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Requisitos de aprobación previa

Nebraska Total Care requiere aprobación previa (PA) para algunos servicios. Este aviso contiene información sobre dichos requisitos de PA. Estos datos aplican a la cobertura de Medicaid que ofrece Nebraska Total Care.

Nebraska Total Care se compromete a proporcionar una atención rentable a nuestros miembros, quienes reciben el tratamiento médicamente necesario. Este compromiso se basa en los estándares de práctica. La PA es un paso que inicia el proveedor. Comprobamos la necesidad médica de atención de salud. Utilizamos criterios médicos o el uso de servicios dentro de la red.

Es responsabilidad del proveedor averiguar qué códigos necesitan aprobación previa.

Los proveedores verifican el estado y los beneficios del miembro antes de prestar los servicios. El pago depende del estado del miembro en el momento del servicio. Los proveedores y los centros no participantes requieren aprobación previa para todos los servicios de planes de organización para el mantenimiento de la salud (HMO). Existen algunas excepciones.

Proveedor: Consulte nuestra herramienta de aprobación previa para ver la lista actualizada.

Los siguientes códigos necesitan aprobación previa a partir del 12/31/2025:

 

Códigos de procedimiento para autorización previa al 12/31/2025

Categoría de servicio

Servicio

Códigos de procedimiento

Administrativo y calidad

Informes de calidad y medidas de rendimiento

G9473, G9474, G9475, G9476, G9477, G9478, G9479, G9490

Servicios de anestesia

Tratamiento intervencionista del dolor (bloqueos nerviosos)

62263, 62264, 62280, 62281, 62282, 62287, 64400, 64405, 64408, 64415, 64416, 64417, 64418, 64420, 64421, 64430, 64445, 64446, 64447, 64448, 64449, 64450, 64451, 64461, 64462, 64463, 64466, 64467, 64468, 64469, 64473, 64474, 64479, 64480, 64483, 64484, 64486, 64487, 64488, 64489, 64490, 64491, 64492, 64493, 64494, 64495, 64505, 64510, 64517, 64520, 64600, 64620, 64622, 64625, 64630, 64632, 64633, 64634, 64635, 64636, 64640, 64650, 64680, 64681

Salud del comportamiento y consumo de sustancias

Gestión, tratamiento y rehabilitación del consumo de drogas y alcohol

Análisis del comportamiento aplicado (ABA)

Gestión, tratamiento y rehabilitación de la salud del comportamiento

Servicios intensivos de salud del comportamiento y crisis (programa de hospitalización parcial (PHP)/programa intensivo ambulatorio (IOP)/programa para crisis)

Evaluaciones psicológicas y neuropsicológicas

Evaluación y terapia psicológica y psiquiátrica

G0552, H0010, H0012, H0014, H0015, H0018, H0019, H0045, H2014, H2034

97151, 97152, 97153, 97154, 97155, 97156, 97158

1001, 1002, A9291, H0036, H0040, H0045, H0046, H2000, H2013, H2015, H2017, H2018, H2020, H2027, H2033, T2048

H2012, S9480, S9485

96105, 96110, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139

0889T, 0890T, 0891T, 0892T, 90870

Salud del comportamiento y consumo de sustancias

Gestión, tratamiento y rehabilitación del consumo de drogas y alcohol

Análisis del comportamiento aplicado (ABA)

Gestión, tratamiento y rehabilitación de la salud del comportamiento

Servicios intensivos de salud del comportamiento y crisis (programa de hospitalización parcial (PHP)/programa intensivo ambulatorio (IOP)/programa para crisis)

Evaluaciones psicológicas y neuropsicológicas

Evaluación y terapia psicológica y psiquiátrica

G0552, H0010, H0012, H0014, H0015, H0018, H0019, H0045, H2014, H2034

97151, 97152, 97153, 97154, 97155, 97156, 97158
1001, 1002, A9291, H0036, H0040, H0045, H0046, H2000, H2013, H2015, H2017, H2018, H2020, H2027, H2033, T2048
H2012, S9480, S9485
96105, 96110, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139
0889T, 0890T, 0891T, 0892T, 90870

Procedimientos cardiovasculares y torácicos

Injerto de derivación de la arteria coronaria (CABG)

33542, 33548

Procedimientos cardiovasculares y torácicos

Procedimientos valvulares cardíacos

33406, 33410, 33411, 33412, 33413, 33930, 33933, 33935, 33940, 33944, 33945

Procedimientos cardiovasculares y torácicos

Inserción, revisión, sustitución y extracción de marcapasos cardíacos o desfibriladores

0698T, 33254, 33255, 33256, 33257, 33258, 33259, 33265, 33266, C1605

Procedimientos cardiovasculares y torácicos

Lobectomía, neumonectomía y procedimientos mediastínicos

32491, 32672, 32850, 32851, 32852, 32853, 32854, 32855, 32856, S2060, S2061

Procedimientos cardiovasculares y torácicos

Derivación vascular periférica

37220, 37221, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 37243, C9782, C9783

Procedimientos cardiovasculares y torácicos

Extirpación de varices, extremidad inferior

36465, 36466, 36468, 36470, 36471, 36475, 36476, 36478, 36479, 36482, 36483, 37500, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37785, S2202

Servicios de consulta y evaluación

Consulta, evaluación y atención preventiva

0794T, 0893T, 99183, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99375, 99377, 99378, A9293, G0182, G0248, G0302, G0303, G0304, G0305, G0378, G0379, G3002, S0255, S0270, S0271, S0272, S0273, S0280, S0281, S9976, S9988, S9990, S9991, S9992, S9994, S9996

Servicios dentales

Servicios bucales y dentales

D0120, D0140, D0145, D0150, D0160, D0170, D0171, D0180, D0190, D0191, D0210, D0220, D0230, D0240, D0250, D0260, D0270, D0272, D0273, D0274, D0277, D0290, D0310, D0320, D0321, D0322, D0330, D0340, D0350, D0351, D0360, D0362, D0363, D0364, D0365, D0366, D0367, D0368, D0369, D0370, D0371, D0380, D0381, D0382, D0383, D0384, D0385, D0386, D0391, D0415, D0416, D0417, D0418, D0421, D0425, D0431, D0460, D0470, D0472, D0473, D0474, D0475, D0476, D0477, D0478, D0479, D0480, D0481, D0482, D0483, D0484, D0485, D0486, D0999, D1110, D1120, D1203, D1204, D1206, D1208, D1310, D1320, D1330, D1351, D1352, D1353, D1510, D1515, D1520, D1525, D1550, D1555, D1708, D1709, D1710, D1711, D1712, D1713, D1714, D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335, D2390, D2391, D2392, D2393, D2394, D2410, D2420, D2430, D2510, D2520, D2530, D2542, D2543, D2544, D2610, D2620, D2630, D2642, D2643, D2644, D2650, D2651, D2652, D2662, D2663, D2664, D2710, D2712, D2720, D2721, D2722, D2740, D2750, D2751, D2752, D2780, D2781, D2782, D2783, D2790, D2791, D2792, D2794, D2799, D2910, D2915, D2920, D2929, D2930, D2931, D2932, D2933, D2934, D2940, D2950, D2951, D2952, D2953, D2954, D2955, D2957, D2960, D2961, D2962, D2970, D2971, D2975, D2980, D2981, D2982, D2983, D2990, D2999, D3110, D3120, D3220, D3221, D3222, D3230, D3240, D3310, D3320, D3330, D3331, D3332, D3333, D3346, D3347, D3348, D3351, D3352, D3353, D3354, D3410, D3421, D3425, D3426, D3430, D3450, D3460, D3470, D3910, D3920, D3950, D3999, D4210, D4211, D4212, D4230, D4231, D4240, D4241, D4245, D4249, D4260, D4261, D4263, D4264, D4265, D4266, D4267, D4268, D4270, D4271, D4273, D4274, D4275, D4276, D4277, D4278, D4320, D4321, D4341, D4342, D4355, D4381, D4910, D4920, D4999, D5110, D5120, D5130, D5140, D5211, D5212, D5213, D5214, D5225, D5226, D5281, D5410, D5411, D5421, D5422, D5510, D5520, D5610, D5620, D5630, D5640, D5650, D5660, D5670, D5671, D5710, D5711, D5720, D5721, D5730, D5731, D5740, D5741, D5750, D5751, D5760, D5761, D5810, D5811, D5820, D5821, D5850, D5851, D5860, D5861, D5862, D5867, D5875, D5899, D5911, D5912, D5913, D5914, D5915, D5916, D5919, D5922, D5923, D5924, D5925, D5926, D5927, D5928, D5929, D5931, D5932, D5933, D5934, D5935, D5936, D5937, D5951, D5952, D5953, D5954, D5955, D5958, D5959, D5960, D5982, D5983, D5984, D5985, D5986, D5987, D5988, D5991, D5992, D5993, D5999, D6010, D6012, D6040, D6050, D6051, D6053, D6054, D6055, D6056, D6057, D6058, D6059, D6060, D6061, D6062, D6063, D6064, D6065, D6066, D6067, D6068, D6069, D6070, D6071, D6072, D6073, D6074, D6075, D6076, D6077, D6078, D6079, D6080, D6090, D6091, D6092, D6093, D6094, D6095, D6100, D6101, D6102, D6103, D6104, D6110, D6111, D6112, D6113, D6114, D6115, D6116, D6117, D6190, D6194, D6199, D6205, D6210, D6211, D6212, D6214, D6240, D6241, D6242, D6245, D6250, D6251, D6252, D6253, D6254, D6545, D6548, D6549, D6600, D6601, D6602, D6603, D6604, D6605, D6606, D6607, D6608, D6609, D6610, D6611, D6612, D6613, D6614, D6615, D6624, D6634, D6710, D6720, D6721, D6722, D6740, D6750, D6751, D6752, D6780, D6781, D6782, D6783, D6790, D6791, D6792, D6793, D6794, D6795, D6920, D6930, D6940, D6950, D6970, D6972, D6973, D6975, D6976, D6977, D6980, D6985, D6999, D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7251, D7260, D7261, D7270, D7272, D7280, D7282, D7283, D7285, D7286, D7287, D7288, D7290, D7291, D7292, D7293, D7294, D7295, D7310, D7311, D7320, D7321, D7340, D7350, D7410, D7411, D7412, D7413, D7414, D7415, D7440, D7441, D7450, D7451, D7460, D7461, D7465, D7471, D7472, D7473, D7485, D7490, D7510, D7511, D7520, D7521, D7530, D7540, D7550, D7560, D7610, D7620, D7630, D7640, D7650, D7660, D7670, D7671, D7680, D7710, D7720, D7730, D7740, D7750, D7760, D7770, D7771, D7780, D7810, D7820, D7830, D7840, D7850, D7852, D7854, D7856, D7858, D7860, D7865, D7870, D7871, D7872, D7873, D7874, D7875, D7876, D7877, D7880, D7899, D7910, D7911, D7912, D7920, D7921, D7940, D7941, D7943, D7944, D7945, D7946, D7947, D7948, D7949, D7950, D7951, D7952, D7953, D7955, D7960, D7963, D7970, D7971, D7972, D7980, D7981, D7982, D7983, D7990, D7991, D7995, D7996, D7997, D7998, D7999, D8010, D8020, D8030, D8040, D8050, D8060, D8070, D8080, D8090, D8210, D8220, D8660, D8670, D8680, D8690, D8691, D8692, D8693, D8999, D9110, D9120, D9210, D9211, D9212, D9215, D9219, D9220, D9221, D9230, D9241, D9242, D9248, D9310, D9410, D9420, D9430, D9440, D9450, D9610, D9612, D9630, D9910, D9911, D9920, D9930, D9931, D9940, D9941, D9942, D9950, D9951, D9952, D9970, D9971, D9972, D9973, D9974, D9975, D9986, D9987, D9999

Cardiología diagnóstica

Ecografía diagnóstica del corazón (ecocardiograma)

93303, 93304, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93350, 93351, 93356

Cardiología diagnóstica

Monitorización cardíaca electrográfica

0695T, 0696T, 0897T, G0429

Neurología diagnóstica

Electroencefalograma (EEG), estudios del sueño y neurodiagnóstico

95805, 95807, 95808, 95810, 95811, 95851, 95852, 95782, 95783, 95872, G0400

Radiología diagnóstica e imagenología

Imágenes de tomografía axial computarizada (CT)

0042T, 0691T, 0710T, 0711T, 0712T, 0713T, 0722T, 0877T, 0878T, 0879T, 0880T, 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 71250, 71260, 71270, 71271, 71275, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72191, 72192, 72193, 72194, 72198, 73200, 73201, 73202, 73206, 73700, 73701, 73702, 73706, 73718, 73719, 73720, 73721, 73722, 73723, 73725, 74150, 74160, 74170, 74174, 74175, 74176, 74177, 74178, 74261, 74262, 75572, 75573, 75574, 75635, 76380, 76497, 77078, G0288, S8032

