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awacke1/Generative-AI-Provider
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| No. | Service Type | CPT Code Range | Rules for Required Evidence of Medical Necessity |
|---|---|---|---|
| 1 | 🫀 Organ Transplant | 50300-50380 | Diagnosis📄, waiting list📃, physician referral👩⚕️ |
| 2 | 🦴 Spinal Fusion Surgery | 22532-22812 | Diagnosis📄, conservative treatment history📚, physician referral👩⚕️ |
| 3 | 🍔 Bariatric Surgery | 43644-43775 | BMI🏋️, documented weight loss attempts📉, physician referral👩⚕️, psychological evaluation🧠 |
| 4 | 🦵 Joint Replacement Surgery | 27130-27447 | Diagnosis📄, conservative treatment history📚, physician referral👩⚕️ |
| 5 | 💉 Chemotherapy | 96401-96549 | Cancer diagnosis🦠, treatment plan💊, medication💊, dosage💊, frequency💊 |
| 6 | ☢️ Radiation Therapy | 77261-77799 | Cancer diagnosis🦠, treatment plan💊, physician referral👩⚕️ |
| 7 | ❤️ Cardiac Surgery | 33010-33999 | Diagnosis📄, conservative treatment history📚, physician referral👩⚕️ |
| 8 | 🧊 Dialysis | 90935-90999 | Diagnosis of kidney disease🩸, treatment plan💊, physician referral👩⚕️ |
| 9 | 🫁 Gastrointestinal Surgery | 43620-44979 | Diagnosis📄, conservative treatment history📚, physician referral👩⚕️ |
| 10 | 🖼️ Advanced Imaging Services | 70450-72159 (CT), 70540-72198 (MRI) | Clinical history📚, prior relevant imaging📸, symptoms justification😷 |
| 11 | 🎯 Interventional Radiology | 37220-37235 | Diagnosis📄, conservative treatment history📚, physician referral👩⚕️ |
| 12 | 🛌 Sleep Study | 95800-95811 | Documented sleep disorder symptoms😴, sleep diary📘, physician referral👩⚕️ |
| 13 | 💉 Infusion Therapy | 96360-96549 | Diagnosis📄, medication💊, dosage💊, frequency💊, duration⏳ |
| 14 | 💊 Pain Management | 64400-64530 | Diagnosis📄, conservative treatment history📚, treatment plan💊 |
| 15 | ❤️ Cardiac Stress Test | 93015-93018 | Documented symptoms😷, cardiac risk factors❤️, physician referral👩⚕️ |
| 16 | 🫁 Pulmonary Function Test | 94010-94799 | Documented respiratory issues😷, physician referral👩⚕️ |