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California Children's Services (CCS) Program Service Code ...

By Greg Rose,2014-04-30 22:55
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California Children's Services (CCS) Program Service Code ...Code,CCS),ccs,CCS

    California Children’s Services (CCS) Program cal child ser Service Code Groupings 1

    This section identifies California Children’s Services (CCS) Service Code Groupings (SCGs). An SCG is a group of procedure codes authorized to a CCS-approved provider for the provision of a group of

    related health care services that are authorized through the Service Authorization Request (SAR) process.

    An SCG SAR enables the provider to render care to a CCS client without obtaining repeated procedure-

    specific SARs.

The following effective dates are listed throughout the section:

i December 1, 2010 m April 1, 2011 q August 1, 2011

    j January 1, 2011 n May 1, 2011 r September 1, 2011

    s October 1, 2011 k February 1, 2011 o June 1, 2011

    l March 1, 2011 p July 1, 2011

INCLUDE SERVICE CODE GROUPS 01 THROUGH 12

Physician Service The following is a list of codes that comprise SCG 01 for physicians.

    Code Group 01

     Authorized HCPCS Codes in Physician SCG 01

    HCPCS C9264 J0580 J1250 n J1930J1931

    Codes C9272 j J0595 q J1260 J1945

    A4217 C9277 l J0598 J1265 J1953

    J0636 J1267 A4648 C9280 o J2001 p

    A4650 C9729 p J0640 J1270 J2150 s

    A9500A9505 G0430 o J0670 q J1300 J2175

    A9507A9510 G0431 J0690 l J1440J1441 J2248

    A9512 G0434 o J0696 J1451 J2270J2271

    A9516A9517 G3001 J0702 J1453 J2275

    A9521 J0129 J0718 J1455 J2278

    A9524 J0132J0133 J0735 n J1458 J2300 n

    A9526A9532 J0135 J0775 l J1460 o J2315

    A9536A9548 J0150 k J0795 J1560 o J2323

    A9550A9554 J0152 k J0833J0834 J1571 J2325

    A9556A9564 J0180 J0878 J1573 J2357

    A9566A9567 J0210 p J0881J0882 J1610 k J2405

    A9569A9572 J0220 l J0885J0886 J1626 J2425 J1630J1631 n A9576A9580 J0278 p J0894 J2469 J1640 A9581A9583 J0285 j J0895 n J2501 J1642 p A9600 J1020 J2503J2505 J0287J0289 j J1644 p A9604 J0290 n J1030 J2562 J1680 A9698A9699 J0300 p J1040 J2675 n J1720 r C2634C2635 J0330 p J1051 i J2700 s J1740 C2637C2641 J0348 J1055 J2724 J1743 C2698C2699 J0360 p J1070 J2778 J1745 C8929C8930 J0400 J1080 J2785 J1750 C9255 J0461 J1100 J2792 J1756 j C9256 l J0480 J1160 r J2793 J1785 m C9259 J0559J0560 J1162 J2794 J1786 m J0570 J1170 2 California Children’s Services (CCS) Program Service Code Groupings November 2011

    cal child ser

    2

     Authorized HCPCS Codes in Physician SCG 01 (continued)

    X5662 J2796 J9208 p X5522 k X5826 m J2805 J9209 o X5528 X5666 m X5828 m J2850 J9260J9261 X5530 X5668 m X5840 m J2920 J9263J9264 X5534 m X5672 X5842 m J2930 J9266 X5536 m X5674 X5844 m J3070 n J9280 m X5540 p X5676 X5846 m J3120 J9303 X5550 n X5678 m X5848 m J3240 J9305 X5552 j X5680 m X5854 J3243 J9310 X5556 X5682 m X5856 J3285 J9320 n X5558 p X5708 X5866 m J3300 J9328 X5560 p X5710 m X5868 m J3301 j J9330 X5562 p X5712 m X5872 m J3303 j J9350 X5564 X5714 m X5880 j J3315 r J9355 X5566 p X5716 m X5882 m J3357 m J9370 n X5572 j X5718 m X5888 m

