Authorization Denials 1 822-822 Status US only on CRs Units UNIT_REQ Units INT 3 823-825 Requested Requested in this CR Units UNIT_APPR Units INT 3 826-828 Approved Approved in this CR CPT 1 Code CPT1_CODE First CPT 5 829-833 Code of CR CPT 1 Units CPT1_UNITS Units for INT 3 834-836 this CPT code in this CR CPT 1 CPT1_MOD1 2 837-838 Modifier 1 CPT 1 CPT1_MOD2 2 839-840 Modifier 2 CPT 2 Code CPT2_CODE Second CPT 5 841-845 Code of CR CPT 2 Units CPT2_UNITS Units for INT 3 846-848 this CPT code in this CR CPT 2 CPT2_MOD1 2 849-850 Modifier 1 CPT 2 CPT2_MOD2 2 851-852 Modifier 2 CPT 3 Code CPT3_CODE Third CPT 5 853-857 Code of CR CPT 3 Units CPT3_UNITS Units for INT 3 858-860 this CPT code in this CR CPT 3 CPT3_MOD1 2 861-862 Modifier 1 CPT 3 CPT3_MOD2 2 863-864 Modifier 2 CPT 4 Code CPT4_CODE Fourth CPT 5 865-869 Code of CR CPT 4 Units CPT4_UNITS Units for INT 3 870-872 this CPT code in this CR CPT 4 CPT4_MOD1 2 873-874 Modifier 1 CPT 4 CPT4_MOD2 2 875-876 Modifier 2
Authorization Status Denials only on CRs 1 822-822 Units Requested UNIT_REQ Units Requested in this CR INT 3 823-825 Units Approved UNIT_APPR Units Approved in this CR INT 3 826-828 CPT 1 Code CPT1_CODE First CPT Code of CR 5 829-833 CPT 1 Units CPT1_UNITS Units for this CPT code in this CR INT 3 834-836 CPT 1 Modifier 1 CPT1_MOD1 2 837-838 CPT 1 Modifier 2 CPT1_MOD2 2 839-840 CPT 2 Code CPT2_CODE Second CPT Code of CR 5 841-845 CPT 2 Units CPT2_UNITS Units for this CPT code in this CR INT 3 846-848 CPT 2 Modifier 1 CPT2_MOD1 2 849-850 CPT 2 Modifier 2 CPT2_MOD2 2 851-852 CPT 3 Code CPT3_CODE Third CPT Code of CR 5 853-857 CPT 3 Units CPT3_UNITS Units for this CPT code in this CR INT 3 858-860 CPT 3 Modifier 1 CPT3_MOD1 2 861-862 CPT 3 Modifier 2 CPT3_MOD2 2 863-864 CPT 4 Code CPT4_CODE Fourth CPT Code of CR 5 865-869 CPT 4 Units CPT4_UNITS Units for this CPT code in this CR INT 3 870-872 CPT 4 Modifier 1 CPT4_MOD1 2 873-874 CPT 4 Modifier 2 CPT4_MOD2 2 875-876 US
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx