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Official Description

Most recent LDL-C greater than or equal to 130 mg/dL (CAD) (DM)

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Short Descr LDL-C >= 130 MG/DL
Medium Descr MOST RECENT LDL-C >= 130 MG/DL
Long Descr Most recent LDL-C greater than or equal to 130 mg/dL (CAD) (DM)
Status Code Not Valid for Medicare Purposes
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Non-Covered Service, not paid under OPPS
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) Z2 - Undefined codes
MUE Not applicable/unspecified.
CCS Clinical Classification 28 - Plastic procedures on nose
GC This service has been performed in part by a resident under the direction of a teaching physician
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GP Services delivered under an outpatient physical therapy plan of care
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
Date
Action
Notes
2024-01-01 Changed Short and Medium Descriptions changed.
2013-01-01 Changed Short Descriptor changed.
2012-01-01 Changed Code description changed.
2011-01-01 Changed Short description changed.
2009-01-01 Changed Code description changed.
2008-01-01 Changed Code description changed.
2007-01-01 Added First appearance in code book in 2007.
Code
Description
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