HCPCS Description Place of Service
36415 Routine venipuncture for collection of specimen(s) 11 – Office, 12 – Home
36416 Collection of capillary blood specimen 11 – Office, 12 – Home
59400 Vaginal delivery w/7 or more antepartum & postpartum 11 – Office, 12 – Home
59409 Vaginal delivery only 11 – Office, 12 – Home
59410 Vaginal delivery; including postpartum care 11 – Office, 12 – Home
59425 Antepartum care only; 4-6 visits 11 – Office, 12 – Home
59426 Antepartum care only; 7 or more visits 11 – Office, 12 – Home
59430 Post-partum care only 11 – Office, 12 – Home
59610 Routine OB care including antepartum, vaginal delivery & postpartum; after previous cesarean 11 – Office, 12 – Home
59612 Vaginal delivery only, after previous cesarean 11 – Office, 12 – Home
59614 Vaginal delivery only after cesarean, including postpartum 11 – Office, 12 – Home
59899 Unlisted maternity procedure (use for labor management in the event of transfer intrapartum) 11 – Office, 12 – Home
90471 Immunization administration, first vaccine. Single or combination vaccine/toxoid (use for injection of vaccination/rhogam injection) 11 – Office, 12 – Home
96360 Intravenous infusion, hydration 11 – Office, 12 – Home
96361 Each additional hour (list separately in addition to code for primary procedure) 11 – Office, 12 – Home
96365 IV for therapy, prophylaxis, or diagnosis (specify substance or drug); initial one (1) hour 11 – Office, 12 – Home
96366 Each additional hour (list separately in addition to code for primary procedure) 11 – Office, 12 – Home
99001 Handling and/or conveyance of specimen for transfer 11 – Office, 12 –
Home EVALUATION AND MANAGEMENT VISITS (99201 – 99348) can be used for initial patient visit
99201 New patient office visit problem focused 11 – Office, 12 – Home
99202 New patient office visit expanded problem 11 – Office, 12 – Home
99203 OV or OP evaluation new patient detailed 30 minutes 11 – Office, 12 – Home
99211 Established patient office visit problem focused 11 – Office, 12 – Home
99212 Established patient office visit expanded problem 11 – Office, 12 – Home
99213 OV or OP evaluation established patient detailed 30 minutes 11 – Office, 12 – Home
99341 Home visit new pt/a problem (low severity) 12 – Home
99342 Home visit new pt/expanded (moderate severity) 12 – Home
99347 Home visit for e/m of established patient; problem focused 12 – Home
99348 Home visit for e/m of established patients; expanded problem focused 12 – Home
99460 Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant 11 – Office
99461 Initial care, per day, for evaluation & management of normal newborn other than hospital or birthing center 12 – Home
99463 Initial hospital or birthing center per day for evaluation & management of normal newborn admit/discharge same day 11 – Office, 12 – Home
99465 Delivery/birthing room resuscitation: provision of positive pressure ventilation and/or chest compressions in presence of acute inadequate ventilation 11 – Office, 12 – Home A4217 Sterile water/saline, 500 ml 11 – Office, 12 – Home
J0171 Injection, adrenalin, epinephrine, 0.1 mg 11 – Office, 12 – Home
J0290 Injection, ampicillin, up to 500 mg 11 – Office, 12 – Home
J0561 Injection, penicillin g benzathine, per 100,000 units 11 – Office, 12 – Home
J0690 Injection, cefazolin sodium, ancef, kefzol, up to 500 mg 11 – Office, 12 – Home
J2590 Injection, oxytocin, up to 10 units 11 – Office, 12 – Home
J2790 Rho d immune globulin injection 300 mcg 11 – Office, 12 – Home
J3430 Injection, vitamin K, per 1 mg 11 – Office, 12 – Home
J3490 UNCLASSIFIED DRUGS (use for erythromycin ointment, or for lidocaine injection and attach a copy of the invoice to the claim) 11 – Office, 12 – Home
J7040 Infusion, normal saline solution, (500 ml=1 unit) 11 – Office, 12 – Home
J7050 Infusion, normal saline solution, 250 cc 11 – Office, 12 – Home
J7120 Ringers lactate infusion up to 1000 cc 11 – Office, 12 – Home
S0077 Injection, clindamycin phosphate, 300 mg 11 – Office, 12 – Home
S3620 Newborn metabolic screening, includes test kit, postage & lab tests specified
11 – Office, 12 – Home S5011 5% dextrose in lactated ringer’s, 1000 ml 11 – Office, 12 – Home
