Never Pay Procedures Under APG Reimbursement

Revised for January 1, 2016 Updates:

Information revised since the last update is highlighted.

Px Code Procedure (Px) Description Alternative
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Date
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20985 Cptr-asst dir ms px No 12/01/08    
20986 Cptr-asst dir ms px io img No 12/01/08    
20987 Cptr-asst dir ms px pre img No 12/01/08    
27412 Autochondrocyte implant knee No 07/01/10    
28890 High energy eswt, plantar f No 12/01/08    
43257 Uppr gi scope w/thrml txmnt No 07/01/10    
55400 Repair of sperm duct No 04/01/13    
55706 Prostate saturation sampling No 07/01/10    
58750 Repair oviduct No 10/01/09    
70554 Fmri brain by tech No 12/01/08    
74261 Ct colonography dx No 04/01/11    
74262 Ct colonography dx w/dye No 04/01/11    
74263 Ct colonography screening No 04/01/11    
75571 Ct hrt w/o dye w/ca test No 04/01/11    
75572 Ct hrt w/3d image No 04/01/11    
75573 Ct hrt w/3d image congen No 04/01/11    
75574 Ct angio hrt w/3d image No 04/01/11    
77082 Dxa bone density vert fx No 10/01/12    
77422 Neutron beam tx, simple No 04/01/09 07/01/10  
77423 Neutron beam tx, complex No 04/01/09 07/01/10  
81161 Dmd dup/delet analysis No 01/01/15    
81200 Aspa gene Yes 01/01/16    
81201 Apc gene full sequence Yes 01/01/16    
81202 Apc gene known fam variants Yes 01/01/16    
81203 Apc gene dup/delet variants Yes 01/01/16    
81205 Bckdhb gene Yes 01/01/16    
81206 Bcr/abl1 gene major bp Yes 01/01/16    
81207 Bcr/abl1 gene minor bp Yes 01/01/16    
81208 Bcr/abl1 gene other bp Yes 01/01/16    
81209 Blm gene Yes 01/01/16    
81210 Braf gene Yes 01/01/16    
81211 Brca1&2 seq & com dup/del Yes 01/01/16    
81212 Brca1&2 185&5385&6174 var Yes 01/01/16    
81213 Brca1&2 uncom dup/del var No 01/01/16    
81214 Brca1 full seq & com dup/del Yes 01/01/16    
81215 Brca1 gene known fam variant Yes 01/01/16    
81216 Brca2 gene full sequence Yes 01/01/16    
81217 Brca2 gene known fam variant Yes 01/01/16    
81220 Cftr gene com variants Yes 01/01/16    
81221 Cftr gene known fam variants Yes 01/01/16    
81222 Cftr gene dup/delet variants Yes 01/01/16    
81223 Cftr gene full sequence Yes 01/01/16    
81224 Cftr gene intron poly t Yes 01/01/16    
81225 Cyp2c19 gene com variants No 01/01/16    
81226 Cyp2d6 gene com variants Yes 01/01/16    
81227 Cyp2c9 gene com variants No 01/01/16    
81228 Cytogen micrarray copy nmbr Yes 01/01/16    
81229 Cytogen m array copy no&snp Yes 01/01/16    
81235 Egfr gene com variants Yes 01/01/16    
81240 F2 gene Yes 01/01/16    
81241 F5 gene Yes 01/01/16    
81242 Fancc gene Yes 01/01/16    
81243 Fmr1 gene detection Yes 01/01/16    
81244 Fmr1 gene characterization Yes 01/01/16    
81245 Flt3 gene Yes 01/01/16    
81246 Flt3 gene analysis No 01/01/16    
81250 G6pc gene Yes 01/01/16    
81251 Gba gene Yes 01/01/16    
81252 Gjb2 gene full sequence Yes 01/01/16    
81253 Gjb2 gene known fam variants Yes 01/01/16    
