evekhm/cms_iom_500 huggingface dataset:
(Medicare Claims Processing Manual)
-  Medicare Summary Notices (MSNs)  80.6 -  Remittance Advice Remark Codes  80.7 -  Claims Adjustment Reason Codes  80.8 -  Advance Beneficiary Notice (ABN) as Applied to the IPPE  90 - Diabetes Screening  90.1 -  HCPCS Coding for Diabetes  Screening  90.2 -  A/B MAC (B) Billing Requirements  90.2.1 -  Modifier Requirements for Pre -diabetes  90.3 -  A/B MAC (A) Billing Requirements  90.3.1 -  Modifier Requirements for Pre -diabetes  90.4 -  Diagnosis Code Reporting 90.5 -  Medicare Summary Notices  90.6 -  Remittance Advice Remark Codes  90.7 -  Claims Adjustment Reason Codes  100 -  Cardiovascular Disease Screening  100.1 -  HCPCS Coding for Cardiovascular Screening 100.2 -  A/B MAC (B) Billing Requirements  100.3 -  A/B MAC (A) Billing Requirements  100.4 -  Diagnosis Code Reporting 100.5 -  Medicare Summary Notices  100.6 -  Remittance Advice Remark Codes  100.7 -  Claims Adjustment Reason Codes  110 -  Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)  110.1 -  Definitions  110.2 -  Coverage  110.3 -  Payment  110.3.1 -  Deductible and Coinsurance  110.3.2 -  HCPCS Code  110.3.3 -  Advanced Beneficiary Notice  110.3.4 -  RHCs/FQHCs Special Billing Instructions  120 -  Diabetes Self Management Training (DSMT) Services  120.1 -  Coding and Payment of DSMT Services  120.2 -  Bill Processing Requirements  120.2.1 -  Special Processing Instructions for Billing Frequency Requirements  120.2.2 -  Advance Beneficiary Notice (ABN) Requirements  120.2.3 -  RHCs/FQHCs Special Billing Instructions  120.3 -  Duplicate Edits  130 -  Human Immunodeficiency Virus (HIV) Screening Tests  130.1 -  Healthcare Common Procedure Coding System (HCPCS) for HIV Screening Tests  130.2 -  Billing Requirements  130.3 -  Payment Method 130.4 -  Types of Bill (TOBs) and Revenue Codes  130.5 -  Diagnosis Code Reporting 130.6 -  Medicare Summary Notice (MSN) and Claim Adjustment Reason  Codes (CARCs)  140 -  Annual Wellness Visit (AWV)  140.1 -  Healthcare Common Procedure Coding System (HCPCS) Coding for the AWV
(Medicare Claims Processing Manual)
Code Reporting 130.6 -  Medicare Summary Notice (MSN) and Claim Adjustment Reason  Codes (CARCs)  140 -  Annual Wellness Visit (AWV)  140.1 -  Healthcare Common Procedure Coding System (HCPCS) Coding for the AWV  140.2 -  A/B MAC (B) Billing Requirements  140.3 -  A/B MAC (A) Billing Requirements  140.4 -  Rural Health Clinic (RHC)/Federally Qualified Health Center (FQHC) Special Billing Instructions  140.5 -  Coinsurance and Deductible  140.6 -  Common Working File (CWF) Edits  140.7 -  Medicare Summary Notices (MSNs), Remittance Advice Remark Codes (RARCs), Claims Adjustment Reason Codes (CARCs), and Advance Beneficiary Notices (ABNs)  140.8 -  Advance Care Planning (ACP) as an Optional Element of an Annual Wellness Visit (AWV)  150 -  Counseling to Prevent Tobacco Use  150.1 -  Healthcare Common Procedure Coding System (HCPCS) and Diagnosis Coding  150.2 -  A/B MAC (B)  Billing Requirements  150.2.1 -  A/B MAC (A)  Billing Requirements  150.3 -  Medicare Summary Notices (MSNs), Remittance Advice Remark Codes (RARCs), Claims Adjustment Reason Codes (CARCs), and Group Codes  150.4 -  Common Working File (CWF)  160 -  Intensive Behavioral Therapy (IBT) for Cardiovascular Disease (CVD) Furnished on or After November 8, 2011  160.1 -  Coding Requirements for IBT for CVD Furnished on or After November 8, 2011  160.2 -  Claims Processing Requirements for IBT for CVD Furnished on or After November 8, 2011 160.2.1 -  Correct Place of Service (POS) Codes for IBT for CVD on Professional Claims  160.2.2 -  Provider Specialty Edits for IBT for CVD on Professional Claims  160.3 Correct Types of Bill (TOB) for IBT for CVD on Institutional Claims  160.4-  Frequency Edits for IBT for CVD Claims  160.5 -  Common Working File (CWF) Edits for IBT for CVD Claims  170 -  Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs  170.1 -  Healthcare Common Procedure Coding System (HCPCS) Codes for Screening for STIs and HIBC
(Medicare Claims Processing Manual)
