Commonwealth of Massachusetts
Executive Office of Health and Human Services Division of Medical Assistance
600 Washington Street
Boston, MA 02111 www.mass.gov/dma
MASSHEALTH
TRANSMITTAL LETTER DEN-63
March 2003

TO:	Dental Providers Participating in MassHealth

FROM:	Douglas S. Brown, Acting Commissioner

RE:	Dental Manual (2003 HCPCS)

The federal government has revised the HCFA Common Procedure Coding System (HCPCS) for MassHealth billing.

This letter transmits changes to your provider manual that contain the new and revised codes. The revised Appendix E is effective for dates of service on or after April 1, 2003.

If you wish to obtain a fee schedule, you may purchase Division of Health Care Finance and Policy regulations from either the Massachusetts State Bookstore or from the Division of Health Care Finance and Policy (see addresses and telephone numbers below). You must contact them first to find out the price of the publication. The Division of Health Care Finance and Policy also has regulations available on disk. The regulation title is 114.3 CMR 16.00: Surgery and Related Anesthesia Care.

Massachusetts State Bookstore	Division of Health Care Finance and Policy State House, Room 116	Two Boylston Street
Boston, MA 02133	Boston, MA 02116
Telephone: (617) 727-2834	Telephone: (617) 988-3100
www.mass.gov/sec/spr	www.mass.gov/dhcfp

DMA Web Site
This transmittal letter and attached pages are available on the Division’s Web site at www.mass.gov/dma.

Questions
If you have any questions about this transmittal letter, please contact MassHealth Provider Services at 617-628-4141 or 1-800-325-5231.

NEW MATERIAL
(The pages listed here contain new or revised language.) Dental Manual
Pages E-1 through E-30

MASSHEALTH
TRANSMITTAL LETTER DEN-63
March 2003
Page 2

OBSOLETE MATERIAL
(The pages listed here are no longer in effect.) Dental Manual
Pages E-1 through E-28 — transmitted by Transmittal Letter DEN-61

Commonwealth of Massachusetts Division of Medical Assistance Provider Manual Series

DENTAL MANUAL	SUBCHAPTER NUMBER AND TITLE
APPENDIX E: ORAL SURGERY SERVICE CODES AND DESCRIPTIONS	PAGE
E-1	
	TRANSMITTAL LETTER
DEN-63	DATE
04/01/03	

The all-numeric service codes that are listed in this appendix may be used when providing services to members in all categories of assistance, including category 4 (EAEDC), and may only be used by oral and maxillofacial surgeons who have submitted proof of certification to the Division. The alphanumeric codes in Sections 621, 622, and 623 may not be used for services provided to category 4 members, with the exception of Service Code D7999.

620 Service Codes and Descriptions: Medical Services

Service
Code	Service Description

OFFICE OR OTHER OUTPATIENT SERVICES

New Patient

99202	Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components (does not include dentoalveolar diagnosis):
an expanded problem focused history;
an expanded problem focused examination; and
straightforward medical decision making

Established Patient

99212	Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components (does not include dentoalveolar diagnosis):
a problem-focused history;
a problem-focused examination; and
straightforward medical decision making

INITIAL HOSPITAL CARE

New or Established Patient

99221	Initial hospital care, per day, for the evaluation and management of a patient, which requires these three key components:
a detailed or comprehensive history;
a detailed or comprehensive examination; and
medical decision making that is straightforward or of low complexity
99222	Initial hospital care, per day, for the evaluation and management of a patient, which requires these three key components:
a comprehensive history;
a comprehensive examination; and
medical decision making of moderate complexity
99223	Initial hospital care, per day, for the evaluation and management of a patient, which requires these three key components:
a comprehensive history;
a comprehensive examination; and
medical decision making of high complexity

620 Service Codes and Descriptions: Medical Services (cont.)

Service
Code	Service Description

SUBSEQUENT HOSPITAL CARE

99231	Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least two of these three key components:
a problem-focused interval history;
a problem-focused examination;
medical decision making that is straightforward or of low complexity
99232	Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least two of these three key components:
an expanded problem-focused interval history;
an expanded problem-focused examination;
medical decision making of moderate complexity
99233	Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least two of these three key components:
a detailed interval history;
a detailed examination;
medical decision making of high complexity

INITIAL INPATIENT CONSULTATIONS

New or Established Patient

99251	Initial inpatient consultation for a new or established patient, which requires these three key components:
a problem-focused history;
a problem-focused examination; and
straightforward medical decision making
99252	Initial inpatient consultation for a new or established patient, which requires these three key components:
an expanded problem-focused history;
an expanded problem-focused examination; and
straightforward medical decision making
99253	Initial inpatient consultation for a new or established patient, which requires these three key components:
a detailed history;
a detailed examination; and
medical decision making of low complexity
99254	Initial inpatient consultation for a new or established patient, which requires three key components:
a comprehensive history;
a comprehensive examination; and
medical decision making of moderate complexity

620 Service Codes and Descriptions: Medical Services (cont.)

Service
Code	Service Description

99255	Initial inpatient consultation for a new or established patient, which requires these three key components:
a comprehensive history;
a comprehensive examination; and
medical decision making of high complexity

FOLLOW-UP INPATIENT CONSULTATIONS

Established Patient

99261	Follow-up inpatient consultation for an established patient, which requires at least two of these three key components:
a problem-focused interval history;
a problem-focused examination;
medical decision making that is straightforward or of low complexity