81254 Gjb6 gene com variants Yes 01/01/16    
81255 Hexa gene Yes 01/01/16    
81256 Hfe gene No 01/01/16    
81257 Hba1/hba2 gene Yes 01/01/16    
81260 Ikbkap gene Yes 01/01/16    
81261 Igh gene rearrange amp meth No 01/01/16    
81262 Igh gene rearrang dir probe No 01/01/16    
81263 Igh vari regional mutation No 01/01/16    
81264 Igk rearrangeabn clonal pop No 01/01/16    
81265 Str markers specimen anal No 01/01/16    
81266 Str markers spec anal addl No 01/01/16    
81267 Chimerism anal no cell selec No 01/01/16    
81268 Chimerism anal w/cell select No 01/01/16    
81270 Jak2 gene No 01/01/16    
81275 Kras gene Yes 01/01/16    
81280 Long qt synd gene full seq Yes 01/01/16    
81281 Long qt synd known fam var Yes 01/01/16    
81282 Long qt syn gene dup/dlt var Yes 01/01/16    
81287 Mgmt gene methylation anal Yes 01/01/16    
81288 Mlh1 gene No 01/01/16    
81290 Mcoln1 gene Yes 01/01/16    
81291 Mthfr gene No 01/01/16    
81292 Mlh1 gene full seq Yes 01/01/16    
81293 Mlh1 gene known variants Yes 01/01/16    
81294 Mlh1 gene dup/delete variant Yes 01/01/16    
81295 Msh2 gene full seq Yes 01/01/16    
81296 Msh2 gene known variants Yes 01/01/16    
81297 Msh2 gene dup/delete variant Yes 01/01/16    
81298 Msh6 gene full seq Yes 01/01/16    
81299 Msh6 gene known variants Yes 01/01/16    
81300 Msh6 gene dup/delete variant Yes 01/01/16    
81301 Microsatellite instability Yes 01/01/16    
81302 Mecp2 gene full seq Yes 01/01/16    
81303 Mecp2 gene known variant Yes 01/01/16    
81304 Mecp2 gene dup/delet variant Yes 01/01/16    
81310 Npm1 gene Yes 01/01/16    
81313 Pca3/klk3 antigen No 01/01/16    
81315 Pml/raralpha com breakpoints Yes 01/01/16    
81316 Pml/raralpha 1 breakpoint Yes 01/01/16    
81317 Pms2 gene full seq analysis Yes 01/01/16    
81318 Pms2 known familial variants Yes 01/01/16    
81319 Pms2 gene dup/delet variants Yes 01/01/16    
81321 Pten gene full sequence Yes 01/01/16    
81322 Pten gene known fam variant Yes 01/01/16    
81323 Pten gene dup/delet variant Yes 01/01/16    
81324 Pmp22 gene dup/delet No 01/01/16    
81325 Pmp22 gene full sequence No 01/01/16    
81326 Pmp22 gene known fam variant No 01/01/16    
81330 Smpd1 gene common variants Yes 01/01/16    
81331 Snrpn/ube3a gene Yes 01/01/16    
81332 Serpina1 gene Yes 01/01/16    
81340 Trb@ gene rearrange amplify No 01/01/16    
81341 Trb@ gene rearrange dirprobe No 01/01/16    
81342 Trg gene rearrangement anal No 01/01/16    
81350 Ugt1a1 gene Yes 01/01/16    
81355 Vkorc1 gene Yes 01/01/16    
81370 Hla i & ii typing lr No 01/01/16    
81371 Hla i & ii type verify lr No 01/01/16    
81372 Hla i typing complete lr No 01/01/16    
81373 Hla i typing 1 locus lr No 01/01/16    
81374 Hla i typing 1 antigen lr No 01/01/16    
81375 Hla ii typing ag equiv lr No 01/01/16    
81376 Hla ii typing 1 locus lr No 01/01/16    
81377 Hla ii type 1 ag equiv lr No 01/01/16    
81378 Hla i & ii typing hr No 01/01/16    
81379 Hla i typing complete hr No 01/01/16    
81380 Hla i typing 1 locus hr No 01/01/16    