CVD Claims  170 -  Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs  170.1 -  Healthcare Common Procedure Coding System (HCPCS) Codes for Screening for STIs and HIBC to Prevent STIs  170.2 -  Diagnosis Code Reporting 170.3 -  Billing Requirements  170.4 -  Types of Bill (TOBs) and Revenue Codes  170.4.1 -  Payment Method 170.5 -  Specialty Codes and Place of Service (POS)  180 -  Alcohol Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse  180.1 -  Policy  180.2. -  Institutional Billing Requirements  180.3 -  Professional Billing Requirements  180.4 -  Claim Adjustment Reason Codes, Remittance Advice Remark Codes, Group Codes and Medicare Summary Notice Messages  180.5 -  Common Working File (CWF) Requirements  190 -  Screening for Depression in Adults (Effective October 14, 2011)  190.1 -  A/B MAC (B) Billing Requirements  190.2 -  Frequency  190.3 -  Place of Service (POS)  190.4 -  Common Working File (CWF) Edits  190.5 -  Professional Billing Requirements  190.6 -  Institutional Billing Requirements  190.7 -  CARCs, RARCs, Group Codes, and MSN Messages  200 -  Intensive Behavioral Therapy for Obesity (Effective November 29, 2011)  200.1 -  Policy  200.2 -  Institutional Billing Requirements  200.3 -  Professional Billing Requirements  200.4 -  Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary Notice (MSN) Messages  200.5 -  Common Working File (CWF) Edits  210 -  Screening for Hepatitis C Virus (HCV)  210.1 -  Institutional Billing Requirements  210.2 -  Professional Billing Requirements  210.3 -  Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary Notice (MSN) Messages  210.4 -  Common Working File (CWF) Edits  220 -  Screening for Lung Cancer with Low Dose Computed Tomography (LDCT)  220.1 -  Healthcare Common Procedure Coding System (HCPCS) Codes  220.2 -  Institutional Billing Requirements  220.3 -  Deductible and Coinsurance  220.4 -  Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary
(Medicare Claims Processing Manual)
Codes  220.2 -  Institutional Billing Requirements  220.3 -  Deductible and Coinsurance  220.4 -  Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary Notice (MSN) Messages
(Medicare Claims Processing Manual)
220.5 -  Common Working File (CWF) Edits   230  Screening for Hepatitis B Virus (HBV)   230.1  Institutional Billing Requirements   230.2  Professional Billing Requirements   230.3  Diagnosis Code Reporting Requirements  230.4  Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary Notice (MSN) Messages  240 -  Prolonged Preventive Services Codes      1.2  Table of Preventive and Screening Services  (Rev. 12299; Issued:10 -12-23; Effective:01 -01-23; Implementation:11 -13-23)   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible   Initial Preventive Physical Examination, IPPE   G0402  Initial  preventive  physical examination; face to face visits, services limited to new beneficiary  during the first 12 months of Medicare enrollment   *Not Rated   WAIVED   G0403  Electrocardiogram,  routine ECG with 12 leads; performed as a screening for the initial preventive physical examination  with interpretation and report   Not Waived   G0404  Electrocardiogram, routine ECG with 12 leads; tracing only,  without  interpretation and report, performed as a screening for the initial preventive physical examination   Not Waived   G0405  Electrocardiogram,  routine ECG with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination   Not Waived   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    Ultrasound Screening  for Abdominal Aortic Aneurysm (AAA)  services furnished prior to January  1, 2017   G0389  Ultrasound, B -scan and /or real time with image documentation; for abdominal  aortic  aneurysm (AAA) ultrasound screening   B  WAIVED  Ultrasound Screening  for Abdominal Aortic Aneurysm (AAA)  services furnished  on or after January 1,  2017   76706  Ultrasound,  abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)   B  WAIVED  Cardiovascular Disease Screening   80061   Lipid  panel   A  WAIVED   82465  Cholesterol,  serum  or whole blood, total   WAIVED   83718  Lipoprotein, direct measurement; high density  cholesterol  (hdl cholesterol)   WAIVED  84478  Triglycerides  WAIVED
(Medicare Claims Processing Manual)
82465  Cholesterol,  serum  or whole blood, total   WAIVED   83718  Lipoprotein, direct measurement; high density  cholesterol  (hdl cholesterol)   WAIVED  84478  Triglycerides  WAIVED   Diabetes Screening Tests   82947  Glucose; quantitative, blood (except reagent strip)   B  WAIVED   82950  Glucose; post glucose dose (includes  glucose)   WAIVED   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    82951  Glucose;  tolerance test (gtt), three specimens (includes glucose)   *Not Rated   WAIVED     Diabetes  Self- Management Training Services (DSMT)   G0108  Diabetes  outpatient  self- management training services,  individual, per 30 minutes   *Not Rated   Not Waived   G0109  Diabetes outpatient self - management training services,  group session  (2 or more), per  30 minutes   Not Waived   Medical Nutrition Therapy (MNT)  Services   97802  Medical nutrition therapy; initial assessment and intervention,  