EMERGENCY DEPARTMENT SERVICES

New or Established Patient

99281	Emergency department visit for the evaluation and management of a patient, which requires these three key components:
a problem-focused history;
a problem-focused examination; and
straightforward medical decision making
99282	Emergency department visit for the evaluation and management of a patient, which requires these three key components:
an expanded problem-focused history;
an expanded problem-focused examination; and
medical decision making of low complexity
99283	Emergency department visit for the evaluation and management of a patient, which requires these three key components:
an expanded problem-focused history;
an expanded problem-focused examination; and
medical decision making of moderate complexity
99284	Emergency department visit for the evaluation and management of a patient, which requires these three key components:
a detailed history;
a detailed examination; and
medical decision making of moderate complexity

620 Service Codes and Descriptions: Medical Services (cont.)

Service
Code	Service Description

99285	Emergency department visit for the evaluation and management of a patient, which requires these three key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status:
a comprehensive history;
a comprehensive examination; and
medical decision making of high complexity 621 Service Codes and Descriptions: Endodontic Services
See 130 CMR 420.426, 420.437, and 420.447 for limitations.

Service
Code	Service Description

Periapical Services

D3410	Apicoectomy/periradicular surgery—anterior (per tooth) (includes retrograde filling) (P.A.) D3421	Apicoectomy/periradicular surgery—bicuspid (first root) (P.A.)
D3426	Apicoectomy/periradicular surgery (each additional root) (P.A.) 622 Service Codes and Descriptions: Exodontic Services
See 130 CMR 420.429, 420.439, and 420.449 for limitations.

Service
Code	Service Description

Extractions (including local anesthesia, suture removal, and routine postoperative care)

D7110	Extraction—single tooth
D7120	Extraction—each additional tooth
D7210	Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth
D7220	Removal of impacted tooth—soft tissue (P.A.) D7230	Removal of impacted tooth—partially bony (P.A.) D7240	Removal of impacted tooth—completely bony (P.A.)

623 Service Codes and Descriptions: Oral and Maxillofacial Surgical Services

Service
Code	Service Description

Introduction

D7280	Surgical exposure of impacted or unerupted tooth for orthodontic reasons (including orthodontic attachments) (P.A.)
D7281	Surgical exposure of impacted or unerupted tooth to aid eruption (for orthodontic purposes) (P.A.)

Surgical Procedures

D7310	Alveoplasty in conjunction with extractions—per quadrant  D7320	Alveoplasty not in conjunction with extractions—per quadrant D7340	Vestibuloplasty—ridge extension (second epithelialization) (P.A.)
D7350	Vestibuloplasty—ridge extension (including soft-tissue grafts, muscle reattachments, revision of soft-tissue attachment, and management of hypertrophied and hyperplastic tissue) (P.A.)
D7430	Excision of benign tumor–lesion diameter up to 1.25 cm D7431		lesion diameter greater than 1.25 cm
D7450	Removal of odontogenic cyst or tumor–lesion diameter up to 1.25 cm D7451		lesion diameter greater than 1.25 cm
D7460	Removal of nonodontogenic cyst or tumor–lesion diameter up to 1.25 cm D7461		lesion diameter greater than 1.25 cm
D7471	Removal of exostosis—per site (P.A.)
D7960	Frenulectomy (frenectomy or frenotomy)—separate procedure D7970	Excision of hyperplastic tissue—per arch (P.A.)
D7999	Unspecified oral surgery procedure, by report (P.A.) (I.C.)
D9930	Treatment of complications (postsurgical)—unusual circumstances, by report (I.C.)

Unclassified Treatment

D9110	Palliative (emergency) treatment of dental pain—minor procedure D9999	Unspecified adjunctive procedure, by report (P.A.) (I.C.)

624	Service Codes and Descriptions: Surgical Services

See 130 CMR 420.451 for limitations.

Service
Code	Service Description

INTEGUMENTARY SYSTEM

SKIN, SUBCUTANEOUS AND ACCESSORY STRUCTURES

	Incision and Drainage	
10060	Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or	

10061	subcutaneous abscess, cyst, furuncle, or paronychia); simple or single
complicated or multiple	
10120	Incision and removal of foreign body, subcutaneous tissues; simple	
10121	complicated	
10140	Incision and drainage of hematoma, seroma, or fluid collection	
10160	Puncture aspiration of abscess, hematoma, bulla, or cyst	
10180	Incision and drainage, complex, postoperative wound infection	
	Excision—Debridement	
11010	Debridement including removal of foreign material associated with open fracture(s) and/or	

11011	dislocation(s); skin and subcutaneous tissues
skin, subcutaneous tissue, muscle fascia, and muscle	
11012	skin, subcutaneous tissue, muscle fascia, muscle, and bone	
11040	Debridement; skin, partial thickness	
11041	skin, full thickness	
11042	skin and subcutaneous tissue	
11043	skin, subcutaneous tissue, and muscle	
11044	skin, subcutaneous tissue, muscle, and bone	
	Biopsy	
11100	Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless	

11101	otherwise listed (separate procedure); single lesion
each separate/additional lesion (List separately in addition to code for primary procedure.)	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Shaving of Epidermal or Dermal Lesions