    X5576 n X5720 s X5890 m J3370 J9390

    J3385 l J9395 k X5578 n X5722 s X5892 m J3396 P9010P9012 X5580 n X5724 s X5894 m J3487J3488 P9016P9017 X5582 n X5726 s X5896 m J3490 P9019P9023 X5584 n X5728 X5898 m J3590 P9031P9041 X5586 n X5738 X5904 m J7310J7311 P9043P9048 X5588 n X5740 X5906 m J7312 l P9050P9060 X5598 m X5744 X5908 m J7321 Q0111Q0113 X5600 X5750 m X5910 m J7325 Q0138Q0139 X5602 l X5752 X5912 m J7605J7606 Q0166 X5604 l X5756 X5914 m J7611 Q2043 p X5606 l X5762 m X5918 J7613 Q2044 p X5608 l X5774 r X5920 J7639 Q3014 X5610 l X5776 X5922 J8705 Q9951 X5612 l X5778 m X5924 J9000 Q9953Q9967 X5614 l X5780 m X5926

    X5928 J9001 Q9968 X5620 m X5782 m

    J9025 S0077 X5622 X5784 m X5930 J9027 S0145 X5628 X5786 X5932 m J9033 S0164 X5630 m X5790 X5934 m

    X5792 J9035 S0189 X5632 X5942 m J9041 S0265 X5636 p X5794 X5944 m J9045 S3713 X5640 m X5796 q X5960 m

    X5642 X5798 q X5962 m J9055 S3860

    J9062 S3862 X5644 X5800 m X5964 m J9070 n T1014 X5646 X5802 m X5966 m J9150 X4522 X5648 p X5804 X5970 J9160 X5500 X5650 X5808 X5972 J9171 X5509 X5652 X5810 m J9175 X5514 m X5654 m X5818 q

    J9185 j X5516 m X5656 p X5820 q

    J9201 X5518 m X5658 m X5822 q

    J9206J9207 X5520 m X5660 X5824 q

    2 California Children’s Services (CCS) Program Service Code Groupings November 2011

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     Authorized HCPCS Codes in Physician SCG 01 (continued)

    X5980 r X6126 X6242 X6366 X6482 p X5984 m X6136 X6252 k X6408 X6486 p X5988 r X6138 m X6254 k X6410 m X6488 p X5992 m X6140 m X6258 X6422 X6490 p X6012 n X6146 m X6262 X6424 X6492 p X6014 X6158 m X6264 X6426 X6494 p X6018 X6160 m X6274 n X6432 k X6496 p X6030 X6162 m X6282 p X6434 m X6504 X6042 X6164 X6284 p X6436 m X6506 X6046 i X6166 X6286 p X6438 m X6512 X6048 i X6168 m X6288 p X6440 X6514 X6058 X6174 X6296 p X6442 m X6516

    X6178 X6060 m X6298 p X6444 p X6520 s X6062 X6196 m X6302 p X6452 m X6522 s X6064 X6198 m X6304 p X6454 m X6524 s X6070 X6204 m X6306 p X6456 m X6526 s X6080 r X6206 X6308 p X6458 m X6528 s X6082 r X6208 X6320 X6460 m X6530 X6084 X6214 m X6326 X6462 p X6532 m X6106 m X6216 X6328 m X6464 p X6534 m X6108 n X6220 X6330 m X6466 p X6550 m X6110 X6222 X6332 r X6470 p X6552 m X6114 m X6226 m X6334 r X6474 p X6116 m X6228 X6336 X6476 p

    X6118 m X6236 X6352 m X6478 p

    X6122 m X6240 X6354 X6480 p

    2 California Children’s Services (CCS) Program Service Code Groupings November 2011

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    Authorized HCPCS Codes in Physician SCG 01 (continued)

    X6556 m X6706 X6944 m X7546 X9940 X6558 m X6714 X6968 X7548 X9942 X6560 X6716 X6970 m X7550 X9944 X6562 m X6718 X6972 m X7551 m X9946 X6566 X6720 n X6974 m X7552 X9948 X6578 m X6728 m X6976 k X7564 X9950 X6582 m X6730 m X6978 m X7566 m X9952 X6588 m X6732 m X6980 m X7568 m X9954 X6598 m X6734 m X6984 m X7570 n X9956 X6600 m X6736 m X6996 m X7572 n X9958 X6604 X6738 m X7010 X7574 n X9960 X6606 X6740 m X7025X7027 X7576 X9962