individual, face-to-face with the patient,  each 15 minutes   B  WAIVED   97803  Medical  nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes   WAIVED   97804  Medical  nutrition therapy; group (2 or more individual(s)), each 30 minutes   WAIVED      Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    G0270  Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis,  medical  condition or treatment regimen (including additional hours needed for renal disease), individual,  face to  face with the patient,  each 15 minutes            B  WAIVED    G0271  Medical nutrition therapy, reassessment  and subsequent intervention(s) following second  referral  in same  year for change in diagnosis, medical condition, or treatment  regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes    WAIVED   Screening  Pap Test  G0123  Screening cytopathology, cervical or vaginal (any reporting  system),  collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision          A  WAIVED   G0124  Screening cytopathology, cervical or vaginal (any reporting  system),  collected in preservative fluid, automated thin layer preparation, requiring interpretation  by physician  WAIVED
(Medicare Claims Processing Manual)
A  WAIVED   G0124  Screening cytopathology, cervical or vaginal (any reporting  system),  collected in preservative fluid, automated thin layer preparation, requiring interpretation  by physician  WAIVED   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    G0141  Screening cytopathology smears,  cervical  or vaginal, performed by automated system, with manual rescreening, requiring interpretation  by physician  A  WAIVED    G0143  Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid,  automated  thin layer preparation, with manual screening  and rescreening by cytotechnologist  under physician supervision   A  WAIVED   G0144  Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation,  with screening by automated system, under physician supervision   A  WAIVED   G0145  Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation,  with screening by automated system and manual rescreening under physician supervision   A  WAIVED   G0147  Screening  cytopathology smears, cervical or vaginal, performed by automated system under physician supervision   A  WAIVED   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    G0148  Screening  cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening   A  WAIVED    P3000 Screening papanicolaou smear,  cervical  or vaginal, up to three smears, by technician  under  physician supervision    WAIVED    P3001 Screening  papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician    WAIVED   Q0091  Screening papanicolaou smear;  obtaining, preparing and conveyance of cervical or vaginal smear to laboratory   WAIVED   Screening Pelvic  Exam   G0101  Cervical  or vaginal  cancer screening; pelvic and clinical  breast  examination  A  WAIVED   Screening Mammography   77052  Computer -aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; screening mammography (list separately in addition to code  for primary procedure)   B  WAIVED   77057  Screening mammography, bilateral  (2-view  film study of each breast)   B  WAIVED
(Medicare Claims Processing Manual)
77057  Screening mammography, bilateral  (2-view  film study of each breast)   B  WAIVED   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    77063  Screening  digital breast tomosynthesis,  bilateral    WAIVED   77067  Screening mammography, bilateral  (2-view  study of each breast), including computer - aided  detection  (CAD) when performed   WAIVED   Bone Mass Measurement   G0130  Single energy x -ray absorptiometry (sexa) bone density study, one or more sites;  appendicular  skeleton (peripheral) (e.g., radius, wrist, heel)   B  WAIVED   77078  Computed tomography, bone mineral density study, 1 or more sites; axial  skeleton  (e.g., hips, pelvis, spine)   WAIVED     77079  Computed tomography, bone mineral density study, 1 or more sites; appendicular skeleton (peripheral)  (e.g.,  radius, wrist, heel)     WAIVED   77080  Dual -energy x- ray absorptiometry (dxa), bone density study, 1 or more  sites;  axial  skeleton (e.g.,  hips, pelvis, spine)   WAIVED   77081  Dual -energy x- ray absorptiometry  (dxa),  bone density study, 1 or more sites;  appendicular  skeleton (peripheral) (e.g., radius, wrist, heel)   WAIVED    Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible         77085  Dual -energy X -ray absorptiometry (DXA), bone density study,  1 or more  sites, axial skeleton, (e.g., hips, pelvis, spine), including vertebral fracture assessment.
