LinuxForHealth FHIR Implementation Guide
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LinuxForHealth FHIR Implementation Guide - Local Development build (v8.0.0). See the Directory of published versions

CodeSystem: Payer Procedure Group Codes

Official URL: http://linuxforhealth.org/fhir/cdm/CodeSystem/payer-procedure-group Version: 8.0.0
Active as of 2022-11-10 Computable Name: PayerProcedureGroupCodeSystem

Procedure group codes for payers

This Code system is referenced in the content logical definition of the following value sets:

This code system http://linuxforhealth.org/fhir/cdm/CodeSystem/payer-procedure-group defines the following codes:

CodeDisplayDefinition
1 Incision & drainage of cystIncision & drainage of cyst
2 Acne surgeryAcne surgery
3 Nail debridement/avulsionNail debridement/avulsion
4 Skin lesion injectionSkin lesion injection
5 Destruction, facial lesionDestruction, facial lesion
6 Destruction, non-facial lesionDestruction, non-facial lesion
7 Destruction of wartsDestruction of warts
8 Excision of breast tissueExcision of breast tissue
9 Other minor skin & breast surgeryOther minor skin & breast surgery
10 Arthrocentesis, sm/med jointArthrocentesis, sm/med joint
11 Arthrocentesis, large jointArthrocentesis, large joint
12 Other major skin surgeryOther major skin surgery
13 Other major breast surgeryOther major breast surgery
14 Other major musculoskeletal surgeryOther major musculoskeletal surgery
15 Other minor musculoskeletal surgeryOther minor musculoskeletal surgery
16 BronchoscopyBronchoscopy
17 LaryngoscopyLaryngoscopy
19 Other minor respiratory proceduresOther minor respiratory procedures
20 Other major respiratory proceduresOther major respiratory procedures
31 Venipuncture (draw blood)Venipuncture (draw blood)
38 Other minor cardiovascular proceduresOther minor cardiovascular procedures
39 Other major cardiovascular proceduresOther major cardiovascular procedures
44 Minor hemic & lymphatic proceduresMinor hemic & lymphatic procedures
45 Major hemic & lymphatic proceduresMajor hemic & lymphatic procedures
46 Upper GI endoscopyUpper GI endoscopy
47 Repair of inguinal herniaRepair of inguinal hernia
48 ColonoscopyColonoscopy
49 Other major digestive proceduresOther major digestive procedures
50 Other minor digestive proceduresOther minor digestive procedures
51 CystourethroscopyCystourethroscopy
52 Transurethral surgeryTransurethral surgery
54 Other minor urinary proceduresOther minor urinary procedures
55 Other major urinary proceduresOther major urinary procedures
58 Minor male genital proceduresMinor male genital procedures
59 Major male genital proceduresMajor male genital procedures
61 ColposcopyColposcopy
62 Dilation & currettageDilation & currettage
63 Laparoscopy, hysteroscopyLaparoscopy, hysteroscopy
64 Minor female genital proceduresMinor female genital procedures
65 Major female genital proceduresMajor female genital procedures
66 Decompression, carpal tunnelDecompression, carpal tunnel
68 Minor endocrine system proceduresMinor endocrine system procedures
69 Major endocrine system proceduresMajor endocrine system procedures
74 Minor nervous system proceduresMinor nervous system procedures
75 Major nervous system proceduresMajor nervous system procedures
76 Cataract removalCataract removal
84 Other minor eye/ocular proceduresOther minor eye/ocular procedures
85 Other major eye/ocular proceduresOther major eye/ocular procedures
94 Other minor ear/auditory proceduresOther minor ear/auditory procedures
95 Other major ear/auditory proceduresOther major ear/auditory procedures
98 Other minor surgery proceduresOther minor surgery procedures
99 Other major surgery proceduresOther major surgery procedures