81381 Hla i typing 1 allele hr No 01/01/16    
81382 Hla ii typing 1 loc hr No 01/01/16    
81383 Hla ii typing 1 allele hr No 01/01/16    
81400 Mopath procedure level 1 Yes 01/01/16    
81401 Mopath procedure level 2 Yes 01/01/16    
81402 Mopath procedure level 3 Yes 01/01/16    
81403 Mopath procedure level 4 Yes 01/01/16    
81404 Mopath procedure level 5 Yes 01/01/16    
81405 Mopath procedure level 6 Yes 01/01/16    
81406 Mopath procedure level 7 Yes 01/01/16    
81407 Mopath procedure level 8 Yes 01/01/16    
81408 Mopath procedure level 9 Yes 01/01/16    
81410 Aortic dysfunction/dilation No 01/01/16    
81411 Aortic dysfunction/dilation No 01/01/16    
81415 Exome sequence analysis No 01/01/16    
81416 Exome sequence analysis No 01/01/16    
81417 Exome re-evaluation No 01/01/16    
81420 Fetal chrmoml aneuploidy Yes 01/01/16    
81425 Genome sequence analysis No 01/01/16    
81426 Genome sequence analysis No 01/01/16    
81427 Genome re-evaluation No 01/01/16    
81430 Hearing loss sequence analys No 01/01/16    
81431 Hearing loss dup/del analys No 01/01/16    
81435 Hereditary colon cancer No 01/01/16    
81436 Hereditary colon ca synd No 01/01/16    
81440 Mitochondrial gene No 01/01/16    
81445 Targeted genomic seq analys No 01/01/16    
81450 Targeted genomic seq analys No 01/01/16    
81455 Targeted genomic seq analys No 01/01/16    
81460 Whole mitochondrial genome No 01/01/16    
81465 Whole mitochondrial genome No 01/01/16    
81470 X-linked intellectual dblt No 01/01/16    
81471 X-linked intellectual dblt No 01/01/16    
81479 Unlisted molecular pathology Yes 01/01/16    
81500 Onco (ovar) two proteins No 01/01/16    
81503 Onco (ovar) five proteins No 01/01/16    
81504 Oncology tissue of origin No 01/01/16    
81506 Endo assay seven anal No 01/01/16    
81507 Fetal aneuploidy trisom risk Yes 01/01/16    
81508 Ftl cgen abnor two proteins Yes 01/01/16    
81509 Ftl cgen abnor 3 proteins Yes 01/01/16    
81510 Ftl cgen abnor three anal Yes 01/01/16    
81511 Ftl cgen abnor four anal Yes 01/01/16    
81512 Ftl cgen abnor five anal Yes 01/01/16    
81519 Oncology breast mrna Yes 01/01/16    
81599 Unlisted maaa No 01/01/16    
83655 Assay of lead Yes 12/01/08    
83890 Molecule isolate Yes 01/01/10    
83891 Molecule isolate nucleic Yes 01/01/10    
83892 Molecular diagnostics Yes 01/01/10    
83893 Molecule dot/slot/blot Yes 01/01/10    
83894 Molecule gel electrophor Yes 01/01/10    
83896 Molecular diagnostics Yes 01/01/10    
83897 Molecule nucleic transfer Yes 01/01/10    
83898 Molecule nucleic ampli, each Yes 01/01/10    
83900 Molecule nucleic ampli 2 seq Yes 01/01/10    
83901 Molecule nucleic ampli addon Yes 01/01/10    
83902 Molecular diagnostics Yes 01/01/10    
83903 Molecule mutation scan Yes 01/01/10    
83904 Molecule mutation identify Yes 01/01/10    
83905 Molecule mutation identify Yes 01/01/10    
83906 Molecule mutation identify Yes 01/01/10    
83907 Lyse cells for nucleic ext Yes 01/01/10    
83908 Nucleic acid, signal ampli Yes 01/01/10    