11310	Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
11311	lesion diameter 0.6 to 1.0 cm
11312	lesion diameter 1.1 to 2.0 cm
11313	lesion diameter over 2.0 cm

Excision—Benign Lesions

11440	Excision, other benign lesion including margins (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less
11441	excised diameter 0.6 to 1.0 cm
11442	excised diameter 1.1 to 2.0 cm
11443	excised diameter 2.1 to 3.0 cm
11444	excised diameter 3.1 to 4.0 cm
11446	excised diameter over 4.0 cm

Excision—Malignant Lesions

11640	Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less
11641	excised diameter 0.6 to 1.0 cm
11642	excised diameter 1.1 to 2.0 cm
11643	excised diameter 2.1 to 3.0 cm
11644	excised diameter 3.1 to 4.0 cm
11646	excised diameter over 4.0 cm

MISCELLANEOUS

	Introduction	
11960	Insertion of tissue expander(s) for other than breast, including subsequent expansion	
11970	Replacement of tissue expander with permanent prosthesis	
11971	Removal of tissue expander(s) without insertion of prosthesis	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

REPAIR (CLOSURE)

Repair—Simple

12011	Simple repair of superficial wounds of face, ears, eyelids, nose, lips, and/or mucous membranes;
2.5 cm or less	
12013	2.6 cm to 5.0 cm	
12014	5.1 cm to 7.5 cm	
12015	7.6 cm to 12.5 cm	
12016	12.6 cm to 20.0 cm	
12017	20.1 cm to 30.0 cm	
12018	over 30.0 cm	
12020	Treatment of superficial wound dehiscence; simple closure	
12021	with packing	
	Repair—Intermediate	
12051	Layer closure of wounds of face, ears, eyelids, nose, lips, and/or mucous membranes; 2.5 cm or	

12052	less
2.6 cm to 5.0 cm	
12053	5.1 cm to 7.5 cm	
12054	7.6 cm to 12.5 cm	
12055	12.6 cm to 20.0 cm	
12056	20.1 cm to 30.0 cm	
12057	over 30.0 cm	
	Repair—Complex	
13131	Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 1.1 cm	

13132	to 2.5 cm
2.6 cm to 7.5 cm	
13133	each additional 5 cm or less (List separately in addition to code for primary procedure.)	
13150	Repair, complex, eyelids, nose, ears, and/or lips; 1.0 cm or less	
13151	1.1 cm to 2.5 cm	
13152	2.6 cm to 7.5 cm	
13153	each additional 5 cm or less (List separately in addition to code for primary procedure.)	
13160	Secondary closure of surgical wound or dehiscence, extensive or complicated	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Adjacent Tissue Transfer or Rearrangement

14040	Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; defect 10 sq cm or less
14041	defect 10.1 sq cm to 30.0 sq cm
14060	Adjacent tissue transfer or rearrangement, eyelids, nose, ears, and/or lips; defect 10 sq cm or less 14061		defect 10.1 sq cm to 30.0 sq cm

Free Skin Grafts

15000	Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues); first 100 sq cm or one percent of body area of infants and children
15120	Split graft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple
digits; first 100 sq cm or less, or one percent of body area of infants and children (except	

15121	15050)
each additional 100 sq cm, or each additional one percent of body area of infants and children,	

15240	or part thereof (List separately in addition to code for primary procedure.)
Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth,	

15241	neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less
each additional 20 sq cm (List separately in addition to code for primary procedure.)	
15260	Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20	

15261	sq cm or less
each additional 20 sq cm (List separately in addition to code for primary procedure.)	
	Flaps (Skin and/or Deep Tissues)	
15570	Formation of direct or tubed pedicle, with or without transfer; trunk	
15572	scalp, arms, or legs	
15574	forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, or feet	
15576	eyelids, nose, ears, lips, or intraoral	
15620	Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae,	

15630	genitalia, hands, or feet
at eyelids, nose, ears, or lips	
15732	Muscle, myocutaneous, or fasciocutaneous flap; head and neck (e.g., temporalis, masseter muscle,	
sternocleidomastoid, levator scapulae)

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Other Flaps and Grafts

15770	Graft; derma-fat-fascia

Other Procedures

15819	Cervicoplasty
15820	Blepharoplasty, lower eyelid (P.A.)
15821		with extensive herniated fat pad (P.A.) 15822	Blepharoplasty, upper eyelid; (P.A.)
15823	with excessive skin weighting down lid (P.A.)
15840	Graft for facial nerve paralysis; free fascia graft (including obtaining fascia) 15841		free muscle graft (including obtaining graft)
15842	free muscle flap by microsurgical technique 15845	regional muscle transfer

Burns, Local Treatment

16000	Initial treatment, first degree burn, when no more than local treatment is required

DESTRUCTION

Destruction, Benign or Premalignant Lesions

17000	Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions; first lesion
17003	second through 14 lesions, each (List separately in addition to code for first lesion.)
17004	Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions
17106	Destruction of cutaneous vascular proliferative lesions (e.g., laser technique); less than 10 sq cm

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Destruction, Malignant Lesions, Any Method

17280	Destruction, malignant lesion (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
17281	lesion diameter 0.6 to 1.0 cm
17282	lesion diameter 1.1 to 2.0 cm
17283	lesion diameter 2.1 to 3.0 cm
17284	lesion diameter 3.1 to 4.0 cm
17286	lesion diameter over 4.0 cm

