J3315 and J9202 with relavent ICDs
For J3315 INJECTION, TRIPTORELIN PAMOATE, 3.75 MG (e.g., Trelstar®):
185
|
MALIGNANT NEOPLASM OF PROSTATE
|
|
For J9202 GOSERELIN ACETATE IMPLANT, PER 3.6 MG (e.g., Zoladex®; note that Zoladex® Implant 10.8 mg, which is billed using 3 units of J9202, is covered only for 185 Malignant Neoplasm of Prostate):
174.0
|
MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF FEMALE BREAST
|
174.1
|
MALIGNANT NEOPLASM OF CENTRAL PORTION OF FEMALE BREAST
|
174.2
|
MALIGNANT NEOPLASM OF UPPER-INNER QUADRANT OF FEMALE BREAST
|
174.3
|
MALIGNANT NEOPLASM OF LOWER-INNER QUADRANT OF FEMALE BREAST
|
174.4
|
MALIGNANT NEOPLASM OF UPPER-OUTER QUADRANT OF FEMALE BREAST
|
174.5
|
MALIGNANT NEOPLASM OF LOWER-OUTER QUADRANT OF FEMALE BREAST
|
174.6
|
MALIGNANT NEOPLASM OF AXILLARY TAIL OF FEMALE BREAST
|
174.8
|
MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF FEMALE BREAST
|
174.9
|
MALIGNANT NEOPLASM OF BREAST (FEMALE) UNSPECIFIED SITE
|
175.0
|
MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF MALE BREAST
|
175.9
|
MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES OF MALE BREAST
|
185
|
MALIGNANT NEOPLASM OF PROSTATE
|
218.0
|
SUBMUCOUS LEIOMYOMA OF UTERUS
|
218.1
|
INTRAMURAL LEIOMYOMA OF UTERUS
|
218.2
|
SUBSEROUS LEIOMYOMA OF UTERUS
|
218.9
|
LEIOMYOMA OF UTERUS UNSPECIFIED
|
617.0
|
ENDOMETRIOSIS OF UTERUS
|
617.1
|
ENDOMETRIOSIS OF OVARY
|
617.2
|
ENDOMETRIOSIS OF FALLOPIAN TUBE
|
617.3
|
ENDOMETRIOSIS OF PELVIC PERITONEUM
|
617.4
|
ENDOMETRIOSIS OF RECTOVAGINAL SEPTUM AND VAGINA
|
617.5
|
ENDOMETRIOSIS OF INTESTINE
|
617.6
|
ENDOMETRIOSIS IN SCAR OF SKIN
|
617.8
|
ENDOMETRIOSIS OF OTHER SPECIFIED SITES
|
617.9
|
ENDOMETRIOSIS SITE UNSPECIFIED
|
626.8*
|
OTHER DISORDERS OF MENSTRUATION AND OTHER ABNORMAL BLEEDING FROM FEMALE GENITAL TRACT
|
V10.3
|
PERSONAL HISTORY OF MALIGNANT NEOPLASM OF BREAST
|
* 626.8 Use for Dysfunctional uterine bleeding only
|
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