101 Office visits, new patientOffice visits, new patient
104 Office visits, established patientOffice visits, established patient
109 Office visits, otherOffice visits, other
110 Office visits, emergencyOffice visits, emergency
111 Emergency department visitsEmergency department visits
113 Physician telephone/online visitsPhysician telephone/online visits
114 ER visits, otherER visits, other
115 Preventive care visitsPreventive care visits
116 Facility visitsFacility visits
120 Outpatient consultsOutpatient consults
121 Inpatient consultsInpatient consults
122 Other consults, location unspecifiedOther consults, location unspecified
124 Psychiatric diagnostic servicesPsychiatric diagnostic services
127 Specialty drugs other than chemotherapySpecialty drugs other than chemotherapy
128 Unlisted general med serviceUnlisted general med service
129 Other medical servicesOther medical services
130 Injections: immunizationsInjections: immunizations
131 Injections: therapeutic/IVInjections: therapeutic/IV
132 Other injections/noninjectablesOther injections/noninjectables
133 Other preventive medical servicesOther preventive medical services
135 Psychotherapy, individualPsychotherapy, individual
136 Psychotherapy, familyPsychotherapy, family
137 Psychotherapy, groupPsychotherapy, group
138 Psych advice, non-patientPsych advice, non-patient
139 Therapeutic psychiatric servicesTherapeutic psychiatric services
140 DialysisDialysis
143 Gastroenterology services (non-surgical)Gastroenterology services (non-surgical)
144 General eye examsGeneral eye exams
145 General ophthalmology servicesGeneral ophthalmology services
147 Ophthalmic diagnostic servicesOphthalmic diagnostic services
148 ENT diagnostic servicesENT diagnostic services
149 Speech/hearing therapySpeech/hearing therapy
150 Other ENT services (non-surgical)Other ENT services (non-surgical)
155 EKGEKG
156 EKG stress testEKG stress test
157 EKG monitoringEKG monitoring
158 PTCA- percutaneous angioplastyPTCA- percutaneous angioplasty
160 EchocardiogramEchocardiogram
161 Cardiac catheterizationCardiac catheterization
162 Dx radiology, other vascularDx radiology, other vascular
163 Other cardiovascular proceduresOther cardiovascular procedures
165 Non-invasive peripheral vascular studiesNon-invasive peripheral vascular studies
166 SpirometrySpirometry
167 Bronchospasm evaluationBronchospasm evaluation
168 Pulmonary function testsPulmonary function tests
169 Other non-surgical pulmonary servicesOther non-surgical pulmonary services
170 Respiratory therapyRespiratory therapy
171 Allergy testingAllergy testing
172 Allergy therapyAllergy therapy
175 Nerve conduction tests/EMGNerve conduction tests/EMG
176 Unlisted neurol Dx proceduresUnlisted neurol Dx procedures
177 Other neurology dx servicesOther neurology dx services
180 ChemotherapyChemotherapy
181 Physical medicine: hot/cold packsPhysical medicine: hot/cold packs
182 Physical medicine: elec stimulationPhysical medicine: elec stimulation
183 Physical medicine: other modesPhysical medicine: other modes
184 Physical medicine: ultrasoundPhysical medicine: ultrasound
185 Physical medicine: manipulationPhysical medicine: manipulation
186 Physical medicine: other proceduresPhysical medicine: other procedures
187 Physical medicine: testingPhysical medicine: testing
189 Physical medicine: unlisted/otherPhysical medicine: unlisted/other
190 Case management servicesCase management services
191 Spinal manipulation, chiroSpinal manipulation, chiro
195 Chiropractic servicesChiropractic services
197 Specimen handlingSpecimen handling
198 Medical supplies and devicesMedical supplies and devices
199 Other medicine proceduresOther medicine procedures
200 Durable medical equipmentDurable medical equipment