Other Procedures

17999	Unlisted procedure, skin, mucous membrane, and subcutaneous tissue (I.C.)

MUSCULOSKELETAL SYSTEM

GENERAL

	Incision	
20000	Incision of soft tissue abscess (e.g., secondary to osteomyelitis); superficial	
20005	deep or complicated	
	Excision	
20200	Biopsy, muscle; superficial	
20205	deep	
20206	Biopsy, muscle, percutaneous needle	
20220	Biopsy, bone, trocar, or needle; superficial (e.g., ilium, sternum, spinous process, ribs)	
20240	Biopsy, bone, excisional; superficial (e.g., ilium, sternum, spinous process, ribs, trochanter of	

20245	femur)
deep (e.g., humerus, ischium, femur)	

Commonwealth of Massachusetts Division of Medical Assistance Provider Manual Series

DENTAL MANUAL	SUBCHAPTER NUMBER AND TITLE
APPENDIX E: ORAL SURGERY SERVICE CODES AND DESCRIPTIONS	PAGE
E-12	
	TRANSMITTAL LETTER
DEN-63	DATE
04/01/03	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Introduction or Removal

20520	Removal of foreign body in muscle or tendon sheath; simple 20525		deep or complicated
20605	Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow, or ankle, olecranon bursa)
20615	Aspiration and injection for treatment of bone cyst	
20670	Removal of implant; superficial (e.g., buried wire, pin, or rod) (separate procedure)	
20680	deep (e.g., buried wire, pin, screw, metal band, nail, rod, or plate)	
20690	Application of a uniplane (pins or wires in one plane), unilateral, external fixation system	
20692	Application of a multiplane (pins or wires in more than one plane), unilateral, external fixation	
system (e.g., Ilizarov, Monticelli type)
20693	Adjustment or revision of external fixation system requiring anesthesia (e.g., new pin(s) or wire(s) and/or new ring(s) or bar(s))
20694	Removal, under anesthesia, of external fixation system	
	Grafts (or Implants)	
20900	Bone graft, any donor area; minor or small (e.g., dowel or button)	
20902	major or large	
20910	Cartilage graft; costochondral	
20912	nasal septum	
20920	Fascia lata graft; by stripper	
20922	by incision and area exposure, complex or sheet	
20924	Tendon graft, from a distance (e.g., palmaris, toe extensor, plantaris)	
20926	Tissue grafts, other (e.g., paratenon, fat, dermis)	
	Other Procedures	
20955	Bone graft with microvascular anastomosis; fibula	
20956	iliac crest	
20962	other than fibula, iliac crest, or metatarsal	
20969	Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or	

20970	great toe (I.C.)
iliac crest	
20999	Unlisted procedure, musculoskeletal system, general (I.C.)	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

HEAD

Incision

21010	Arthrotomy, temporomandibular joint

Excision

21015	Radical resection of tumor (e.g., malignant neoplasm), soft tissue of face or scalp 21025	Excision of bone (e.g., for osteomyelitis or bone abscess); mandible
21026	facial bone(s)
21029	Removal by contouring of benign tumor of facial bone (e.g., fibrous dysplasia) (P.A.) 21030	Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage 21031	Excision of torus mandibularis
21032	Excision of maxillary torus palatinus
21034	Excision of malignant tumor of maxilla or zygoma
21040	Excision of benign tumor or cyst of mandible; by enucleation and curettage 21044	Excision of malignant tumor of mandible
21045	radical resection
21046	Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (e.g., locally aggressive or destructive lesion(s))
21047	requiring extra-oral osteotomy and partial mandibulectomy (e.g., locally aggressive or destructive lesion(s))
21048	Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (e.g., locally aggressive or destructive lesion(s))
21049	requiring extra-oral osteotomy and partial maxillectomy (e.g., locally aggressive or destructive lesion(s))
21050	Condylectomy, temporomandibular joint (separate procedure)
21060	Meniscectomy, partial or complete, temporomandibular joint (separate procedure) 21070	Coronoidectomy (separate procedure)

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Introduction or Removal

21076	Impression and custom preparation; surgical obturator prosthesis 21077		orbital prosthesis
21079	interim obturator prosthesis (P.A.) (I.C.) 21080	definitive obturator prosthesis (P.A.) (I.C.) 21081	mandibular resection prosthesis (P.A.) (I.C.) 21082	palatal augmentation prosthesis (P.A.) (I.C.) 21083	palatal lift prosthesis (P.A.) (I.C.)
21084	speech aid prosthesis (P.A.) (I.C.) 21085	oral surgical splint (P.A.) (I.C.) 21086	auricular prosthesis (P.A.) (I.C.) 21087	nasal prosthesis (P.A.) (I.C.) 21088	facial prosthesis (P.A.) (I.C.)
21089	Unlisted maxillofacial prosthetic procedure (P.A.) (I.C.)
21100	Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)
21110	Application of interdental fixation device for conditions other than fracture or dislocation, includes removal (I.C.)
21116	Injection procedure for temporomandibular joint arthrography	
	Repair, Revision, and/or Reconstruction	
21137	Reduction forehead; contouring only (P.A.)	
21138	contouring and application of prosthetic material or bone graft (includes obtaining autograft)	