(Medicare Claims Processing Manual)
WAIVED    76977  Ultrasound  bone  density measurement and interpretation,  peripheral site(s), any method    WAIVED  NOTE:  Anesthesia services furnished in conjunction with and in support of a screening colonoscopy  are reported  with  CPT code  00812 and coinsurance  and deductible  are waived.  When a screening colonoscopy becomes a diagnostic colonoscopy, anesthesia services are reported with CPT code 00811 and with the PT modifier; only the deductible is waived.  Coinsurance  and deductible  are waived  for moderate sedation  services  (reported with G0500 or 99153) when furnished in conjunction with and in support of a screening colonoscopy service and when reported with modifier 33.  When a screening colonoscopy becomes a diagnostic colonoscopy, moderate sedation services (G0500 or 99153) are reported with only the PT modifier; only the deductible is waived.  For dates of service  in calendar year (CY) 2023 through CY 2026, when the  PT modifier is appended to at least one code on the claim to indicate that a screening colorectal cancer procedure, HCPCS G0104, G0105, or G0121, has become a diagnostic or therapeutic service, contractors shall continue to waive deductible, and shall appl y a reduced coinsurance of 15% for all procedure codes that meet the requirements stated above and are performed on that date of service and billed on the same claim.  For dates of service in CY 2027 through CY 2029, contractors shall continue to waive deductible and shall apply a reduced coinsurance of 10% for  all procedure  codes  that meet  the requirements  stated  above  and are performed on that date of service and billed on the same claim.  For dates of service on or after January 1, 2030, contractors shall continue to waive deductible and shall waive  coinsurance  for all procedure  codes  that meet  the requirements  stated  above and are performed on that date of service and billed on the same claim.   Colorectal Cancer Screening   G0104  Colorectal cancer screening;  flexible sigmoidoscopy   A   WAIVED
(Medicare Claims Processing Manual)
Colorectal Cancer Screening   G0104  Colorectal cancer screening;  flexible sigmoidoscopy   A   WAIVED   G0105  Colorectal cancer screening;  colonoscopy on individual at high risk   WAIVED    G0106  Colorectal cancer screening;  alternative  to G0104, screening sigmoidoscopy,  barium enema   *Not Rated  Coins. Applies  & Ded. is waived   G0120  Colorectal cancer screening;  alternative to G0105, screening colonoscopy,  barium enema.  Coins. Applies  & Ded. is waived      Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    G0121  Colorectal cancer screening;  colonoscopy on individual not meeting criteria for high risk   A   WAIVED   82270  Blood, occult, by peroxidase activity (e.g., guaiac),  qualitative; feces, consecutive   WAIVED   G0328  Colorectal cancer screening;  fecal  occult blood test, immunoassay, 1 -3 simultaneous    WAIVED     81528  Oncology (colorectal) screening,  quantitative real -time target and signal  amplification  of 10 DNA markers     WAIVED     G0327  Colorectal cancer screening;  blood- based biomarker Colon ca scrn;bld -bsd biomrk    WAIVED    G0102  Prostate cancer screening;  digital rectal examination   D  Not Waived  Prostate Cancer Screening   G0103  Prostate  cancer  screening; prostate specific antigen test (PSA)     WAIVED   Glaucoma Screening   G0117  Glaucoma  screening  for high risk patients furnished by an optometrist or ophthalmologist   I  Not Waived   G0118  Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist    Not Waived    Influenza  Virus  Vaccine  For the Medicare -covered  codes  for the influenza vaccines approved by FDA for current influenza vaccine season, please go  to: https:// www.cms.gov/Medicare/Me  dicare -Fee-for-Service-Part-B - Drugs/McrPartBDrugAvgSalesPrice/Va  ccinesPricing.html    90630  Influenza virus vaccine, quadrivalent  (IIV4),  split virus, preservative free, for intradermal use   B  WAIVED