    X7578 X6610 X6742 X7052 X9964 X6612 n X6754 X7060X7061 X7584 p X9966 X6614 X6758 X7122 X7586 o X9968

    X6760 m X7624 X6616 X7364 X9970 X6618 m X6764 m X7632 X7366 Z0100 X6620 X6776 m X7434 X7638 Z0102 X6622 X6778 m X7436 X7642 Z0104 X6624 X6780 m X7444 X7644 j Z0106 X6626 X6782 m X7470 m X7646 Z0108 X6628 m X6784 m X7488 n X7648 r Z0306 X6630 X6792 X7490 X7654 k Z0316 X6632 X6794 X7492 j X7700 Z0324 X6634 X6810 n X7496 X7702 Z0326 X6636 m X6816 X7498 X7706 Z0328Z0329 X6638 X6826 m X7504 X7708 Z7500 X6640 m X6828 p X7506 X7710 Z7502

    X7716 X6642 m X6830 p X7508 Z7504 X6644 m X6832 m X7510 X7718 Z7506 X6646 m X6856 m X7512 X7720 Z7508

    X7724 X6648 m X6862 m X7520 Z7510 X6656 s X6864 m X7522 n X7726 Z7512 X6658 m X6870 m X7524 n X9922 Z7514 X6660 m X6888 r X7526 n X9924 Z7600

    X9926 X6664 m X6890 r X7528 Z7602 X6666 X6892 r X7530 X9928 Z7610 X6670 m X6894 r X7532 X9930 Z7612

    X9932 X6672 m X6896 m X7536 m X6700 X6912 m X7540 m X9934

    X6702 X6920 X7542 X9936

    X6704 X6942 X7544 X9938

    2 California Children’s Services (CCS) Program Service Code Groupings November 2011

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     Authorized CPT-4 Codes in Physician SCG 01

CPT-4 01202 00406 00640 00882

    Codes 00410 00670 00902 01210 00100 00450 00700 00904 01212 0010200104 00452 00702 00906 0121401215 00120 00454 00730 00908 01220 00124 00470 00740 00910 01230 00126 00472 00750 00912 01232 00140 00474 00752 00914 01234 00142 00500 00754 00916 01250 0014400145 00520 00756 00918 01260 0014700148 00522 00770 0092000922 01270 00160 00524 00790 00924 01272 00162 00528 00792 00926 01274 00164 00529 00794 00928 01320 00170 00530 0079600797 00930 01340 00172 00532 00800 00932 01360 00174 00534 00802 00934 01380 00176 00537 00810 00936 01382 00190 0053900542 00820 00938 01390 00192 00546 00830 00940 01392 00210 00548 00832 00942 01400 00211 00550 00834 00944 01402 00212 00560 00836 00948 01404 0021400216 00561 00840 00950 01420 00218 0056200563 00842 00952 01430 00220 00566 00844 01112 01432 00222 00567 00846 01120 01440 00300 00580 00848 01130 01442 00320 00600 00851 01140 01444 00322 00604 00860 01150 01462 00326 00620 00862 01160 01464 00350 00622 0086400866 01170 01470 00352 0062500626 00868 01173 01472 00400 00630 00870 01180 01474 00402 00632 0087200873 01190 01480

    01200 00404 0063400635 00880

    2 California Children’s Services (CCS) Program Service Code Groupings October 2010

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     Authorized CPT-4 Codes in Physician SCG 01 (continued)

    01482 29260 01860 11750 3162631627 01484 01916 11752 29280 3162831633 01486 01920 11760 29305 3163531638 01490 01922 11762 29325 3164031641 01500 0192401926 11765 29345 31643 01502 0193001933 1200112002 29355 3164531646 01520 0193501936 1200412007 29358 31656 01522 0195101953 12011 29365 3242132422 01610 01958 1201312018 29405 3255032551 01620 0196001963 1202012021 29425 32552 01622 0196501966 1203112032 29435 32560 01630 0196701969 1203412037 29440 3256132562 01634 0199001992 1204112042 29445 36000 01636 01996 1204412047 29450 36400 01638 01999 1205112057 29505 3640536406 01650 1002110022 1310013102 29515 36410 01652 10040 1312013122 29520 36420 01654 1006010061 1313113133 29530 36425 01656 10120 1315013153 29540 36500 01670 10121 13160 29550 36510 01680 10140 1400014001 29580 3655536558 01682 10160 1402014021 29581 3656036561 01710 10180 1404014041 29590 36563 01712 1100011001 1406014061 29700 3656536566 01714 1100411006 1430114302 29705 3656836571 01716 11008 14350 29710 3657536576 01730 1104011041 15851 29715 36578 01732 1104211044 16000 29720 3658036585 01740 1105511057 16020 29730 3658936590 01742 1110011101 17000 29740 36593 01744 1120011201 1700317004 29750 3659536597 01756 1140011404 1710617107 30000 36598 01758 11406 1711017111 30020 36600 01760 1142011424 17250 30200 36620 01770 11426 2101121012 30300 36625 01772 1144011444 2601026011 30901 36640 01780 11446 29049 30903 36660 01782 1160011604 29055 3090530906 36680 01810 11606 29058 31000 3822038221 01820 1162011624 29065 31002 38300 0182901830 11626 29075 31231 38500 01832 1164011644 29085 31500 38505 01840 11646 29105 31502 40800 01842 1172011721 2912529126 31603 40804