21139	(P.A.)
contouring and setback of anterior frontal sinus wall (P.A.)	
21141	Reconstruction midface, LeFort I; single piece, segment movement in any direction (e.g., for Long	

21142	Face Syndrome), without bone graft (P.A.)
two pieces, segment movement in any direction, without bone graft	
21143	three or more pieces, segment movement in any direction, without bone graft	
21145	single piece, segment movement in any direction, requiring bone grafts (includes obtaining	

21146	autografts) (P.A.)
two pieces, segment movement in any direction, requiring bone grafts (includes obtaining	

21147	autografts) (e.g., ungrafted unilateral alveolar cleft) (P.A.)
three or more pieces, segment movement in any direction, requiring bone grafts (includes	

21150	obtaining autografts) (e.g., ungrafted bilateral alveolar cleft or multiple osteotomies) (P.A.)
Reconstruction midface, LeFort II; anterior intrusion (e.g., Treacher-Collins Syndrome) (P.A.)	
21151	any direction, requiring bone grafts (includes obtaining autografts) (P.A.)	

6624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

21154	Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I (P.A.)
21155	with LeFort I (P.A.)
21159	Reconstruction midface, LeFort III (extra- and intracranial) with forehead advancement (e.g., mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I (P.A.)
21160	with LeFort I (P.A.)
21172	Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts) (P.A.)
21175	Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (e.g., plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts) (P.A.)
21181	Reconstruction by contouring of benign tumor of cranial bones (e.g., fibrous dysplasia),
	extracranial	
21182	Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and	
	extracranial excision of benign tumor of cranial bone (e.g., fibrous dysplasia), with multiple	
	autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm	
21183	total area of bone grafting greater than 40 sq cm but less than 80 sq cm	
21184	total area of bone grafting greater than 80 sq cm	
21188	Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining	
	autografts) (P.A.)	
21193	Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft	
	(P.A.)	
21194	with bone graft (includes obtaining graft) (P.A.)	
21195	Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation (P.A.)	
21196	with internal rigid fixation (P.A.)	
21198	Osteotomy, mandible, segmental (P.A.)	
21206	Osteotomy, maxilla, segmental (e.g., Wassmund or Schuchard) (P.A.)	
21208	Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant) (P.A.)	
21209	reduction (P.A.)	
21210	Graft, bone; nasal, maxillary or malar areas (includes obtaining graft) (P.A.)	
21215	mandible (includes obtaining graft) (P.A.)	
21230	Graft; rib cartilage, autogenous, to face, chin, nose, or ear (includes obtaining graft) (P.A.)	
21235	ear cartilage, autogenous, to nose or ear (includes obtaining graft) (P.A.)	
21240	Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft) (P.A.)	
21242	Arthroplasty, temporomandibular joint, with allograft (P.A.)	
21243	Arthroplasty, temporomandibular joint, with prosthetic joint replacement (P.A.)	
21244	Reconstruction of mandible, extraoral, with transosteal bone plate (e.g., mandibular staple bone	
	plate) (P.A.)	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

21247	Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (e.g., for hemifacial microsomia) (P.A.)
21255	Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts) (P.A.)
21260	Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach (P.A.)	
21261	combined intra- and extracranial approach (P.A.)	
21263	with forehead advancement (P.A.)	
21267	Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach	

21268	(P.A.)
combined intra- and extracranial approach (P.A.)	
21270	Malar augmentation, prosthetic material (P.A.)	
21275	Secondary revision of orbitocraniofacial reconstruction (P.A.)	
21280	Medial canthopexy (separate procedure) (P.A.)	
21282	Lateral canthopexy (P.A.)	
21295	Reduction of masseter muscle and bone (e.g., for treatment of benign masseteric hypertrophy);	

21296	extraoral approach (P.A.) intraoral approach (P.A.)	
	Other Procedures	
21299	Unlisted craniofacial and maxillofacial procedure (P.A.) (I.C.)	
	Fracture and/or Dislocation	
21300	Closed treatment of skull fracture without operation	
21310	Closed treatment of nasal bone fracture without manipulation	
21315	Closed treatment of nasal bone fracture; without stabilization	
21320	with stabilization	
21325	Open treatment of nasal fracture; uncomplicated	
21330	complicated, with internal and/or external skeletal fixation	
21335	with concomitant open treatment of fractured septum	
21336	Open treatment of nasal septal fracture, with or without stabilization	
21337	Closed treatment of nasal septal fracture, with or without stabilization	
21338	Open treatment of nasoethmoid fracture; without external fixation	
21339	with external fixation	
21340	Percutaneous treatment of nasoethmoid complex fracture, with splint, wire, or headcap fixation,	
including repair of canthal ligaments and/or the nasolacrimal apparatus

