Association between NCQA Patient-Centered Medical Home Recognition for Primary Care Practices and Quality of Care for Children with Disabilities and Special Health Care Needs. APPENDIX C: CPT and ICD-9-CM Codes Used in Attribution Algorithms

01/01/2014

CPT Code Definition
Well-Child Visits
   Procedure Codes 99381-99385, 99391-99395, 99432, 99461
   ICD-9-CM Diagnosis Codes   V20.2, V20.3, V70.0, V70.3, V70.5, V70.6, V70.8, V70.9
Other Preventive and Primary Care Services
   Procedure Codes 99401-99404, 99411, 99412, 99420, 99429, 99406-99409, 96110, 96111, 99441-99444, 99339, 99340, 99173, 99174, 92551, 92552, 92567, 90460, 90461, 90471-90474  
   ICD-9-CM Diagnosis Codes V64.00, V64.01, V64.02, V64.03, V64.04, V64.05, V64.06, V64.08
Evaluation and Management Services
   Procedure Codes 99201-99205, 99211-99215, 99341-99345, 99347-99350, T1015
Other Services Likely Coordinated by Medical Home
   Procedure Codes 95115, 95117, 99366, 99367, 94005, 99600-99602, 92506, 98966-98969, 99502

 

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