(Medicare Claims Processing Manual)
90630  Influenza virus vaccine, quadrivalent  (IIV4),  split virus, preservative free, for intradermal use   B  WAIVED     Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    90653  Influenza  virus  vaccine, inactivated, subunit, adjuvanted, for intramuscular use    WAIVED   90654  Influenza virus vaccine, split virus, preservative  free, for intradermal use, for adults ages 18 -64  WAIVED    90655  Influenza virus vaccine, split virus, preservative free, when administered to children 6 -35 months of age, for intramuscular use   WAIVED   90656  Influenza virus vaccine, split virus, preservative free, when  administered  to individuals 3 years and older, for intramuscular use  WAIVED   90657  Influenza  virus  vaccine,  split virus, when administered to children 6 - 35 months of age, for intramuscular use   WAIVED      90658  Influenza virus vaccine, trivalent  (IIV3),  split virus,  0.5 mL dosage,  for intramuscular use    WAIVED  90660  Influenza  virus  vaccine, live, for intranasal use  WAIVED    90661  Influenza virus vaccine, derived  from  cell cultures, subunit, preservative and antibiotic free, for intramuscular use    WAIVED   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible    90662  Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased  antigen  content, for intramuscular use    WAIVED   90672  Influenza virus vaccine, live, quadrivalent,  for intranasal use   WAIVED    90673  Influenza virus vaccine, trivalent, derived from recombinant  DNA (RIV3), hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use    WAIVED   90674  Influenza virus vaccine, quadrivalent (ccIIV4), derived  from  cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use  WAIVED       90682  Influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA,  hemagglutinin  (HA) protein only, preservative and antibiotic free, for intramuscular use     WAIVED
(Medicare Claims Processing Manual)
WAIVED   90685  Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered  to children  6- 35 months of age, for intramuscular use   WAIVED   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible     90686  Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered  to individuals  3 years of age and older, for intramuscular use    WAIVED    90687 Influenza virus vaccine, quadrivalent, split virus, when administered to children  6-35 months  of age, for intramuscular use    WAIVED    90688 Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age  and older, for intramuscular use    WAIVED    90694  Influenza virus vaccine, quadrivalent (aIIV4), inactivated, adjuvanted, preservative free, 0.5 mL dosage,  for intramuscular  use   WAIVED    90756  Influenza virus vaccine, quadrivalent (ccIIV4), derived  from  cell cultures, subunit, antibiotic free, 0.5mL dosage, for intramuscular use    WAIVED   G0008  Administration  of influenza virus vaccine   WAIVED                Pneumococcal Vaccine   90670  Pneumococcal  conjugate  vaccine,  13 valent,  for intramuscular use          B  WAIVED   90671  Pneumococcal conjugate vaccine,  15 valent  (PCV15), for intramuscular use   WAIVED   90677  Pneumococcal  conjugate vaccine,  20 valent  (PCV20),  for intramuscular  use  WAIVED    90732  Pneumococcal  polysaccharide vaccine, 23 -valent, adult or immunosuppressed patient dosage,  when  administered  to individuals 2 years or older, for subcutaneous or intramuscular use     WAIVED   G0009  Administration  of pneumococcal vaccine   WAIVED   Service  CPT/ HCPCS   Long  Descriptor  USPSTF  Rating  Coins./ Deductible   Hepatitis B Vaccine   90739  Hepatitis  B vaccine, adult  dosage  (2 dose schedule), for intramuscular use   A   WAIVED    90740  Hepatitis B vaccine, dialysis or immunosuppressed patient  dosage  (3 dose schedule), for intramuscular use     WAIVED