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

21343	Open treatment of depressed frontal sinus fracture
21344	Open treatment of complicated (e.g., comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches
21345	Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint
21346	Open treatment of nasomaxillary complex fracture (LeFort II type); with wiring and/or local	
	fixation	
21347	requiring multiple open approaches	
21348	with bone grafting (includes obtaining graft)	
21355	Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with	
	manipulation	
21356	Open treatment of depressed zygomatic arch fracture (e.g., Gillies approach)	
21360	Open treatment of depressed malar fracture, including zygomatic arch and malar tripod	
21365	Open treatment of complicated (e.g., comminuted or involving cranial nerve foramina) fracture(s)	
	of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple	
	surgical approaches	
21366	with bone grafting (includes obtaining graft)	
21385	Open treatment of orbital floor blowout fracture; transantral approach (Caldwell-Luc type	
	operation)	
21386	periorbital approach	
21387	combined approach	
21390	periorbital approach, with alloplastic or other implant	
21395	periorbital approach with bone graft (includes obtaining graft)	
21400	Closed treatment of fracture of orbit, except blowout; without manipulation	
21401	with manipulation	
21406	Open treatment of fracture of orbit, except blowout; without implant	
21407	with implant	
21408	with bone grafting (includes obtaining graft)	
21421	Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or	
	fixation of denture or splint	
21422	Open treatment of palatal or maxillary fracture (LeFort I type)	
21423	complicated (comminuted or involving cranial nerve foramina), multiple approaches	
21431	Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation of	
denture or splint

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

21432	Open treatment of craniofacial separation (LeFort III type); with wiring and/or internal fixation 21433		complicated (e.g., comminuted or involving cranial nerve foramina), multiple surgical
approaches
21435	complicated, utilizing internal and/or external fixation techniques (e.g., head cap, halo device, and/or intermaxillary fixation)
21436	complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)
21440	Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure) 21445	Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure) 21450	Closed treatment of mandibular fracture; without manipulation
21451	with manipulation
21452	Percutaneous treatment of mandibular fracture, with external fixation 21453	Closed treatment of mandibular fracture with interdental fixation 21454	Open treatment of mandibular fracture with external fixation
21461	Open treatment of mandibular fracture; without interdental fixation 21462		with interdental fixation
21465	Open treatment of mandibular condylar fracture
21470	Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints
21480	Closed treatment of temporomandibular dislocation; initial or subsequent	
21485	complicated (e.g., recurrent requiring intermaxillary fixation or splinting), initial or	
	subsequent	
21490	Open treatment of temporomandibular dislocation	
21493	Closed treatment of hyoid fracture; without manipulation	
21494	with manipulation	
21495	Open treatment of hyoid fracture	
21497	Interdental wiring, for condition other than fracture	

21499	Other Procedures

Unlisted musculoskeletal procedure, head (I.C.)	

ARTHROSCOPY

29800	Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure) (P.A.) (I.C.)
29804	Arthroscopy, temporomandibular joint, surgical (P.A.) (I.C.) 29999	Unlisted procedure, arthroscopy

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description
RESPIRATORY SYSTEM

NOSE

Excision

30130	Excision turbinate, partial or complete, any method
30140	Submucous resection turbinate, partial or complete, any method

Repair

30520	Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft
30580	Repair fistula; oromaxillary (combine with 31030 if antrotomy is included) (I.C.)	
30600	oronasal	
	Other Procedures	
30901	Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method	
30903	Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method	
30905	Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial	
30906	subsequent	
30999	Unlisted procedure, nose	
	
ACCESSORY SINUSES	
	Incision	
31000	Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)	
31020	Sinusotomy, maxillary (antrotomy); intranasal	
31030	radical (Caldwell-Luc) without removal of antrochoanal polyps	
31032	radical (Caldwell-Luc) with removal of antrochoanal polyps	
	Excision	
31225	Maxillectomy; without orbital exenteration	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Endoscopy

31233	Nasal/sinus endoscopy, diagnostic with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)
31256	Nasal/sinus endoscopy, surgical, with maxillary antrostomy	
31267	with removal of tissue from maxillary sinus	
31290	Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region	
31292	Nasal/sinus endoscopy, surgical; with medial or inferior orbital wall decompression	
31293	with medial orbital wall and inferior orbital wall decompression	
31294	with optic nerve decompression	

31299	Other Procedures

Unlisted procedure, accessory sinuses (I.C.)	

LARYNX

	Introduction	
31500	Intubation, endotracheal, emergency procedure	
31502	Tracheotomy tube change prior to establishment of fistula tract	

TRACHEA AND BRONCHI

	Incision	
31600	Tracheostomy, planned (separate procedure)	
31603	Tracheostomy, emergency procedure; transtracheal	
31605	cricothyroid membrane	

HEMIC AND LYMPHATIC SYSTEMS

LYMPH NODES AND LYMPHATIC CHANNELS

	Excision	
38500	Biopsy or excision of lymph node(s); open, superficial	
38505	by needle, superficial (e.g., cervical, inguinal, axillary)	
38510	open, deep cervical node(s)	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

DIGESTIVE SYSTEM

LIPS

Excision

40490	Biopsy of lip
40500	Vermilionectomy (lip shave), with mucosal advancement 40510	Excision of lip; transverse wedge excision with primary closure 40520		V-excision with primary direct linear closure
40525		full thickness, reconstruction with local flap (e.g., Estlander or fan) 40527		full thickness, reconstruction with cross lip flap (Abbe-Estlander) 40530	Resection of lip, more than one-fourth, without reconstruction

Repair (Cheiloplasty)

40650	Repair lip, full thickness; vermilion only 40652		up to half vertical height
40654	over one-half vertical height, or complex
40700	Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral 40701		primary bilateral, one stage procedure
40702	primary bilateral, one of two stages
40720	secondary, by recreation of defect and reclosure (P.A.)
40761	with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle (P.A.)

