Ablation of prostate, transrectal, Special high intensity focused ultrasound Coverage C9747 Add 7/1/17 New surgical procedure effective July 1, 2017. (HIFU), including imaging Instructions guidance Effective Special Notes HCPCS Action Long Descriptor Date COV (Any reference or xref code) Service furnished under a reciprocal billing arrangement by a substitute physician; or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a Q5 Modification rural area 7/1/2017 Service furnished under a fee-for-time compensation arrangement by a substitiute physician; or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically Q6 Modification underserved area, or a rural area 7/1/2017 Not payable by J1725 Modification 7/1/2017 Medicare by Levonorgestrel-releasing intrauterine contraceptive Medicare Add system (Kyleena), 19.5 mg 7/1/2017 statute 1862 (A) (1) Injection, hydroxyprogesterone caproate, not Carrier Q9985 Add otherwise specified, 10 mg 7/1/2017 Judgement Injection, hydroxyprogesterone caproate Carrier Add (Makena), 10 mg 7/1/2017 Judgement
C9747 Add Ablation of prostate, transrectal, high intensity focused ultrasound (HIFU), including imaging guidance 7/1/17 Special Coverage Instructions New surgical procedure effective July 1, 2017. HCPCS Action Long Descriptor Effective Date COV Special Notes (Any reference or xref code) Q5 Modification Service furnished under a reciprocal billing arrangement by a substitute physician; or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area 7/1/2017 Q6 Modification Service furnished under a fee-for-time compensation arrangement by a substitiute physician; or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area 7/1/2017 J1725 Modification 7/1/2017 Not payable by Medicare Add Levonorgestrel-releasing intrauterine contraceptive system (Kyleena), 19.5 mg 7/1/2017 by Medicare statute 1862 (A) (1) Q9985 Add Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg 7/1/2017 Carrier Judgement Add Injection, hydroxyprogesterone caproate (Makena), 10 mg 7/1/2017 Carrier Judgement