    2913029131 01844 11730 31605 4080801850 11732 29200 31620

    01852 11740 29240 3162231625

    2 California Children’s Services (CCS) Program Service Code Groupings September 2011

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     Authorized CPT-4 Codes in Physician SCG 01 (continued)

    4081940820 7055770559 57415 69100 72240 4083040831 6100061001 69105 71010 72255 41000 61070 69200 71015 72265 41005 62267 69210 7102071023 72270 41800 62270 69420 71030 72275 42000 62272 70010 7103471035 72285 4323443237 62284 70015 71040 7229172292 43239 6229062291 70030 71060 72295 4376043761 6231062311 70100 71090 73000 46600 6231862319 70110 7110071101 73010 49080 64450 70120 7111071111 73020 4944049442 64455 70130 71120 73030 49446 64632 70134 71130 73040 4945049452 65205 70140 71250 73050 49460 65210 70150 71260 73060 49465 65220 70160 71270 73070 5110051102 65222 70170 71275 73080 51600 65430 70190 7155071552 73085 51605 65435 70200 71555 73090 51610 65800 70210 72010 73092 51700 65805 70220 72020 73100 5170151703 67500 70240 72040 73110 51705 67515 70250 72050 73115 51710 67700 70260 72052 73120 5172551726 67710 70300 7206972070 73130 5172751729 67715 70310 72072 73140 51736 67800 70320 72074 7320073202 51741 67801 70328 72080 73206 s 5178451785 67805 70330 72090 7321873223 51792 67810 70332 72100 732255179751798 67820 70360 72110 73500 5360053601 67840 70370 72114 73510 5362053621 67850 70373 72120 73520 5366053661 67930 70380 7212572133 73525 53855 67935 70390 7214172142 73530

    73540 54000 67938 70450 7214672149 54050 68020 70460 7215672158 73542 54055 68040 70470 72159 73550 54056 68100 7048070482 72170 73560 54057 68110 7048670488 72190 73562 54060 68200 7049070492 72191 s 7356473565 54065 68801 70496 s 7219272197 73580 54500 68810 70498 s 72198 73590 56442 68840 70540 72200 73592 57400 69000 7054270549 72202

    57410 69020 7055170553 72220

    2 California Children’s Services (CCS) Program Service Code Groupings November 2011

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     Authorized CPT-4 Codes in Physician SCG 01 (continued)

73600 74425 78135 75820 76776

    73610 74430 75822 7680076802 78140 73615 74440 75825 76805 78185 73620 74445 75827 7681076812 7819078191 73630 74450 75831 7681576817 78195 73650 74455 75833 7682076821 78199 73660 74470 75840 7682576828 7820178202 7370073702 74475 75842 7683076831 7820578206 73706 s 74480 75860 7685676857 7821578216 7371873723 74485 75870 76870 78220 73725 74710 75872 7687276873 78223 74000 74740 75880 76880 7823078232 74010 74775 75885 7688576886 78258 74020 75600 75887 76930 7826178262 74022 75605 75889 76932 78264

    76937 74150 75625 75891 7827078272

    76940 74160 75630 75893 78278 74170 75650 75984 7694176942 78282 74175 s 75658 75989 76946 7829078291 7418174183 75660 7599275996 76950 7829978300 74185 75662 7600076001 76965 7830578306 74190 75665 76010 76970 78315 74210 75671 76080 76975 78320 74220 75676 76098 76998 78399 74230 75680 7610076102 76999 78414 74235 75685 76120 7700177003 78428 7424074241 75705 76125 7701177014 78445 7424574247 75710 76140 7702177022 7845378454 7424974251 7703177032 75716 76150 7845678458 74260 75722 76350 7705177059 78466 74270 75724 76380 7707177077 78468 74280 7708077081 75726 7649676499 78472 74283 75731 76506 7800078001 7860078601 7429074291 75733 76510 78003 7860578606 7430074301 75736 7651176513 7800678007 7860978610 74305 7801078011 75741 76514 78630 74320 75743 76516 7801578016 78635 7432774330 75746 76519 78018 78645 74340 78020 75756 76529 78650 74355 75774 76536 78070 78660 74360 75791 76604 78075 7869978701 74363 75801 76645 78099 7870778709 74400 75803 76700 7810278104 78725 74410 75805 76705 7811078111 78730 74415 7812078122 75807 76770 78740 74420 7580975810 76775 78130 78761