Radiología diagnóstica e imagenología

Imágenes por resonancia magnética (MRI)/Angiografía por resonancia magnética (MRA)

0697T, 0724T, 0898T, 0899T, 0900T, 70336, 70540, 70542, 70543, 70544, 70545, 70546, 70547, 70548, 70549, 70551, 70552, 70553, 71550, 71551, 71552, 71555, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72159, 72195, 72196, 72197, 73218, 73219, 73220, 73221, 73222, 73223, 73225, 74181, 74182, 74183, 74185, 74712, 74713, 75557, 75559, 75561, 75563, 75565, 76498, 77046, 77047, 77048, 77049, 77084, C8900, C8901, C8902, C8903, C8905, C8906, C8908, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, S8037, S8042

Radiología diagnóstica e imagenología

Mamografía

0694T

Radiología diagnóstica e imagenología

Otras ecografías diagnósticas

0689T, 0690T, 0876T

Radiología diagnóstica e imagenología

Gammagrafía con radioisótopos, tomografía por emisión de positrones (PET) y medicina nuclear

78429, 78430, 78431, 78432, 78433, 78434, 78451, 78452, 78453, 78454, 78459, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78499, 78608, 78609, 78811, 78812, 78813, 78814, 78815, 78816

Servicios de diálisis y nefrología

Hemodiálisis y diálisis peritoneal

0692T, C8000

Equipo médico duradero (DME)

DME y suministros

A4100, A4210, A4239, A4341, A4342, A4560, A4593, A4594, A6501, A6507, A6511, A6590, A6591, A7049, A8003, A9156, A9900, A9999, E0152, E0170, E0172, E0190, E0193, E0194, E0221, E0236, E0240, E0250, E0255, E0256, E0260, E0261, E0265, E0266, E0290, E0292, E0294, E0295, E0296, E0297, E0300, E0301, E0302, E0303, E0304, E0316, E0328, E0329, E0371, E0372, E0373, E0450, E0453, E0455, E0460, E0461, E0463, E0464, E0465, E0466, E0467, E0468, E0469, E0470, E0480, E0481, E0482, E0483, E0490, E0491, E0492, E0493, E0500, E0530, E0550, E0575, E0605, E0606, E0607, E0610, E0616, E0617, E0619, E0620, E0625, E0630, E0635, E0636, E0637, E0638, E0639, E0640, E0641, E0642, E0650, E0651, E0652, E0656, E0658, E0659, E0670, E0675, E0676, E0677, E0678, E0679, E0680, E0681, E0682, E0683, E0691, E0692, E0693, E0694, E0711, E0715, E0721, E0732, E0733, E0734, E0735, E0736, E0737, E0738, E0739, E0743, E0745, E0747, E0748, E0749, E0760, E0764, E0766, E0767, E0770, E0781, E0782, E0783, E0784, E0785, E0786, E0791, E0912, E0954, E0983, E0984, E0986, E1002, E1003, E1004, E1005, E1006, E1007, E1008, E1010, E1011, E1012, E1030, E1031, E1032, E1033, E1034, E1035, E1037, E1050, E1060, E1070, E1083, E1084, E1086, E1087, E1088, E1089, E1090, E1092, E1093, E1100, E1110, E1130, E1140, E1150, E1160, E1161, E1170, E1171, E1172, E1180, E1190, E1195, E1200, E1220, E1223, E1224, E1229, E1230, E1232, E1233, E1234, E1235, E1236, E1237, E1238, E1240, E1250, E1260, E1270, E1280, E1285, E1290, E1295, E1301, E1310, E1399, E1406, E1800, E1801, E1802, E1803, E1804, E1805, E1806, E1807, E1808, E1810, E1811, E1812, E1813, E1814, E1815, E1816, E1818, E1822, E1823, E1825, E1826, E1827, E1828, E1829, E1830, E1832, E1840, E1841, E1905, E2102, E2103, E2204, E2227, E2228, E2291, E2292, E2293, E2294, E2295, E2298, E2310, E2311, E2312, E2313, E2321, E2322, E2325, E2327, E2328, E2329, E2330, E2331, E2343, E2351, E2370, E2375, E2376, E2378, E2402, E2502, E2504, E2506, E2508, E2510, E2512, E2599, E2603, E2604, E2605, E2606, E2607, E2608, E2609, E2613, E2614, E2615, E2616, E2617, E2620, E2621, E2622, E2624, E2628, E3000, E8000, E8001, E8002, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0008, K0009, K0010, K0011, K0012, K0014, K0108, K0455, K0606, K0609, K0730, K0742, K0800, K0801, K0802, K0806, K0807, K0808, K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0868, K0877, K0884, K0885, K0886, K0890, K0891, K0898, K0899, K1035, K1036, Q3025, Q3026, Q3031, S4030, S4031, S4035, S4037, S4040, S4042, S5035, S5036, S8092, S8262, T1999

Equipo médico duradero (DME)

Terapia enteral y parenteral (fórmulas/bombas)

B4105, B9002

Equipo médico duradero (DME)

Aparatos ortopédicos, prótesis y dispositivos del Sistema de pago prospectivo para pacientes ambulatorios (OPPS)

C1735, C1736, C1737, C1742, C1826, C1827, C1832, L0112, L0456, L0457, L0458, L0460, L0462, L0464, L0469, L0480, L0482, L0484, L0486, L0488, L0631, L0635, L0636, L0637, L0638, L0639, L0640, L0648, L0650, L0651, L0700, L0710, L0720, L0810, L0820, L0830, L0859, L0999, L1000, L1001, L1005, L1006, L1007, L1200, L1300, L1310, L1320, L1499, L1653, L1680, L1681, L1685, L1686, L1690, L1700, L1710, L1720, L1730, L1755, L1840, L1843, L1844, L1845, L1846, L1860, L1932, L1933, L1945, L1951, L1952, L1970, L2000, L2005, L2010, L2020, L2030, L2034, L2036, L2037, L2038, L2108, L2112, L2126, L2128, L2134, L2136, L2350, L2525, L2627, L2628, L2999, L3230, L3671, L3674, L3730, L3740, L3765, L3766, L3900, L3901, L3904, L3905, L3916, L3961, L3967, L3971, L3973, L3975, L3976, L3977, L3978, L3981, L3999, L4000, L4020, L4631, L5010, L5020, L5050, L5060, L5100, L5105, L5150, L5160, L5200, L5210, L5220, L5230, L5250, L5270, L5280, L5301, L5312, L5321, L5331, L5341, L5400, L5410, L5420, L5430, L5450, L5460, L5500, L5505, L5510, L5520, L5530, L5535, L5540, L5560, L5570, L5580, L5585, L5590, L5595, L5600, L5610, L5611, L5613, L5614, L5615, L5616, L5639, L5643, L5645, L5647, L5649, L5651, L5657, L5681, L5683, L5700, L5701, L5702, L5703, L5705, L5706, L5707, L5716, L5718, L5722, L5724, L5726, L5728, L5780, L5781, L5782, L5783, L5795, L5814, L5816, L5818, L5822, L5824, L5826, L5827, L5828, L5830, L5840, L5841, L5845, L5848, L5859, L5926, L5930, L5950, L5960, L5961, L5964, L5966, L5968, L5969, L5979, L5980, L5981, L5987, L5988, L5990, L5991, L5999, L6000, L6010, L6020, L6026, L6028, L6029, L6031, L6032, L6033, L6034, L6035, L6036, L6038, L6039, L6050, L6055, L6100, L6110, L6120, L6130, L6200, L6205, L6250, L6300, L6310, L6320, L6350, L6360, L6370, L6380, L6382, L6384, L6400, L6450, L6500, L6550, L6570, L6580, L6582, L6584, L6586, L6588, L6590, L6621, L6624, L6638, L6646, L6648, L6693, L6696, L6697, L6700, L6707, L6708, L6709, L6712, L6713, L6714, L6715, L6721, L6722, L6880, L6881, L6883, L6884, L6885, L6900, L6905, L6910, L6915, L6920, L6925, L6930, L6935, L6940, L6945, L6950, L6955, L6960, L6965, L6970, L6975, L7007, L7008, L7009, L7040, L7045, L7170, L7185, L7186, L7190, L7191, L7259, L7364, L7366, L7368, L7406, L7499, L7900, L8035, L8039, L8040, L8041, L8042, L8043, L8044, L8045, L8046, L8047, L8499, L8600, L8605, L8609, L8610, L8612, L8614, L8619, L8627, L8628, L8629, L8631, L8659, L8670, L8678, L8679, L8680, L8681, L8682, L8683, L8684, L8685, L8686, L8687, L8688, L8689, L8690, L8691, L8692, L8693, L8694, L8720

Cirugía de oído, nariz y garganta (ENT)

Procedimientos diagnósticos en nariz, boca, faringe y oído

0881T, 30120, 30520, 30620, 30630, 31276, 42145, 42831, 42835, 42836, 69300, 69716

Procedimientos gastroenterológicos

Endoscopia gastrointestinal (y diagnóstica)

0884T, 0886T, 91110, 91111, 91112, A9268, A9269, S2140, S2142

Cirugía general y abdominal

Laparotomía exploratoria (y cirugía abdominal abierta mayor)

0600T, 0601T, 0673T, 0686T, 0868T, 0870T, 0871T, 0873T, 0874T, 47133, 47135, 47140, 47141, 47142, 47143, 47144, 47145, 47146, 47147, 47370, 47371, 47380, 47381, 48160, 48550, 48551, 48552, 48554, 48556, S2102

Cirugía general y abdominal

Derivación gástrica y reducción de volumen (bariátrica)

43290, 43291, 43328, 43644, 43645, 43647, 43648, 43770, 43771, 43772, 43773, 43774, 43775, 43842, 43843, 43845, 43846, 43847, 43848, C9784, C9785

Cirugía general y abdominal

Cirugía estructural gástrica, esofágica y bariátrica

43881, 43882, 43886, 43887, 43888, 43999

Cirugía general y abdominal

Laparoscopia

C9736, S2103

Cirugía general y abdominal

Otras reparaciones de hernias

49595

Cirugía general y abdominal

Resección del intestino delgado/Resección y estoma

44132, 44133, 44135, 44136, 44137, 44715, 44720, 44721

Cirugía ginecológica

Histerectomía abdominal y vaginal

58150, 58260, 58262, 58290, 58291, 58541, 58542, 58543, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573

Cirugía ginecológica

Ginecología menor, sin histerectomía y maternidad

56625, 56800, 56805, 57110, 57291, 57292, 58350, 59840, 59841, 59850, 59851, 59852, 59855, 59856, 59857, 59866, 59871, 59897, 59898, 59899, S4011, S4013, S4014, S4015, S4016, S4017, S4018, S4020, S4021, S4022, S4023, S4025, S4026, S4027, S4028, S9001, S9002, S9208, S9209, S9211, S9212, S9213, S9214

Cirugía ginecológica

Otras cirugías ginecológicas (ovario/trompas)

58661, 58720, 58760, 58770, 58920, 58940

Procedimientos hematológicos y oncológicos

Transfusión de sangre y productos derivados de la sangre

P9051

Procedimientos hematológicos y oncológicos

Trasplante de médula ósea

0584T, 0585T, 0586T, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38220, 38221, 38230, 38232, 38240, 38241, 38242, S2150, S2152

Procedimientos hematológicos y oncológicos

Radiología terapéutica (oncología radioterápica)

77371, 77372, 77373, 77385, 77386, 77423, C2623, G0293, G0294, G0339, G0340

Servicios de salud y comunitarios en el hogar

Servicios de infusión en el hogar

S5497, S5498, S5501, S5502, S5517, S5518, S5520, S5521, S5522, S5523, S9098, S9325, S9326, S9327, S9328, S9329, S9330, S9331, S9335, S9336, S9338, S9339, S9345, S9346, S9347, S9348, S9349, S9351, S9353, S9355, S9357, S9359, S9361, S9363, S9364, S9365, S9366, S9367, S9368, S9370, S9372, S9373, S9374, S9375, S9376, S9377, S9379, S9490, S9494, S9497, S9500, S9501, S9502, S9503, S9504, S9538, S9542, S9560, S9590, S9810

Servicios de salud y comunitarios en el hogar

Servicios de centros de convalecencia

G0299, G0300, T1002, T1003, T1021, T1022, T1024, T1027, T1028, T1029, T1030, T1031

Servicios de salud y comunitarios en el hogar

Atención no hospitalaria (por ejemplo, atención de salud en el hogar, atención para pacientes terminales)

99500, 99501, 99502, 99503, 99504, 99505, 99506, 99507, 99509, 99510, 99511, G0128, G0151, G0152, G0153, G0154, G0156, G0162, G0529, G0530, G0531, G9187, Q5001, Q5002, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5009, Q5010, Q5098, Q5099, Q5100, S9122, S9123, S9124, S9125, S9126, S9127, S9128, S9129, S9131

Servicios de salud y comunitarios en el hogar

Servicios suplementarios y exenciones estatales

S5108, S5109, S5110, S5111, S5115, S5116, S5165, S5180, S5181, T2013, T2027, T2028, T2029, T2035, T2043, T2044, T2045, T2046, T5001

Procedimientos tegumentarios

Blefaroplastia y procedimientos de cejas

15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924, 67938, 67950

Procedimientos tegumentarios

Reconstrucción mamaria y mastectomía

19300, 19303, 19316, 19318, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19370, 19371, 19396, 19499, S2053, S2054, S2055

Procedimientos tegumentarios

Reconstrucción compleja e injertos (sustitutos cutáneos)

Q4199, Q4224, Q4225, Q4236, Q4256, Q4257, Q4258, Q4259, Q4260, Q4261, Q4262, Q4263, Q4264, Q4265, Q4266, Q4267, Q4268, Q4269, Q4270, Q4271, Q4272, Q4273, Q4274, Q4275, Q4276, Q4277, Q4278, Q4279, Q4280, Q4281, Q4282, Q4283, Q4284, Q4285, Q4286, Q4287, Q4288, Q4289, Q4290, Q4291, Q4292, Q4293, Q4294, Q4295, Q4296, Q4297, Q4298, Q4299, Q4300, Q4301, Q4302, Q4303, Q4304, Q4309, Q4311, Q4312, Q4313, Q4314, Q4315, Q4316, Q4317, Q4318, Q4319, Q4320, Q4321, Q4322, Q4323, Q4324, Q4325, Q4326, Q4327, Q4328, Q4329, Q4330, Q4331, Q4332, Q4333, Q4346, Q4347, Q4348, Q4349, Q4350, Q4351, Q4352, Q4353, Q4354, Q4355, Q4356, Q4357, Q4358, Q4359, Q4360, Q4361, Q4362, Q4363, Q4364, Q4365, Q4366, Q4367, Q4368, Q4369, Q4370, Q4371, Q4372, Q4373, Q4375, Q4376, Q4377, Q4378, Q4379, Q4380, Q4381, Q4382, Q4383, Q4384, Q4385, Q4386, Q4387, Q4388, Q4389, Q4390, Q4391, Q4392, Q4393, Q4394, Q4395, Q4396, Q4397

Procedimientos tegumentarios

Desbridamiento de heridas, infecciones o quemaduras

97602, 97605

Procedimientos tegumentarios

Injerto de piel

15734, 15736, 15738, 15769, 15771, 15772, 15773, 15774, 15776, A2001, A2002, A2003, A2004, A2005, A2006, A2007, A2008, A2009, A2010, A2011, A2012, A2013, A2014, A2015, A2016, A2017, A2018, A2019, A2020, A2021, A2022, A2023, A2024, A2025, A2026, A2027, A2028, A2029, A2030, A2031, A2032, A2033, A2034, A2035, A2036, A2037, A2038, A2039

Procedimientos tegumentarios

Reparación de heridas y destrucción de lesiones

13100, 13101, 13102, 13120, 13121, 13122, 13131, 13132, 13133, 13150, 13151, 13152, 13153, 13160, 17340, 17360, 17999

Servicios de laboratorio y patología

Pruebas genéticas y moleculares

0006M, 0012M, 0013M, 0019M, 0020M, 81105, 81106, 81161, 81162, 81163, 81164, 81165, 81166, 81167, 81171, 81172, 81173, 81174, 81175, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81195, 81200, 81204, 81205, 81206, 81207, 81208, 81209, 81210, 81212, 81215, 81216, 81217, 81218, 81219, 81222, 81223, 81225, 81226, 81227, 81229, 81233, 81234, 81235, 81236, 81237, 81239, 81241, 81242, 81243, 81244, 81250, 81251, 81252, 81253, 81255, 81256, 81260, 81261, 81268, 81270, 81271, 81274, 81275, 81276, 81277, 81284, 81285, 81286, 81289, 81290, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81301, 81302, 81304, 81305, 81306, 81307, 81308, 81309, 81312, 81314, 81315, 81317, 81318, 81319, 81320, 81327, 81329, 81330, 81331, 81332, 81333, 81336, 81337, 81342, 81343, 81344, 81345, 81349, 81350, 81355, 81370, 81371, 81372, 81373, 81374, 81375, 81376, 81377, 81378, 81379, 81380, 81381, 81382, 81383, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81418, 81441, 81443, 81449, 81451, 81456, 81457, 81458, 81459, 81462, 81463, 81464, 81479, 81506, 81517, 81518, 81522, 81523, 81542, 81552, 81558, S3713, S3818, S3819, S3820, S3822, S3823, S3828, S3829, S3830, S3831, S3833, S3834, S3835, S3837, S3840, S3843, S3847, S3848, S3851, S3855, S3860, S3862, S3870, S3890

Servicios de laboratorio y patología

Inmunología

86812, 86813, 86816, 86817, 86821, 86825, 86826, 86828, 86829, 86830, 86831, 86832, 86833, 86834, 86835

Servicios de laboratorio y patología

Laboratorio: química, hematología y banco de sangre

80184, 80220, 83890, 83891, 83892, 83893, 83894, 83896, 83897, 83898, 83900, 83901, 83902, 83903, 83904, 83905, 83906, 83907, 83908, 83909, 83912, 83913, 83914, 83992, 88720, 88738, 89050, 89055, 89060, 89125, 89190, 89398

Servicios de laboratorio y patología

Examen microscópico (bacteriano, toxicológico, COVID-19)

80324, 80325, 80345, 80347, 80350, 80351, 80352, 80356, 80362, 80363, 87484, 87593, G0482, G0483, G6053

Servicios de laboratorio y patología

Patología

88230, 88233, 88235, 88237, 88239, 88240, 88241, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88267, 88269, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, 88291, 88299, 88350, 88384, 88385, 88386

Servicios de laboratorio y patología

Análisis de laboratorio patentados (códigos PLA)

0002U, 0003U, 0045U, 0046U, 0047U, 0048U, 0049U, 0050U, 0051U, 0054U, 0055U, 0056U, 0060U, 0062U, 0063U, 0067U, 0069U, 0070U, 0071U, 0073U, 0074U, 0075U, 0076U, 0078U, 0079U, 0080U, 0082U, 0083U, 0084U, 0087U, 0088U, 0089U, 0090U, 0092U, 0094U, 0101U, 0102U, 0103U, 0105U, 0108U, 0111U, 0112U, 0113U, 0114U, 0117U, 0118U, 0120U, 0126U, 0128U, 0129U, 0130U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U, 0139U, 0153U, 0154U, 0155U, 0156U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U, 0163U, 0168U, 0169U, 0170U, 0171U, 0172U, 0173U, 0174U, 0175U, 0177U, 0179U, 0180U, 0181U, 0182U, 0183U, 0184U, 0185U, 0186U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0194U, 0195U, 0196U, 0197U, 0198U, 0199U, 0200U, 0201U, 0242U, 0243U, 0244U, 0245U, 0246U, 0247U, 0285U, 0286U, 0287U, 0288U, 0289U, 0290U, 0291U, 0292U, 0293U, 0294U, 0295U, 0296U, 0297U, 0298U, 0299U, 0300U, 0306U, 0307U, 0308U, 0309U, 0310U, 0313U, 0314U, 0315U, 0317U, 0318U, 0319U, 0320U, 0322U, 0327U, 0328U, 0329U, 0331U, 0333U, 0334U, 0335U, 0336U, 0339U, 0340U, 0341U, 0343U, 0345U, 0347U, 0348U, 0349U, 0350U, 0353U, 0355U, 0356U, 0357U, 0358U, 0359U, 0360U, 0361U, 0362U, 0363U, 0364U, 0365U, 0366U, 0367U, 0368U, 0369U, 0370U, 0371U, 0372U, 0373U, 0374U, 0375U, 0376U, 0377U, 0378U, 0379U, 0384U, 0385U, 0386U, 0387U, 0388U, 0389U, 0390U, 0391U, 0392U, 0393U, 0395U, 0396U, 0397U, 0398U, 0400U, 0401U, 0403U, 0405U, 0406U, 0407U, 0409U, 0410U, 0411U, 0412U, 0413U, 0414U, 0415U, 0417U, 0418U, 0419U, 0420U, 0421U, 0422U, 0423U, 0424U, 0425U, 0426U, 0433U, 0434U, 0436U, 0437U, 0438U, 0439U, 0440U, 0443U, 0444U, 0449U, 0450U, 0451U, 0452U, 0453U, 0454U, 0457U, 0458U, 0459U, 0460U, 0461U, 0462U, 0463U, 0465U, 0466U, 0467U, 0468U, 0469U, 0470U, 0472U, 0473U, 0474U, 0475U, 0476U, 0477U, 0478U, 0479U, 0480U, 0481U, 0485U, 0486U, 0487U, 0488U, 0489U, 0493U, 0494U, 0495U, 0496U, 0497U, 0498U, 0499U, 0500U, 0501U, 0502U, 0503U, 0506U, 0507U, 0508U, 0509U, 0510U, 0511U, 0516U, 0523U, 0529U, 0530U, 0531U, 0532U, 0533U, 0534U, 0536U, 0537U, 0538U, 0539U, 0540U, 0543U, 0544U, 0549U, 0552U, 0553U, 0554U, 0555U, 0560U, 0561U, 0562U, 0565U, 0566U, 0567U, 0568U, 0569U, 0571U, 0575U, 0576U, 0578U, 0582U, 0583U, 0585U, 0586U, 0592U, 0597U

Medicamentos y farmacia

Medicamentos (inyecciones, infusiones y otras formas)

0708T, 0709T, A9274, A9277, A9278, A9513, A9542, A9607, C9021, C9022, C9025, C9026, C9027, C9034, C9035, C9036, C9037, C9038, C9040, C9044, C9045, C9048, C9049, C9050, C9051, C9052, C9053, C9054, C9055, C9056, C9057, C9058, C9061, C9063, C9065, C9071, C9072, C9073, C9075, C9076, C9079, C9080, C9081, C9082, C9083, C9088, C9089, C9094, C9095, C9096, C9097, C9098, C9121, C9122, C9130, C9131, C9132, C9133, C9134, C9135, C9136, C9151, C9166, C9167, C9168, C9173, C9174, C9175, C9255, C9256, C9257, C9259, C9260, C9261, C9263, C9264, C9265, C9266, C9267, C9269, C9270, C9271, C9272, C9273, C9276, C9277, C9278, C9280, C9281, C9284, C9286, C9287, C9289, C9291, C9292, C9293, C9294, C9295, C9296, C9297, C9298, C9301, C9302, C9303, C9304, C9305, C9306, C9399, C9442, C9445, C9448, C9449, C9450, C9451, C9452, C9453, C9454, C9455, C9456, J0121, J0129, J0139, J0172, J0174, J0175, J0177, J0178, J0179, J0180, J0184, J0202, J0205, J0208, J0215, J0217, J0218, J0219, J0220, J0221, J0222, J0223, J0224, J0225, J0256, J0257, J0291, J0364, J0480, J0485, J0490, J0491, J0517, J0565, J0567, J0577, J0578, J0584, J0585, J0586, J0587, J0588, J0589, J0591, J0593, J0594, J0596, J0597, J0598, J0599, J0601, J0602, J0603, J0604, J0605, J0606, J0607, J0608, J0609, J0614, J0638, J0642, J0668, J0691, J0717, J0718, J0738, J0739, J0741, J0751, J0752, J0775, J0791, J0799, J0800, J0801, J0802, J0850, J0870, J0879, J0881, J0882, J0885, J0887, J0888, J0889, J0890, J0893, J0894, J0896, J0897, J0901, J1072, J1190, J1202, J1203, J1290, J1299, J1301, J1302, J1303, J1304, J1305, J1306, J1307, J1322, J1323, J1324, J1325, J1326, J1411, J1412, J1413, J1414, J1426, J1429, J1434, J1439, J1440, J1441, J1442, J1447, J1448, J1449, J1454, J1456, J1458, J1459, J1460, J1470, J1480, J1490, J1500, J1510, J1520, J1530, J1540, J1550, J1551, J1552, J1555, J1556, J1557, J1558, J1559, J1560, J1561, J1562, J1566, J1568, J1569, J1572, J1575, J1576, J1595, J1599, J1602, J1628, J1632, J1640, J1652, J1655, J1680, J1729, J1740, J1743, J1744, J1745, J1746, J1747, J1748, J1785, J1786, J1809, J1823, J1825, J1826, J1930, J1931, J1932, J1950, J1951, J1952, J1954, J1961, J2170, J2182, J2212, J2267, J2277, J2278, J2311, J2313, J2323, J2325, J2326, J2327, J2329, J2350, J2351, J2353, J2354, J2355, J2356, J2357, J2403, J2425, J2427, J2428, J2468, J2501, J2502, J2503, J2504, J2505, J2506, J2507, J2508, J2562, J2724, J2777, J2778, J2779, J2781, J2782, J2786, J2792, J2793, J2795, J2797, J2801, J2802, J2820, J2840, J2860, J2941, J2998, J3031, J3032, J3055, J3060, J3095, J3110, J3111, J3240, J3241, J3245, J3247, J3262, J3263, J3285, J3299, J3304, J3315, J3316, J3357, J3358, J3380, J3385, J3391, J3392, J3393, J3394, J3396, J3397, J3398, J3399, J3401, J3402, J3403, J3487, J3488, J3490, J3590, J3591, J7169, J7171, J7172, J7173, J7174, J7177, J7178, J7179, J7181, J7184, J7188, J7190, J7191, J7193, J7194, J7196, J7197, J7198, J7199, J7200, J7201, J7202, J7203, J7204, J7205, J7207, J7210, J7211, J7212, J7213, J7214, J7294, J7310, J7311, J7312, J7313, J7314, J7315, J7316, J7318, J7320, J7321, J7323, J7324, J7325, J7326, J7327, J7329, J7330, J7331, J7332, J7333, J7335, J7351, J7352, J7353, J7355, J7356, J7401, J7504, J7508, J7511, J7513, J7514, J7516, J7518, J7521, J7525, J7527, J7599, J7601, J7639, J7682, J7686, J7699, J8499, J8522, J8541, J8561, J8562, J8565, J8611, J8612, J8705, J8999, J9000, J9001, J9002, J9010, J9011, J9015, J9017, J9019, J9020, J9021, J9022, J9023, J9024, J9025, J9026, J9027, J9028, J9029, J9032, J9033, J9034, J9035, J9038, J9039, J9040, J9041, J9042, J9043, J9045, J9046, J9047, J9048, J9049, J9050, J9051, J9052, J9054, J9055, J9056, J9057, J9060, J9061, J9062, J9063, J9064, J9065, J9071, J9072, J9073, J9074, J9075, J9076, J9090, J9091, J9092, J9093, J9094, J9097, J9098, J9100, J9110, J9118, J9119, J9120, J9130, J9140, J9144, J9145, J9150, J9151, J9153, J9155, J9161, J9171, J9172, J9173, J9174, J9175, J9176, J9177, J9178, J9179, J9181, J9185, J9190, J9196, J9198, J9199, J9200, J9201, J9202, J9204, J9205, J9206, J9207, J9208, J9209, J9210, J9211, J9212, J9213, J9214, J9215, J9216, J9217, J9218, J9219, J9223, J9225, J9226, J9227, J9228, J9229, J9230, J9245, J9246, J9248, J9249, J9258, J9261, J9262, J9263, J9264, J9265, J9266, J9267, J9268, J9269, J9271, J9272, J9273, J9274, J9275, J9276, J9280, J9281, J9286, J9289, J9290, J9291, J9292, J9294, J9295, J9296, J9297, J9298, J9299, J9301, J9302, J9303, J9304, J9305, J9306, J9307, J9308, J9309, J9311, J9312, J9313, J9314, J9315, J9316, J9317, J9318, J9319, J9320, J9321, J9322, J9323, J9324, J9328, J9329, J9330, J9331, J9332, J9333, J9334, J9340, J9341, J9342, J9345, J9347, J9348, J9350, J9351, J9352, J9353, J9354, J9355, J9357, J9358, J9359, J9360, J9361, J9370, J9371, J9375, J9376, J9380, J9381, J9382, J9390, J9393, J9394, J9395, J9400, J9600, J9999, M0224, Q0155, Q0224, Q2017, Q2025, Q2026, Q2027, Q2028, Q2042, Q2043, Q2044, Q2045, Q2046, Q2047, Q2048, Q2049, Q2050, Q2051, Q2052, Q2053, Q2054, Q2055, Q2056, Q2057, Q2058, Q3027, Q3028, Q4074, Q4082, Q5101, Q5103, Q5104, Q5105, Q5106, Q5107, Q5108, Q5109, Q5110, Q5111, Q5113, Q5115, Q5116, Q5117, Q5118, Q5119, Q5120, Q5121, Q5122, Q5123, Q5124, Q5125, Q5126, Q5127, Q5128, Q5129, Q5130, Q5133, Q5134, Q5135, Q5136, Q5137, Q5138, Q5140, Q5141, Q5142, Q5143, Q5144, Q5145, Q5146, Q5147, Q5148, Q5149, Q5150, Q5151, Q5152, Q5153, Q5154, Q5155, Q5156, Q5157, Q5158, Q5159, Q9972, Q9973, Q9975, Q9976, Q9977, Q9978, Q9979, Q9996, Q9997, Q9998, Q9999, S0013, S0088, S0122, S0126, S0128, S0132, S0145, S0148, S0190

Medicamentos y farmacia

Radiofármacos

C7901, C7902

Neurocirugía

Incisión y resección del sistema nervioso central (CNS)

61796, 61797, 61798, 61799, 63620, 63621

Neurocirugía

Inserción de catéter o estimulador espinal

0587T, 0588T, 0589T, 0590T, 0674T, 0675T, 0676T, 0677T, 0678T, 0680T, 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 62350, 62351, 62355, 62360, 62361, 62362, 62365, 62367, 62369, 62370, 63650, 63655, 63661, 63662, 63685, 63688, 64553, 64555, 64560, 64561, 64566, 64568, 64590, 64595, 95980, 95981, 95982

Oftalmología y cuidado de la vista

Exámenes oculares generales y diagnósticos

0563T, 0687T, 0688T, 0704T, 0705T, 0706T

Oftalmología y cuidado de la vista

Glaucoma y procedimientos oculares

0671T, 66020, 67715

Oftalmología y cuidado de la vista

Ayudas visuales y otros suministros ópticos

S0500, S0504, S0506, S0508, S0510, S0512, S0514, S0515, S0516, S0518, S0580, S0581, S0590, S0592, S0595, V2020, V2100, V2101, V2102, V2103, V2104, V2105, V2106, V2107, V2108, V2109, V2110, V2111, V2112, V2113, V2114, V2115, V2118, V2121, V2199, V2200, V2201, V2202, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2210, V2211, V2212, V2213, V2214, V2215, V2218, V2219, V2220, V2221, V2299, V2300, V2301, V2302, V2303, V2304, V2305, V2306, V2307, V2308, V2309, V2310, V2311, V2312, V2313, V2314, V2315, V2318, V2319, V2320, V2321, V2399, V2410, V2430, V2499, V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2525, V2526, V2530, V2531, V2599, V2600, V2610, V2615, V2623, V2624, V2625, V2626, V2627, V2628, V2629, V2700, V2702, V2710, V2715, V2718, V2730, V2744, V2745, V2750, V2755, V2756, V2760, V2761, V2762, V2770, V2780, V2781, V2782, V2783, V2784, V2786, V2787, V2788, V2790, V2797, V2799

Cirugía ortopédica y de columna vertebral

Ortopedia general, traumatología y tratamiento de fracturas

0707T, 0869T, 20939, 21120, 21121, 21122, 21123, 21125, 21127, 21137, 21138, 21139, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21155, 21159, 21160, 21172, 21175, 21179, 21180, 21181, 21182, 21183, 21184, 21188, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21208, 21209, 21210, 21215, 21230, 21235, 21240, 21242, 21243, 21244, 21247, 21248, 21249, 21255, 21256, 21260, 21261, 21263, 21267, 21268, 21270, 21275, 21280, 21282, 21295, 21296, 21299, 22101, 22102, 22103, 22110, 22112, 22114, 22116, 22206, 22207, 22208, 22210, 22212, 22214, 22216, 22220, 22222, 22224, 22226, 22510, 22511, 22512, 22513, 22514, 22515, 22521, 22522, 22523, 22524, 22532, 22856, 22857, 22858, 22860, 22861, 22862, 22864, 22865, 24360, 24361, 24362, 24363, 24366, 24370, 24371, 25332, 25441, 25442, 25443, 25444, 25445, 25446, 25447, 25449, 26530, 26531, 26535, 26536, 27096, 27125, 27278, 27279, 27437, 27438, 27702, 27703, 27704

Cirugía ortopédica y de columna vertebral

Reconstrucción articular mayor y artroscopia

23470, 23472, 23473, 23474, 27130, 27132, 27134, 27137, 27138, 27440, 27441, 27442, 27443, 27445, 27446, 27447, 27486, 27487

Cirugía ortopédica y de columna vertebral

Cirugía de columna (fusión, laminectomía y deformidad)

0719T, 0790T, 22533, 22534, 22548, 22551, 22552, 22554, 22556, 22558, 22585, 22586, 22590, 22595, 22600, 22610, 22612, 22614, 22630, 22632, 22633, 22634, 22800, 22802, 22804, 22808, 22810, 22812, 22818, 22819, 22830, 22836, 22837, 22838, 22840, 22841, 22842, 22843, 22844, 22845, 22846, 22847, 22848, 22849, 22850, 22852, 22853, 22855, 63001, 63003, 63005, 63011, 63012, 63015, 63016, 63017, 63020, 63030, 63035, 63040, 63042, 63043, 63044, 63045, 63046, 63047, 63048, 63050, 63051, 63052, 63053, 63055, 63056, 63057, 63064, 63066, 63075, 63076, 63077, 63078, 63081, 63082, 63085, 63086, 63087, 63088, 63090, 63091, 63101, 63102, 63103, 63170, 63172, 63173, 63185, 63190, 63191, 63194, 63195, 63196, 63197, 63198, 63199, 63200, 63250, 63251, 63252, 63265, 63266, 63267, 63268, 63270, 63271, 63272, 63273, 63275, 63276, 63277, 63278, 63280, 63281, 63282, 63283, 63285, 63286, 63287, 63290, 63295, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307, 63308, C7504, C7505, C7507, C7508, C9757, G0276, G0277, S2350, S2351, S2360, S2361

Fisioterapia, terapia ocupacional y del habla

Fisioterapia (PT), terapia ocupacional (OT) y del habla

0693T, 97110, 97112, 97113, 97116, 97124, 97139, 97140, 97150, 97161, 97162, 97163, 97165, 97166, 97167, 97530, 97542, G0129, S8948

Fisioterapia, terapia ocupacional y del habla

Modalidades terapéuticas (ecografía, tracción, estimulación)

97010, 97012, 97014, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97750, 97755, 97760, 97761, 97763

Cirugía plástica y reconstructiva

Cirugía reconstructiva cosmética y funcional

11950, 11951, 11952, 11954, 11960, 15780, 15781, 15782, 15783, 15786, 15787, 15788, 15789, 15792, 15793, 15824, 15825, 15826, 15828, 15829, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15840, 15841, 15842, 15845, 15847, 15876, 15877, 15878, 15879

Cirugía plástica y reconstructiva

Cirugía plástica de nariz (rinoplastia)

30400, 30410, 30420, 30430, 30435, 30450, 30460, 30462, 30465

Servicios respiratorios

Pruebas de función pulmonar (PFT) y diagnósticas

94005, 94774, 94777

Servicios del habla, el lenguaje y la audición

Evaluación de la audición y el habla

92507, 92508, 92521, 92522, 92523, 92524, 92526, 92551, 92597, 92605, 92606, 92607, 92608, 92609, 92610, 92612, 92613, 92614, 92615, 92616, 92617

Servicios del habla, el lenguaje y la audición

Audífonos y suministros de audiología

V5030, V5040, V5050, V5060, V5070, V5080, V5095, V5100, V5110, V5120, V5130, V5140, V5150, V5171, V5172, V5181, V5190, V5211, V5212, V5213, V5214, V5215, V5221, V5230, V5244, V5245, V5246, V5247, V5250, V5251, V5252, V5253, V5254, V5255, V5256, V5257, V5258, V5259, V5260, V5261, V5262, V5263, V5265, V5268, V5269, V5270, V5271, V5272, V5273, V5274, V5281, V5282, V5283, V5284, V5285, V5286, V5287, V5288, V5289, V5290, V5298, V5336

Servicios de telesalud

Telesalud (llamadas, comunicación en línea, monitorización remota)

G0406

Inyecciones e infusiones terapéuticas

Inyecciones: músculos, tendones, bursas, articulaciones, tejidos blandos

20552, 20553

Inyecciones e infusiones terapéuticas

Vacunas y productos de inmunoglobulina

90281, 90283, 90284, 90291, 90378, 90741, 91305, 91306

Servicios de transporte

Transporte: paciente, proveedor, equipo

A0430, A0435

Cirugía urológica y renal

Procedimientos diagnósticos, genitales masculinos (incluye cirugía menor)

54125, 54520, 54660, 54680, 54690, 55175, 55180

Cirugía urológica y renal

Trasplante de riñón

50300, 50320, 50323, 50325, 50327, 50328, 50329, 50340, 50360, 50365, 50370, 50380, S2065

Cirugía urológica y renal

Nefrectomía y reconstrucción mayor del tracto urinario

0672T, 0888T, 50547, 50548, 53430

Cirugía urológica y renal

Procedimientos del tracto urinario

0872T

Cirugía urológica y renal

Resección transuretral de próstata (TURP)

0867T