83909 Nucleic acid, high resolute Yes 01/01/10    
83912 Genetic examination Yes 01/01/10    
83913 Molecular, rna stabilization Yes 01/01/10    
83914 Mutation ident ola/sbce/aspe Yes 01/01/10    
85004 Automated diff wbc count Yes 10/01/09    
85610 Prothrombin time Yes 10/01/09    
86849 Immunology procedure Yes 04/01/12    
87536 Hiv-1, dna, quant Yes 12/01/08    
87539 Hiv-2, dna, quant No 04/01/10    
87900 Virtual phenotype Yes 01/01/10    
87901 GeNo - APG Carve Outtype, dna, hiv reverse t Yes 12/01/08    
87902 GeNo - APG Carve Outtype, dna, hepatitis C Yes 12/01/08    
87903 PheNo - APG Carve Outtype, dna hiv w/culture Yes 12/01/08    
87904 PheNo - APG Carve Outtype, dna hiv w/clt add Yes 10/01/09    
87999 Microbiology procedure Yes 12/01/08    
88230 Tissue culture, lymphocyte Yes 01/01/10    
88233 Tissue culture, skin/biopsy Yes 01/01/10    
88235 Tissue culture, placenta Yes 01/01/10    
88237 Tissue culture, bone marrow Yes 01/01/10    
88239 Tissue culture, tumor Yes 01/01/10    
88240 Cell cryopreserve/storage Yes 01/01/10    
88241 Frozen cell preparation Yes 01/01/10    
88245 Chromosome analysis, 20-25 Yes 01/01/10    
88248 Chromosome analysis, 50-100 Yes 01/01/10    
88249 Chromosome analysis, 100 Yes 01/01/10    
88261 Chromosome analysis, 5 No 01/01/10    
88262 Chromosome analysis, 15-20 Yes 01/01/10    
88263 Chromosome analysis, 45 Yes 01/01/10    
88264 Chromosome analysis, 20-25 No 01/01/10    
88267 Chromosome analys, placenta Yes 01/01/10    
88269 Chromosome analys, amniotic Yes 01/01/10    
88271 Cytogenetics, dna probe Yes 01/01/10    
88272 Cytogenetics, 3-5 Yes 01/01/10    
88273 Cytogenetics, 10-30 Yes 01/01/10    
88274 Cytogenetics, 25-99 Yes 01/01/10    
88275 Cytogenetics, 100-300 Yes 01/01/10    
88280 Chromosome karyotype study Yes 01/01/10    
88283 Chromosome banding study No 01/01/10    
88285 Chromosome count, additional Yes 01/01/10    
88289 Chromosome study, additional No 01/01/10    
88291 Cyto/molecular report Yes 01/01/10    
88299 Cytogenetic study No 01/01/16    
90470 H1N1 Administration Yes 10/01/09 07/01/11  
90473 Immune admin oral/nasal Yes 10/01/09 04/01/11  
90655 Flu vaccine no preserv 6-35m Yes 10/01/09 04/01/11  
90656 Flu vaccine no preserv 3 & > Yes 10/01/09 04/01/11  
90657 Flu vaccine, 3 yrs, im Yes 10/01/09 04/01/11  
90658 Flu vaccine, 3 yrs & >, im Yes 10/01/09 04/01/11  
90660 Flu vaccine, nasal Yes 10/01/09 04/01/11  
90663 Flu vacc pandemic Yes 10/01/09 07/01/11  
90669 Pneumococcal vacc, ped <5 Yes 10/01/09 04/01/11  
90732 Pneumococcal vaccine Yes 10/01/09 04/01/11  
90863 Pharmacologic mgmt w/psytx No 04/01/13    
90875 Psychophysiological therapy No 07/01/10    
90876 Psychophysiological therapy No 07/01/10    
90880 Hypnotherapy No 04/01/09    
90901 Biofeedback train, any meth No 07/01/10    
90911 Biofeedback peri/uro/rectal No 07/01/10    
95012 Exhaled nitric oxide meas No 12/01/08    
95965 Meg, spontaneous No 12/01/08    
95966 Meg, evoked, single No 12/01/08    
