This list became effective on 10/1/2004.  The funding level provides coverage through line 546.  For your convenience, the corresponding Condition Index (pdf) and Treatment Index (pdf) may be accessed by clicking on the desired index.

• An ICD-9-CM code (pdf) file and a CPT-4/HCPCS code (pdf) file are now available to view the placement of individual codes on the October 1, 2004 List.  Click on the desired link to view a searchable PDF file sorted by code.  Note that the ICD-9-CM file includes all codes appearing on the List in addition to any valid fourth- or fifth-digit codes that are subsumed within those codes.  For example, the three-digit code 860 appears on line 5 of the Prioritized List and this file will include codes 860, 860.0, 860.1, 860.2, 860.3, 860.4, 860.5.  In this way the inclusion of 860 indicates that all valid fourth-digit codes are present on the line (i.e., 860.6-860.9 are not valid codes and therefore are not included).

The CPT-4/HCPCS file now includes both medical and surgical CPT-4 codes and all HCPCS codes appearing on the list.  All codes are listed individually except where the standard set of medical therapy codes appear on a line.  This standard set of codes is 90471-90472, 90780-90799, 90901-90937, 90945-91105, 91122-92060, 92070-92353, 92358-92371, 92502-92504, 92511-92606, 92610-92960, 92970-92977, 93000-93662, 93701-93790, 93875-95075, 95115-95999, 96100-96117, 96400-96999, 97504-97537, 97601-97750, 97799, 99050-99054, 99058-99078, 99175, 99185-99362, 99374-99375, 99379-99440, 99499 and will be represented in the file as "9xxxx".  Should any of these codes appear on a line that does not include the full set of medical therapy codes shown above, they will be listed individually.  Also, any codes that are not included in this set of codes (e.g., 92065) will be listed separately in addition to 9xxxx if they appear on the same line.

The code lists are only included here for assistance to those who wish to search the list by code.  Please refer to the  October 1, 2004 Prioritized List of Health Services (pdf) for the official definition of each line item.  If any discrepancies are found please email to report them to us.

• Also available  are an ICD-9-CM code text file and CPT-4/HCPCS code text file.  These files are in a tab-delimited text file format for downloading and contain the same information as describe above with one exception.  Whereas the PDF file for ICD-9-CM placement includes the decimal point to aid in searching, the text file omits the decimal point.  This is because of the assumption that the text file will be used to load into a database file, in which case the decimal point is usually not included.  (If you need either text file please contact Dorothy Allen )

 

• Interim Modifications to Prioritized List Effective October 1, 2004 (pdf)

This notice to the Senate President dated July 21, 2004 identifies those changes that are new to the Prioritized List of Health Services that went into effect on October 1, 2004.