Specialties, www.bpsweb.org

1835P0200X
 
Under the Pharmacy Service Providers; Pharmacist the Pediatrics was added:

Pediatrics
A licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists that ensures the safe and effective use of medications for all children from neonates through adolescents.

Source: Board of Pharmacy Specialties, www.bpsweb.org

226000000X
 
Under the Respiratory, Developmental, Rehabilitative and Restorative Service Providers the Recreational Therapist Assistant was added:

Recreational Therapist Assistant
Recreational Therapist Assistants work in support of or assistant to Recreational Therapists treating patients with disabilities, injuries, and illnesses. Recreational Therapist Assistants work in a variety of settings providing treatments using recreational activities, including games, sports, and crafts.

Source: National Uniform Claim Committee, 2015