Read MEDICAID GUIDELINE text version

MEDICAID CODING GUIDELINE Effective: 4-1-02

SURGICAL (STERILE) TRAYS CODE:

A4550

PROCEDURES THAT ALLOW A SURGICAL (STERILE) TRAY:

G0105 19101 19120 19125 19126 20200 20205 20220 20225 20240 25111 28290 28292 28293 28294 28296 28297 28298 28299 32000 37609 38220 38221 38500 43200 43202 43220 43226 43234 43235 43239 43245 43247 43249 43250 43251 43258 45378 45379 45380 45382 45383 45384 45385 49080 49081 52005 52007 52010 52204 52214 52224 52234 52235 52240 52250 52260 52270 52275 52276 52277 52282 52283 52290 52300 52301 52305 52310 52315 57520 57522 58120 62270 96440 96445 96450

SP/4-1-02 Revised ­ BK/1/1/05

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MEDICAID GUIDELINE

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