Other Procedures

40799	Unlisted procedure, lips (I.C.)

VESTIBULE OF MOUTH

	Incision	
40800	Drainage of abscess, cyst, hematoma, vestibule of mouth; simple	
40801	complicated	
40804	Removal of embedded foreign body, vestibule of mouth; simple	
40805	complicated	
40806	Incision of labial frenum (frenotomy)	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Excision, Destruction

40808	Biopsy, vestibule of mouth
40810	Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair 40812		with simple repair
40814	with complex repair
40816	complex, with excision of underlying muscle
40818	Excision of mucosa of vestibule of mouth as donor graft
40819	Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)
40820	Destruction of lesion or scar of vestibule of mouth by physical methods (e.g., laser, thermal, cryo, chemical)

	Repair	
40830	Closure of laceration, vestibule of mouth; 2.5 cm or less	
40831	over 2.5 cm or complex	
40840	Vestibuloplasty; anterior (P.A.)	
40842	posterior, unilateral (P.A.)	
40843	posterior, bilateral (P.A.)	
40844	entire arch (P.A.)	
40845	complex (including ridge extension, muscle repositioning) (P.A.)	
	Other Procedures	
40899	Unlisted procedure, vestibule of mouth (I.C.)	

TONGUE AND FLOOR OF MOUTH

	Incision	
41000	Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual	
41005	sublingual, superficial	
41006	sublingual, deep, supramylohyoid	
41007	submental space	
41008	submandibular space	
41009	masticator space	
41010	Incision of ligual frenum (frenotomy)	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

41015	Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual 41016		submental
41017	submandibular
41018	masticator space

Excision

41100	Biopsy of tongue; anterior two-thirds 41105		posterior one-third
41108	Biopsy of floor of mouth
41110	Excision of lesion of tongue without closure
41112	Excision of lesion of tongue with closure; anterior two-thirds 41113		posterior one-third
41114	with local tongue flap
41115	Excision of lingual frenum (frenectomy) 41116	Excision, lesion of floor of mouth 41120	Glossectomy; less than one-half tongue 41130		hemiglossectomy
41135	partial, with unilateral radical neck dissection
41140	complete or total, with or without tracheostomy, without radical neck dissection  41145	complete or total, with or without tracheostomy, with unilateral radical neck dissection
41150	composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection
41153	composite procedure with resection floor of mouth, with suprahyoid neck dissection 41155	composite procedure with resection floor of mouth, mandibular resection, and radical neck
dissection (Commando type)

Repair

41250	Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue 41251		posterior one-third of tongue
41252	Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex

Other Procedures

41500	Fixation of tongue, mechanical, other than suture (e.g., K-wire) 41510	Suture of tongue to lip for micrognathia (Douglas type procedure) 41520	Frenoplasty (surgical revision of frenum, e.g., with Z-plasty) 41599	Unlisted procedure, tongue, floor of mouth (I.C.)

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

DENTOALVEOLAR STRUCTURES

Incision

41800	Drainage of abscess, cyst, hematoma from dentoalveolar structures
41805	Removal of embedded foreign body from dentoalveolar structures; soft tissues 41806		bone

Excision, Destruction

41820	Gingivectomy, excision gingiva, each quadrant (P.A.) (I.C.) 41821	Operculectomy, excision pericoronal tissues
41822	Excision of fibrous tuberosities, dentoalveolar structures 41823	Excision of osseous tuberosities, dentoalveolar structures
41825	Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair 41826		with simple repair
41827	with complex repair
41828	Excision of hyperplastic alveolar mucosa, each quadrant (specify) 41830	Alveolectomy, including curettage of osteitis or sequestrectomy 41850	Destruction of lesion (except excision), dentoalveolar structures (I.C.)

Other Procedures

41874	Alveoloplasty, each quadrant (specify)
41899	Unlisted procedure, dentoalveolar structures (I.C.)

PALATE AND UVULA

	Incision	
42000	Drainage of abscess of palate, uvula	
	Excision, Destruction	
42100	Biopsy of palate, uvula	
42104	Excision, lesion of palate, uvula; without closure	
42106	with simple primary closure	
42107	with local flap closure	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

42120	Resection of palate or extensive resection of lesion 42140	Uvulectomy, excision of uvula (P.A.)
42145	Palatopharyngoplasty (e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty) (P.A.) 42160	Destruction of lesion, palate or uvula (thermal, cryo, or chemical)

Repair

42180	Repair, laceration of palate; up to 2 cm 42182		over 2 cm or complex
42200	Palatoplasty for cleft palate, soft and/or hard palate only
42205	Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only 42210		with bone graft to alveolar ridge (includes obtaining graft)
42215	Palatoplasty for cleft palate; major revision 42220		secondary lengthening procedure 42225		attachment pharyngeal flap
42226	Lengthening of palate, and pharyngeal flap 42227	Lengthening of palate, with island flap
42235	Repair of anterior palate, including vomer flap 42260	Repair of nasolabial fistula
42280	Maxillary impression for palatal prosthesis (P.A.) 42281	Insertion of pin-retained palatal prosthesis (P.A.)

