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CHC LABS INC.

GAMMA GLUTAMYL TRANSFERASE

(82977)

003.1

Salmonella septicemia

006.0-006.9

Acute amebic dysentery without abscess

014.00-014.86

Tuberculous peritonitis unspecified examination

017.90-017.96

Tuberculosis of other specified organs unspecified examination

018.90-018.96

Unspecified miliary tuberculosis unspecified examination

020.0-020.9

Bubonic plague

022.3

Anthrax septicemia

027.0

Listeriosis

027.1

Erysipelothrix infection

030.1

Tuberculoid leprosy (type T)

032.83

Diphtheritic peritonitis

036.1

Meningococcal encephalitis

036.2

Meningococcemia

038.0-038.9

Streptococcal septicemia

039.2

Abdominal actinomycotic infection

040.0

Gas gangrene

042

Human immunodeficiency virus (HIV) disease

054.0

Eczema herpeticum

054.5

Herpetic septicemia

060.0-060.1

Sylvatic yellow fever

070.0-070.9

Viral hepatitis A with hepatic coma

072.71

Mumps hepatitis

073.0

Ornithosis with pneumonia

074.8

Other specified diseases due to Coxsackie virus

075

Infectious mononucleosis

078.5

Cytomegaloviral disease

079.99

Unspecified viral infection

082.0-082.9

Spotted fevers

084.9

Other pernicious complications of malaria

086.1

Chagas’ disease with other organ involvement

088.81

Lyme disease

091.62

Secondary syphilitic hepatitis

095.3

Syphilis of liver

100.0

Leptospirosis icterohemorrhagica

112.5

Disseminated candidiasis

115.00

Infection by histoplasma capsulatum without manifestation

120.9

Schistosomiasis unspecified

121.1

Clonorchiasis

121.3

Fascioliasis

122.0

Echinococcus granulosus infection of liver

122.5

Echinococcus multilocularis infection of liver

122.8

Echinococcosis unspecified of liver

122.9

Echinococcosis other and unspecified

130.5

Hepatitis due to toxoplasmosis

135

Sarcoidosis

150.0-159.9

Malignant neoplasm of cervical esophagus

160.0-165.9

Malignant neoplasm of nasal cavities

170.0-176.9

Malignant neoplasm of bones of skull and face except mandible

179-189.9

Malignant neoplasm of uterus, part unspecified

 

272.9

Unspecified disorder of lipoid metabolism

273.4

Alpha-1 antitrypsin deficiency

275.0

Disorders of iron metabolism

275.1

Disorders of copper metabolism

275.3

Disorders of phosphorus metabolism

275.40-275.49

Unspecified disorder of calcium metabolism

277.1

Disorders of porphyrin metabolism

277.3

Amyloidosis

277.4

Disorders of bilirubin excretion

277.6

Other deficiencies of circulating enzymes

282.60-282.69

Sickle-cell anemia unspecified

286.6

Defibrination syndrome

286.7

Acquired coagulation factor deficiency

289.4

Hypersplenism

291.0-291.9

Alcohol withdrawal delirium

303.00-303.03

Acute alcoholic intoxication in alcoholism, unspecified drinking behavior

303.90-303.93

Other and unspecified alcohol dependence, unspecified drinking behavior

304.00-304.93

Opioid type dependence, unspecified use

305.00-305.93

Nondependent alcohol abuse, unspecified drinking behavior

357.5

Alcoholic polyneuropathy

359.2

Myotonic disorders

452

Portal vein thrombosis

453.0-453.9

Budd-Chiari syndrome

456.0-456.21

Esophageal varices with bleeding

555.0-555.9

Regional enteritis of small intestine

556.0-556.9

Ulcerative (chronic) enterocolitis

557.0

Acute vascular insufficiency of intestine

558.1-558.9

Gastroenteritis and colitis due to radiation

560.0-560.9

Intussusception

562.01

Diverticulitis of small intestine (without hemorrhage)

 

