CODE | HCPCS ***CODE | DESCRIPTION | MAXIMUM ALLOWANCE | ||
0821 | 90999 | HEMODIALYSIS/COMPOSITE | BY REPORT | ||
0825 | 90993, 90989 | SUPPORT SERVICES (HEMODIALYSIS | BY REPORT | ||
0831 | 90999 | PERITONEAL DIALYSIS/COMPOSITE | BY REPORT | ||
0835 | 90993, 90989 | SUPPORT SERVICES (IP) | BY REPORT | ||
0841 | 90999 | CAPD/COMPOSITE | BY REPORT | ||
0845 | 90993, 90989 | SUPPORT SERVICES/CAPD | BY REPORT | ||
0849 | 90945 | OTHER CAPD DIALYSIS | BY REPORT | ||
0851 | 90999 | CONTINUOUS CYCLING PERITONEAL DIALYSIS (CCPD) | BY REPORT | ||
0855 | 90993, 90989 | SUPPORT SERVICES (CCPD) | BY REPORT | ||
0634 * | EPO- INJECTION, EPOETIN ALFA, under 10,000 UNITS | BY REPORT | |||
0635 * | EPO- INJECTION, EPOETIN ALFA, above 10,000 UNITS | ||||
0636** | ARANESP- INJECTION, DARBEPOETIN ALFA, 1 MCG | BY REPORT | |||
* Providers must also put HCPCS Q4081 on claim form.
* * Providers must also put HCPCS JO882 on claim form.
*** These HCPCS codes will become effective upon implementation of MIHMS. (APA Office Note: This occurred on September°1, 2010.)
10-144 C.M.R. ch. 101, § III-7