96102 Psycho testing by technician No 04/01/09 04/01/10  
96119 Neuropsych testing by tec No 04/01/09 04/01/10  
97012 Mechanical traction therapy No 04/01/13    
97124 Massage therapy No 04/01/09 07/01/10  
97150 Group therapeutic procedures No 04/01/09 04/01/10  
97810 Acupunct w/o stimul 15 min No 04/01/09    
97811 Acupunct w/o stimul addl 15m No 04/01/09    
97813 Acupunct w/stimul 15 min No 04/01/09    
97814 Acupunct w/stimul addl 15m No 04/01/09    
98940 Chiropractic manipulation No 01/01/12    
98941 Chiropractic manipulation No 04/01/11    
98942 Chiropractic manipulation No 01/01/12    
98943 Chiropractic manipulation No 01/01/12    
99002 Device Handling No 04/01/11    
0004M Scoliosis dna alys No 01/01/16    
0006M Onc hep gene risk classifier No 01/01/16    
0007M Onc gastro 51 gene nomogram No 01/01/16    
0008M Onc breast risk score No 01/01/16    
0009M Fetal aneuploidy trisom risk No 01/01/16    
0010M Onc Prostate prob score No 01/01/16    
0019T Extracorp shock wv tx,ms nos No 04/01/10    
0126T Chd risk imt study No 01/01/13    
0216T Njx paravert w/us lumb/sac No 01/01/13    
0217T Njx paravert w/us lumb/sac No 01/01/13    
0218T Njx paravert w/us lumb/sac No 01/01/13    
0310T Motor function mapping ntms No 04/01/13    
0311T Cal & alys cntrl artl press No 04/01/13    
1000F Tobacco use assessed No 12/01/08    
20696 Comp multiplane ext fixation No 01/01/13    
20697 Comp ext fixate strut change No 01/01/13    
4000F Tobacco use txmnt counseling No 12/01/08    
95800 Slp stdy unattended No 01/01/13    
95801 Slp stdy unatnd w/anal No 01/01/13    
95806 Sleep study unatt&resp efft No 01/01/13    
C9259 Injection, pralatrexate, 1 mg Yes 01/01/11    
C9287 Inj, brentuximab vedotin Yes 07/01/12    
C9716 Radiofrequency energy to anu No 07/01/10    
D0421 Gen tst suscept oral disease Yes 01/01/16    
D9221 General anesthesia ea ad 15m No 07/01/11    
D9242 IV sedation ea ad 30 m No 07/01/11    
D9920 Behavior management, by report No 12/01/08 07/01/11  
G0008 Admin influenza virus vac Yes 10/01/09 04/01/11  
G0009 Admin pneumococcal vaccine Yes 10/01/09 04/01/11  
G0398 Home sleep test/type 2 Porta No 01/01/13    
G0399 Home sleep test/type 3 Porta No 01/01/13    
G0400 Home sleep test/type 4 Porta No 01/01/13    
G0464 Colorec ca scr, sto bas dna Yes 01/01/16    
G8402 Smoke preven interven counse No 12/01/08    
G8403 Smoke preven Outcounsel No 12/01/08    
G9016 Demo-smoking cessation coun No 12/01/08    
G9141 Influenza A (H1N1) - administration No 10/01/09 07/01/11  
G9142 Influenza A (H1N1) - vaccine No 10/01/09 07/01/11  
G9143 Warfarin respon genetic test Yes 01/01/16    
H0018 Alcohol and/or drug services No 07/01/10    
H0023 Behavioral health outreach service - planned approach to reach a targeted population No 10/01/10    
H0032 MH svc plan dev by non-md No 07/01/10    
H0037 Comm psy sup tx pgm per diem No 07/01/10    
H2029 Sex offend tx svc, per diem No 07/01/10    
J0128 Injection, abarelix, 10 mg Yes 01/01/11    
J0365 Injection, aprotonin, 10,000 kiu Yes 01/01/11    