200.00-208.91

Reticulosarcoma unspecified site

211.5

Benign neoplasm of liver and biliary passages

211.6

Benign neoplasm of pancreas except islets of Langerhans

211.7

Benign neoplasm of islets of Langerhans

228.04

Hemangioma of intra-abdominal structures

230.7

Carcinoma in situ of other and unspecified parts of intestine

230.8

Carcinoma in situ of liver and biliary system

230.9

Carcinoma in situ of other and unspecified digestive organs

235.0-238.9

Neoplasm of uncertain behavior of major salivary gland

239.0

Neoplasm of unspecified nature of digestive system

250.00-250.93

Diabetes mellitus without complication type II or unspecified type not stated as uncontrolled

252.00-252.02

Hyperparathyroidism

263.1

Malnutrition of mild degree

263.9

Unspecified protein-calorie malnutrition

268.0

Rickets active

268.2

Osteomalacia unspecified

269.0

Deficiency of vitamin K

270.2

Other disturbances of aromatic amino-acid metabolism

270.9

Unspecified disorder of amino-acid metabolism

271.0

Glycogenosis

272.0

Pure hypercholesterolemia

272.1

Pure hyperglyceridemia

272.2              Mixed hyperlipidemia

272.4 Other and unspecified hyperlipidemia

Lipidoses

 

272.7


 

562.03

Diverticulitis of small intestine with hemorrhage

562.11

Diverticulitis of colon (without hemorrhage)

562.13

Diverticulitis of colon with hemorrhage

567.0

Peritonitis in infectious diseases classified elsewhere

567.1

Pneumococcal peritonitis

567.21

Peritonitis (acute) generalized

567.22

Peritoneal abscess

567.23

Spontaneous bacterial peritonitis

567.29

Other suppurative peritonitis

567.38

Other retroperitoneal abscess

567.39

Other retroperitoneal infections

567.81

Choleperitonitis

567.82

Sclerosing mesenteritis

567.89

Other specified peritonitis

567.9

Unspecified peritonitis

569.83

Perforation of intestine

570

Acute and subacute necrosis of liver

571.0-571.9

Alcoholic fatty liver

572.0-572.8

Abscess of liver

573.0-573.9

Chronic passive congestion of liver

574.00-574.91

Calculus of gallbladder with acute cholecystitis without obstruction

575.0-575.9

Acute cholecystitis

576.0-576.9

Postcholecystectomy syndrome

581.0-581.9

Nephrotic syndrome with lesion of proliferative glomerulonephritis

582.0-582.9

Chronic glomerulonephritis with lesion of proliferative glomerulonephritis

583.0-583.9

Nephritis and nephropathy not specified as acute or chronic with lesion of proliferative glomerulonephritis

584.5-584.9

Acute renal failure with lesion of tubular necrosis

585.6

End Stage Renal Disease

586

Renal failure unspecified

587

Renal sclerosis unspecified

588.0-588.9

Renal osteodystrophy

590.00-590.9

Chronic pyelonephritis without lesion of renal medullary necrosis

642.50-642.54

Severe pre-eclampsia unspecified as to episode of care

646.70

Liver disorders in pregnancy unspecified as to episode of care

646.71

Liver disorders in pregnancy with delivery

646.73

Antepartum liver disorders

782.4

Jaundice unspecified, not of newborn

789.1

Hepatomegaly

790.4

Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase (LDH)

790.5

Other nonspecific abnormal serum enzyme levels

960.0-979.9

Poisoning by penicillins

980.0-989.89

Toxic effect of ethyl alcohol

V42.7

Liver replaced by transplant

V58.61-V58.69

Long-term (current) use of anticoagulants

V67.1

Follow-up examination following radiotherapy

V67.2

Follow-up examination following chemotherapy

V67.51

Follow-up examination following completed treatment with high-risk medication not elsewhere classified

 

 

   This policy has been duplicated from the most current Medicare National Coverage Determination or Local Medical Review Policy available at the time this booklet was printed in October 2005. Medicare will consider this test(s) medically reasonable and necessary only if the test(s) was performed for any of the diagnoses/conditions listed on this page. This information is subject to change without notice, and Covenant Health Care Labs (CHC) is not responsible for consequences that may result from using such information. CHC is not indicating one code is more acceptable than another, and that selected codes should reflect the patients actual medical condition as noted in their medical record.

 

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