Other Procedures

42299	Unlisted procedure, palate, uvula (I.C.)

SALIVARY GLAND AND DUCTS

	Incision	
42300	Drainage of abscess; parotid, simple	
42305	parotid, complicated	
42310	Drainage of abscess; submaxillary or sublingual, intraoral	
42320	submaxillary, external	
42325	Fistulization of sublingual salivary cyst (ranula)	
42326	with prosthesis	
42330	Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral	
42335	submandibular (submaxillary), complicated, intraoral	
42340	parotid, extraoral or complicated intraoral	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Excision

42400	Biopsy of salivary gland; needle 42405		incisional
42408	Excision of sublingual salivary cyst (ranula)
42409	Marsupialization of sublingual salivary cyst (ranula)
42410	Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection 42415		lateral lobe, with dissection and preservation of facial nerve
42420		total, with dissection and preservation of facial nerve 42425		total, en bloc removal with sacrifice of facial nerve 42440	Excision of submandibular (submaxillary) gland
42450	Excision of sublingual gland

Repair

42500	Plastic repair of salivary duct, sialodochoplasty; primary or simple 42505		secondary or complicated
42507	Parotid duct diversion, bilateral (Wilke type procedure); 42508		with excision of one submandibular gland
42509	with excision of both submandibular glands
42510	with ligation of both submandibular (Wharton's) ducts

Other Procedures

42550	Injection procedure for sialography 42600	Closure salivary fistula
42650	Dilation salivary duct
42660	Dilation and catheterization of salivary duct, with or without injection 42665	Ligation salivary duct, intraoral
42699	Unlisted procedure, salivary glands or ducts (I.C.)

PHARYNX, ADENOIDS, AND TONSILS

	Incision	
42700	Incision and drainage abscess; peritonsillar	
42720	retropharyngeal or parapharyngeal, intraoral approach	
42725	retropharyngeal or parapharyngeal, external approach	

6624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Excision, Destruction

42800	Biopsy; oropharynx
42802	hypopharynx
42804	nasopharynx, visible lesion, simple
42806		nasopharynx, survey for unknown primary lesion 42808	Excision or destruction of lesion of pharynx, any method 42809	Removal of foreign body from pharynx
42810	Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues
42815	Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx
42842	Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure	
42844	closure with local flap (e.g., tongue, buccal)	
42845	closure with other flap	
42860	Excision of tonsil tags	
42870	Excision or destruction lingual tonsil, any method (separate procedure)	
	Repair	
42900	Suture pharynx for wound or injury	
	Other Procedures	
42960	Control oropharyngeal hemorrhage, primary or secondary (e.g., post-tonsillectomy); simple	
42961	complicated, requiring hospitalization	
42962	with secondary surgical intervention	
42970	Control of nasopharyngeal hemorrhage, primary or secondary (e.g., post-adenoidectomy); simple,	

42971	with posterior nasal packs, with or without anterior packs and/or cautery
complicated, requiring hospitalization	
42972	with secondary surgical intervention	
42999	Unlisted procedure, pharynx, adenoids, or tonsils (I.C.)	

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

NERVOUS SYSTEM

EXTRACRANIAL NERVES, PERIPHERAL NERVES, AND AUTONOMIC NERVOUS SYSTEM

Introduction/Injection of Anesthetic Agent (Nerve Block), Diagnostic and Therapeutic

Somatic Nerves

64400	Injection, anesthetic agent; trigeminal nerve, any division or branch

Destruction by Neurolytic Agent (e.g., Chemical, Thermal, Electrical, Radiofrequency, or Chemodenervation)

Somatic Nerves

64600	Destruction by neurolytic agent, trigeminal nerve, supraorbital, infraorbital, mental, or inferior alveolar branch

Neuroplasty (Exploration, Neurolysis or Nerve Decompression)

64722	Decompression, unspecified nerve(s) (specify)
64727	Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty.) (Neuroplasty includes external neurolysis.)

Transection or Avulsion

64732	Transection or avulsion of; supraorbital nerve 64734		infraorbital nerve
64736	mental nerve
64738	inferior alveolar nerve by osteotomy 64740	lingual nerve

Neurorrhaphy

64864	Suture of facial nerve; extracranial

624 Service Codes and Descriptions: Surgical Services (cont.)

Service
Code	Service Description

Neurorrhaphy with Nerve Graft

64885	Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length

Other Procedures

64999	Unlisted procedure, nervous system (I.C.)

OPERATING MICROSCOPE

69990	Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure.)

625	Service Codes and Descriptions: Radiology Services

The following service codes are reimbursable only when performed in an office location.

DIAGNOSTIC RADIOLOGY (DIAGNOSTIC IMAGING)

HEAD AND NECK

70100	Radiologic examination, mandible; partial, less than four views	
70110	complete, minimum of four views	
70140	Radiologic examination, facial bones; less than three views	
70150	complete, minimum of three views	
70160	Radiologic examination, nasal bones, complete, minimum of three views	
70210	Radiologic examination, sinuses, paranasal, less than three views	
70220	Radiologic examination, sinuses, paranasal, complete, minimum of three views	
70240	Radiologic examination, sella turcica	
70328	Radiologic examination, temporomandibular joint, open and closed mouth; unilateral	
70330	bilateral	
70360	Radiologic examination; neck, soft tissue	
70380	Radiologic examination, salivary gland for calculus	

This publication contains codes that are copyrighted by the American Medical Association. Certain terms used in the service descriptions for HCPCS codes are defined in the Current Procedural Terminology (CPT) code book.

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