J0480 Injection, basiliximab, 20 mg Yes 01/01/11    
J0585 Botulinum toxin a per unit Yes 12/01/08 01/01/15  
J0587 Botulinum toxin type B Yes 12/01/08    
J0740 Injection, cidofovir, 375 mg Yes 01/01/11    
J0882 Darbepoetin alfa, esrd use Yes 12/01/08 01/01/12  
J0886 Epoetin alfa 1000 units ESRD Yes 12/01/08 01/01/12 10/01/13
J0890 Peginesatide injection No 07/01/13    
J1440 Filgrastim 300 mcg injection Yes 12/01/08    
J1441 Filgrastim 480 mcg injection Yes 12/01/08    
J1566 Injection, immune globulin, intravenous, lyophilized (e.g. powder), not otherwise specified, 500 mg Yes 01/01/11    
J1675 Injection, histrelin acetate, 10 micrograms Yes 01/01/11    
J1725 Hydroxyprogesterone caproate Yes 04/01/12    
J1931 Injection, laronidase, 0.1 mg Yes 01/01/11    
J2315 Naltrexone, depot form Yes - Only for Article 32 providers 01/01/10 07/01/11  
J2323 Natalizumab injection Yes - only for TOUCH providers 01/01/10 01/01/11  
J2358 Olanzapine long-acting inj Yes 04/01/11    
J2426 Paliperidone palmitate inj Yes 04/01/11    
J2505 Injection, pegfilgrastim 6mg Yes 12/01/08    
J2562 Injection, plerixafor, 1 mg Yes 01/01/11    
J2794 Risperidone, long acting Yes 04/01/09    
J2997 Alteplase recombinant Yes 04/01/10 04/01/11  
J3110 Injection, teriparatide, 10 mcg Yes 01/01/11    
J3285 Injection, treprostinil, 1 mg Yes 01/01/11    
J3490 Drugs unclassified injection Yes 04/01/10    
J3590 Unclassified biologics Yes 04/01/10    
J7187 Humate-P, inj Yes 12/01/08    
J7189 Factor viia Yes 12/01/08    
J7190 Factor viii Yes 12/01/08    
J7191 Factor VIII (porcine) Yes 12/01/08    
J7192 Factor viii recombinant Yes 12/01/08    
J7193 Factor IX No - APG Carve Outn-recombinant Yes 12/01/08    
J7194 Factor ix complex Yes 12/01/08    
J7195 Factor IX recombinant Yes 12/01/08    
J7197 Antithrombin iii injection Yes 12/01/08    
J7198 Anti-inhibitor Yes 12/01/08    
J7199 Hemophilia clot factor No - APG Carve Outc Yes 12/01/08    
J7300 Intraut copper contraceptive Yes 12/01/08    
J7302 LevoNo - APG Carve Outrgestrel iu contracept Yes 12/01/08    
J7307 EtoNo - APG Carve Outgestrel implant system Yes 12/01/08    
J8520 Capecitabine, oral, 150 mg Yes 01/01/11    
J9001 Injection, doxorubicin hydrochloride, all lipid formulations, 10 mg Yes 01/01/11    
J9019 Erwinaze injection Yes 07/01/14    
J9027 Clofarabine injection Yes 12/01/08    
J9033 Injection, bendamustine hcl, 1 mg Yes 01/01/11    
J9035 Injection, bevacizumab, 10 mg Yes 01/01/11    
J9055 Injection, cetuximab, 10 mg Yes 01/01/11    
J9098 Injection, cytarabine liposome, 10 mg Yes 01/01/11    
J9120 Injection, dactinomycin, 0.5 mg Yes 01/01/11    
J9160 Injection, denileukin diftitox, 300 micrograms Yes 01/01/11    
J9207 Injection, ixabepilone, 1 mg Yes 01/01/11    
J9219 Leuprolide acetate implant, 65 mg Yes 01/01/11    
J9225 Histrelin implant (vantas), 50 mg Yes 01/01/11    
J9226 Supprelin LA implant Yes 10/01/10    
J9245 Injection, melphalan hydrochloride, 50 mg Yes 01/01/11    
