General List
99224 Subsequent observation care; low
99225 Subsequent observation care; moderate
99226 Subsequent observation care; high
Effective Jan, 1 2011 Medicare would not pay for CPT 90658 (Influenza) and below are the replacement codes. * Need to verify if commercial insurances would accept these changes.
Q2035 Afluria vacc, 3 yrs & >, im
Q2036 Flulaval vacc, 3 yrs & >, im
Q2037 Fluvirin vacc, 3 yrs & >, im
Q2038 Fluzone vacc, 3 yrs & >, im
Q2039 NOS flu vacc, 3 yrs & >, im
Pediatrics Additions
90460 - Imadm any route 1st vac/tox
90461 - Inadm any route addl vac/tox
90644 - MENINGOCOCCAL & HIB CONJ VACCINE 4 DOSE IM
90664 - INFLUENZA VAC PANDEMIC FORMULA LIVE INTRANASAL
90666 - INFLUENZA VACCINE PANDEMIC SPLT PRSRV FREE IM
90667 - INFLUENZA VACCINE PANDEMIC SPLT ADJUVANT IM
90668 - INFLUENZA VACCINE PANDEMIC SPLT IM
Pulmonary and Sleep studies Additions
31634 - BRONCHOSCOPY BALLOON OCCLUSION
95800 - SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME
95801 - SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL
American Board of Medical Specialties
Family Medicine – Adolescent Medicine; Geriatric Medicine; Hospice and Palliative Medicine; Sleep Medicine; Sports Medicine
Internal Medicine – Adolescent Medicine; Advanced Heart Failure and Transplant Cardiology; Cardiovascular Disease; Clinical Cardiac Electrophysiology; Critical Care Medicine; Endocrinology, Diabetes, and Metabolism; Gastroenterology; Geriatric Medicine; Hematology; Hospice and Palliative Medicine; Infectious Disease; Interventional Cardiology; Medical Oncology; Nephrology; Pulmonary Disease; Rheumatology; Sleep Medicine; Sports Medicine; Transplant Hepatology
Pediatrics – Adolescent Medicine; Child Abuse Pediatrics; Developmental-Behavioral Pediatrics; Hospice and Palliative Medicine; Medical Toxicology; Neonatal-Perinatal Medicine;
Neurodevelopmental Disabilities; Pediatric Cardiology; Pediatric Critical Care Medicine; Pediatric Emergency Medicine; Pediatric Endocrinology; Pediatric Gastroenterology; Pediatric Hematology-Oncology; Pediatric Infectious Diseases; Pediatric Nephrology; Pediatric Pulmonology; Pediatric Rheumatology; Pediatric Transplant Hepatology; Sleep Medicine; Sports Medicine
American Osteopathic Association
Family Physicians – No subspecialties
Internal Medicine – Allergy/Immunology; Cardiology; Endocrinology; Gastroenterology; Hematology; Hematology/Oncology; Infectious Disease; Pulmonary Diseases; Nephrology; Oncology; Rheumatology
Pediatrics – Adolescent and Young Adult Medicine; Neonatology; Pediatric Allergy /Immunology;
Pediatric Endocrinology; Pediatric Pulmonology
American Board of Physician Specialties
The ABPS does not certify subspecialists. Therefore, eligible certifications are:
American Board of Family Medicine Obstetrics; Board Certification in Family Practice; and Board
Certification in Internal Medicine. There is no Board certification specific to Pediatrics.
Pediatrics most used CPTs and ICDs
Pediatrics most used CPTs and ICDs
Initial physical examination and Default ICD"S
S.NO Description CPT ICD
1 PREVENTIVE MEDICINE UNDER 1YR 99381 V20.2
2 Physical examination for age 1 to 4 99382 V20.2
3 PREVENTIVE MEDICINE (5-11)YR 99383 V20.2
4 Physical examination for 12-17yrs 99384 V20.2
5 Preventive Exam age (18-39) 99385 V70.0
Estabilished physical examination and Default ICD"S
6 Est Preventive medicine under 1 yr 99391 V20.2
7 Est Preventive medicine (2-4) yr 99392 V20.2
8 Est Preventive medicine (5-11) yr 99393 V20.2
9 Est Preventive medicine (12-17) yr 99394 V20.2
10 Est Preventive medicine (18-39 yr 99395 V70.0
Vaccines and their 'default ICD's' if not performed along with Physical examination
11 Hep A ped/adoles 2- dose sch 90633 V05.3
12 Hep A ped/adoles 3- dose sch 90634 V05.3
13 HiB 4- dose sch 90645 V03.81
14 HiB 3- dose sch 90647 V03.81
15 HPV 3-dose sch 90649 V05.8
16 Influenza virus vac 6-35 months preserve free 90655 V04.81
17 Influenza virus vac 3 yrs & older preserve free 90656 V04.81
18 Influenza virus vac 6-35 months 90657 V04.81
19 Influenza virus vac 3 yrs & older 90658 V04.81
20 Influenza virus vac intranasal 90660 V04.81
21 Pneumo conj vac > 5 yrs 90669 V03.82
22 Rotovirus 3- dose sch 90680 V05.8
23 Dtap > 7 yrs 90700 V06.1
24 MMR 90707 V06.4
25 Measles & rubella 90708 V03.89
26 MMRV 90710 V05.4
27 IPV 90713 V04.0
28 Tdap < 7 yrs 90715 V06.5
29 Varicella virus 90716 V05.4
30 Pneumo poly vac 2 yrs or older 90732 V03.82
31 Meningococcal poly vac 90733 V03.89
32 Meningococcal conj vac 90734 V03.89
33 Hep B adolsc 2- dose sch 90743 V05.3
34 Hep B ped/adolsc 3- dose sch 90744 V05.3
35 Hep B adult 90746 V05.3
36 HepB-Hib 90748 V03.89
Vaccine Administration as per age
37 Immunization Admin > 8 yrs 90465
38 Immunization Admin > 8 yrs addition 90466
39 Immunization Admin < 8 yrs 90471
40 Immunization Admin < 8 yrs addition 90472
41 Immunization Admin intranasal/oral > 8 yrs 90467
42 Immunization Admin intranasal/oral > 8 yrs Add 90468
43 Immunization Admin intranasal/oral < 8 yrs 90473
44 Immunization Admin intranasal/oral < 8 yrs Add 90474
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