201 X-ray, head & neckX-ray, head & neck
202 X-ray, chestX-ray, chest
204 X-ray, spine/pelvisX-ray, spine/pelvis
205 X-ray, GI tractX-ray, GI tract
206 X-ray, abdomenX-ray, abdomen
207 X-ray, OB/GynX-ray, OB/Gyn
208 X-ray, extremitiesX-ray, extremities
210 CT scan, head & neckCT scan, head & neck
211 CT scan, chestCT scan, chest
212 CT scan, spineCT scan, spine
213 CT scan, abdomen/pelvisCT scan, abdomen/pelvis
214 CT scan, extremitiesCT scan, extremities
215 PET scanPET scan
216 Magnetic resonance (NMR/MRI)Magnetic resonance (NMR/MRI)
220 Myelograms/discogramsMyelograms/discograms
221 Cholecystograms/cholangiogramsCholecystograms/cholangiograms
222 Cholecysto/cholangiogram, invCholecysto/cholangiogram, inv
223 MammogramsMammograms
225 AortogramsAortograms
226 AngiogramsAngiograms
227 LymphangiogramsLymphangiograms
228 VenogramsVenograms
229 Dx radiology, misc/otherDx radiology, misc/other
241 Dx ultrasound, abdominalDx ultrasound, abdominal
242 Dx ultrasound, pregnancyDx ultrasound, pregnancy
243 EchocardiogramEchocardiogram
249 Dx ultrasound, otherDx ultrasound, other
269 Therapeutic radiologyTherapeutic radiology
279 Nuclear medicine, diagnosticNuclear medicine, diagnostic
289 Nuclear medicine, therapeuticNuclear medicine, therapeutic
299 Other radiology procedureOther radiology procedure
301 Blood chemisty tests, automatedBlood chemisty tests, automated
302 Blood chemistry, Rx monitorBlood chemistry, Rx monitor
303 Lab tests, organ/disease panelLab tests, organ/disease panel
304 Clinical path, consultationClinical path, consultation
306 Routine urinalysisRoutine urinalysis
307 Other urinalysisOther urinalysis
311 Thyroid function tests (RIA)Thyroid function tests (RIA)
312 Thyroid function tests (non-RIA)Thyroid function tests (non-RIA)
313 Other radioimmunoassays (RIA)Other radioimmunoassays (RIA)
319 Other chemistry testsOther chemistry tests
320 Other toxicology testsOther toxicology tests
331 Blood count, automatedBlood count, automated
332 Blood count, manualBlood count, manual
334 Blood test: sedimentation rateBlood test: sedimentation rate
335 Blood count: plateletBlood count: platelet
336 Blood test: Hgb/HctBlood test: Hgb/Hct
338 Blood test: prothrombin timeBlood test: prothrombin time
339 Other hematology testsOther hematology tests
349 Immunology testsImmunology tests
361 Definitive bacterial cultureDefinitive bacterial culture
362 Antibiotic sensitivity studiesAntibiotic sensitivity studies
363 Bacterial culture, urineBacterial culture, urine
364 Bacterial culture, screeningBacterial culture, screening
369 Other microbiology testsOther microbiology tests
371 Pap smearPap smear
372 Surgical pathologySurgical pathology
378 Molecular pathologyMolecular pathology
379 Other anatomic pathology servicesOther anatomic pathology services
389 Miscellaneous pathology testsMiscellaneous pathology tests
399 Other lab & path proceduresOther lab & path procedures
440 Cesarean section deliveriesCesarean section deliveries
445 Vaginal deliveriesVaginal deliveries
449 Major maternity procs & related careMajor maternity procs & related care
450 Other maternity procs & related careOther maternity procs & related care
470 Anesthesia servicesAnesthesia services
478 Home health PT/OT/STHome health PT/OT/ST
480 Other home health servicesOther home health services
485 Transportation servicesTransportation services
490 Dental: diagnostic & preventiveDental: diagnostic & preventive
491 Dental: basic restorativeDental: basic restorative
492 Dental: major restorativeDental: major restorative
493 Dental: orthodonticsDental: orthodontics
494 Dental: otherDental: other
498 Performance tracking codesPerformance tracking codes
499 Unmapped codesUnmapped codes