J9263 Injection, oxaliplatin, 0.5 mg Yes 01/01/11    
J9264 Injection, paclitaxel protein-bound particles, 1 mg Yes 01/01/11    
J9266 Injection, pegaspargase, per single dose vial Yes 01/01/11    
J9268 Injection, pentostatin, 10 mg Yes 01/01/11    
J9303 Injection, panitumumab, 10 mg Yes 01/01/11    
J9305 Injection, pemetrexed, 10 mg Yes 01/01/11    
J9310 Injection, rituximab, 100 mg Yes 01/01/11    
J9350 Injection, topotecan, 4 mg Yes 01/01/11    
J9355 Injection, trastuzumab, 10 mg Yes 01/01/11    
J9600 Injection, porfimer sodium, 75 mg Yes 01/01/11    
Q0091 Obtaining screen pap smear No 01/01/12    
Q2043 Provenge Yes 07/01/14    
Q2049 Imported lipodox inj No 01/01/16    
Q4074 Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms Yes 01/01/11    
S0166 Inj olanzapine 2.5mg No 04/01/11    
S0190 Mifepristone, oral, 200 mg Yes 12/01/08    
S0191 Misoprostol, oral, 200 mcg Yes 12/01/08    
S3800 Genetic testing als No 01/01/16    
S3818 BRCA1 gene anal Yes 01/01/10    
S3819 BRCA2 gene anal Yes 01/01/10    
S3820 Comp BRCA1/BRCA2 Yes 01/01/10    
S3822 Sing mutation brst/ovar Yes 01/01/10    
S3823 3 mutation brst/ovar Yes 01/01/10    
S3828 Comp MLH1 gene Yes 01/01/10    
S3829 Comp MLH2 gene Yes 01/01/10    
S3830 Gene test HNPCC comp Yes 01/01/10    
S3831 Gene test HNPCC single Yes 01/01/10    
S3833 Comp APC sequence Yes 01/01/10    
S3834 Sing mutation APC Yes 01/01/10    
S3835 Gene test cystic fibrosis Yes 01/01/10    
S3840 DNA analysis RET-oncogene Yes 01/01/10    
S3841 Gene test retinoblastoma No 01/01/16    
S3842 Gene test Hippel-Lindau Yes 01/01/10    
S3843 DNA analysis factor v Yes 01/01/10    
S3844 DNA analysis deafness Yes 01/01/10    
S3845 Gene test alpha-thalassemia No 01/01/10    
S3846 Gene test beta-thalassemia Yes 01/01/10    
S3847 Gene test Tay-Sachs Yes 01/01/10    
S3848 Gene test Gaucher Yes 01/01/10    
S3849 Gene test Niemann-Pick Yes 01/01/10    
S3850 Gene test sickle cell Yes 01/01/10    
S3851 Gene test canavan Yes 01/01/10    
S3852 DNA analysis APOE alzheimer Yes 01/01/10    
S3853 Gene test myo musclr dyst Yes 01/01/10    
S3854 Gene profile panel breast No 01/01/16    
S3861 Genetic test brugada Yes 01/01/16    
S3865 Comp genet test hyp cardiomy Yes 01/01/16    
S3866 Spec gene test hyp cardiomy Yes 01/01/16    
S3870 Cgh test developmental delay No 01/01/16    
S3890 Fecal dna analysis No 01/01/16    
S4989 Contracept IUD Yes 12/01/08    
S8940 Hippotherapy per session No 12/01/08    
S9075 Smoking cessation treatment No 12/01/08    
S9128 Speech therapy, in the home, No 12/01/08    
S9129 Occupational therapy, in the No 12/01/08    
S9131 PT in the home per diem No 12/01/08    
S9453 Smoking cessation class No 12/01/08    
S9480 Intensive outpatient psychia No 07/01/10 01/01/11  
V5014 Hearing aid repair/modifying Yes 04/01/12    
V5362 Speech screening No 04/01/11    
V5364 Dysphagia screening No 04/01/11    

∗ Procedure codes listed as carve outs should not be billed using APGs. Indication as a carve out does not guarantee alternative payment.