    2 California Children’s Services (CCS) Program Service Code Groupings November 2011

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     9

     Authorized CPT-4 Codes in Physician SCG 01 (continued)

7879978802 8018480186 82696 82150 82482

    78804 80188 82154 8248582489 82705 7880578806 80190 82157 8249182492 82710 78808 80192 82160 82495 82715 78990 80194 8216382164 82507 8272582726 78999 80195 82172 82520 82728 79005 8019680198 82175 82523 82731 79101 8020080202 82180 82525 82735 79200 80299 82205 82528 82742 79300 8100081003 82232 82530 8274682747 79403 81005 8223982240 82533 8275982760 79440 81007 8224782248 8254082544 8277582776 79445 81015 82252 82550 8278482785 79900 81025 82261 8255282554 8278782788 79999 81050 82270 82565 82800 80047 81099 8227182272 82570 82803 80048 82000 82274 82575 82805 80051 82003 82286 82585 82810 80053 8200982010 82300 82595 82820 80055 82013 82306 82600 82926 80061 8201682017 82308 8260782608 82928 80069 82024 82310 82610 82938 80074 82030 8233082331 82615 82941 80076 82040 82340 8262682627 82943 8010080101 o 8204282044 82355 8263382634 8294582948 80102 82045 82360 82638 8295082953 80150 82055 82365 82646 82955 80152 82085 82370 82649 82960 80154 82088 8237382376 8265182652 8296282963 8015680158 82101 8237882380 82654 82965 80160 8210382106 8238282384 82656 82975 80162 82107 82387 8265782658 8297782980 80164 82108 82390 82664 82985 80166 82120 82397 82666 8300183003 80168 8212782128 82415 82668 83008 80170 82131 8243582436 8267082672 83009 8017280174 8213582136 82438 82677

    80176 8213982140 82441 82679

    80178 82143 82465 82690

    80182 82145 82480 82693

    2 California Children’s Services (CCS) Program Service Code Groupings September 2011

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     Authorized CPT-4 Codes in Physician SCG 01 (continued)

83010 84597 83695 83986 84270

    8301283015 83698 83987 84275 84600 83018 8370083701 83992 84285 84620 8302083021 83704 83993 84295 84630 83026 8371883719 84022 84300 84681 83030 83721 84030 84302 8470284703 83033 83727 84035 84305 84704 83036 83735 84060 84307 84830 83045 83775 84066 84311 84999 8305083051 83785 84075 84315 85002 83055 8378883789 84078 8437584379 85004 83060 83805 8408084081 84392 8500785009 83065 83825 84085 8440284403 8501385014 8306883071 83835 84087 84425 85018 83080 83840 84100 84430 85025 83088 8385783858 8410584106 84432 85027 83090 83864 84110 8443684437 85032 83150 83866 8411984120 84439 85041 83491 8387283874 8412684127 8444284443 8504485046 8349783500 83876 8413284135 8444584446 8504885049 83505 83880 84138 84450 85055 83516 83883 84140 84460 85060 8351883520 83885 8414384144 84466 85097 83525 83887 84146 8447884482 85130 8352783528 8389083894 84150 8448484485 85170 83540 8389683898 8415284157 84488 85175 83550 83900 84160 84490 85210 83570 8390183906 84163 84510 85220

    84512 83582 8390783909 8416584166 85230 83586 83912 8418184182 84520 85240 83593 83913 8420284203 84525 8524485247

    84540 83605 83914 8420684207 85250 83615 8391583916 84210 84545 85260 83625 8391883919 84220 84550 85270 83630 83921 84228 84560 85280

    8457784578 83631 83925 8423384235 8529085293 8363283634 83930 84238 84580 8530085303 83655 83935 84244 84583 8530585307

    84585 8366183664 83945 84252

    83670 83951 s 84255 84588

    83690 83970 84260 8459084591

    2 California Children’s Services (CCS) Program Service Code Groupings September 2011

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