| Limited Coverage Determination for Flow Cytometry - L-93B-R2 |
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| FLOW CYTOMETRY CODES: |
| 042 |
Human immunodeficiency virus (HIV) disease |
| 079.51–079.53 |
Retrovirus |
| 150.0-150.5 |
Malignant neoplasm of esophagus |
| 150.8-150.9 |
Malignant neoplasm of esophagus |
| 151.0-151.6 |
Malignant neoplasm of stomach |
| 151.8-151.9 |
Malignant neoplasm of stomach |
| 153.0-153.9 |
Malignant neoplasm of colon |
| 154.0 |
Malignant neoplasm of rectosigmoid junction |
| 154.1 |
Malignant neoplasm of rectum |
| 174.0-174.6 |
Malignant neoplasm of female breast |
| 174.8-174.9 |
Malignant neoplasm of female breast |
| 175.0 |
Malignant neoplasm of nipple and areola of male breast |
| 175.9 |
Malignant neoplasm of other and unspecified sites of male breast |
| 183.0 |
Malignant neoplasm of ovary |
| 183.8 |
Malignant neoplasm of other specified sites of uterine adnexa |
| 185 |
Malignant neoplasm of prostate |
| 188.0 |
Malignant neoplasm of trigone of urinary bladder |
| 188.1-188.9 |
Malignant neoplasm of bladder |
| 193 |
Malignant neoplasm of thyroid gland |
| 194.0 |
Malignant neoplasm adrenal gland |
| 197.2 |
Secondary malignant neoplasm of respiratory and digestive systems, pleura |
| 197.6 |
Secondary malignant neoplasm of respiratory and digestive systems, retroperitoneum and peritoneum |
| 198.81 |
Secondary malignant neoplasm of breast |
| 200.00-200.08 |
Reticulosarcoma |
| 200.10-200.18 |
Lymphosarcoma |
| 200.20-200.28 |
Burkitt's tumor or lymphoma |
| 200.30-200.38 |
Marginal zone lymphoma |
| 200.40-200.48 |
Mantle cell lymphoma |
| 200.50-200.58 |
Primary central nervous system lymphoma |
| 200.60-200.68 |
Anaplastic large cell lymphoma |
| 200.70-200.78 |
Large cell lymphoma |
| 200.80-200.88 |
Other named variants |
| 201.00-201.08 |
Hodgkin's paragranuloma |
| 201.10-201.18 |
Hodgkin's granuloma |
| 201.20-201.28 |
Hodgkin's sarcoma |
| 201.40-201.48 |
Lymphocytic-histiocytic predominance |
| 201.50-201.58 |
Nodular sclerosis |
| 201.60-201.68 |
Mixed cellularity |
| 201.70-201.78 |
Lymphocytic depletion |
| 201.90-201.98 |
Hodgkin's disease |
| 202.00-202.08 |
Nodular lymphoma |
| 202.10-202.18 |
Mycosis fungoides |
| 202.20-202.28 |
Szary's disease |
| 202.30-202.38 |
Malignant histiocytosis |
| 202.40-202.48 |
Leukemic reticuloendotheliosis |
| 202.50-202.58 |
Letterer-Siwe disease |
| 202.60-202.68 |
Malignant mast cell tumors |
| 202.70-202.78 |
Peripheral T cell lymphoma |
| 202.80-202.88 |
Other lymphomas |
| 202.90-202.98 |
Other and unspecified malignant neoplasms of lymphoid and histiocytic tissue |
| 203.00 |
Multiple myeloma, without mention of having achieved remission |
| 203.02 |
Multiple myeloma, in relapse |
| 203.10-203.12 |
Plasma cell leukemia |
| 203.80-203.82 |
Other immunoproliferative neoplasms |
| 204.00-204.02 |
Acute lymphoid leukemia |
| 204.10-204.12 |
Chronic lymphoid leukemia |
| 204.20-204.22 |
Subacute lymphoid leukemia |
| 204.80-204.82 |
Other lymphoid leukemia |
| 204.90-204.92 |
Unspecified lymphoid leukemia |
| 205.00-205.02 |
Acute myeloid leukemia |
| 205.10-205.12 |
Chronic myeloid leukemia |
| 205.20-205.22 |
Subacute myeloid leukemia |
| 205.30-205.32 |
Myeloid sarcoma |
| 205.80-205.82 |
Other myeloid leukemia |
| 205.90-205.92 |
Unspecified myeloid leukemia |
| 206.00-206.02 |
Acute monocytic leukemia |
| 206.10-206.12 |
Chronic monocytic leukemia |
| 206.20-206.22 |
Subacute monocytic leukemia |
| 206.80-206.82 |
Other monocytic leukemia |
| 206.90-206.92 |
Unspecified monocytic leukemia |
| 207.00-207.02 |
Acute erythremia and erythroleukemia |
| 207.10-207.12 |
Chronic erythremia |
| 207.20-207.22 |
Megakaryocytic leukemia |
| 207.80-207.82 |
Other specified leukemia |
| 208.00-208.02 |
Acute leukemia of unspecified cell type |
| 208.10-208.12 |
Chronic leukemia of unspecified cell type |
| 208.20-208.22 |
Subacute leukemia of unspecified cell type |
| 208.80-208.82 |
Other leukemia of unspecified cell type |
| 208.90-208.92 |
Unspecified leukemia |
| 227.0 |
Benign neoplasm of adrenal gland |
| 233.0 |
Carcinoma in situ of breast |
| 238.71-238.77 |
Neoplasm of uncertain behavior, other lymphatic and hematopoietic tissues |
| 238.79 |
Neoplasm of uncertain behavior, other lymphatic and hematopoietic tissues |
| 259.2 |
Carcinoid syndrome |
| 273.1–273.3 |
Disorders of plasma protein metabolism |
| 273.8–273.9 |
Disorders of plasma protein metabolism |
| 279.00–279.06 |
Deficiency of humoral immunity |
| 279.09 |
Deficiency of humoral immunity other |
| 279.10–279.13 |
Deficiency of cell-mediated immunity |
| 279.19 |
Deficiency of cell-mediated immunity other |
| 279.2–279.3 |
Disorders involving the immune mechanism |
| 279.41 |
Autoimmune lymphoproliferative syndrome |
| 279.49 |
Autoimmune disease, not elsewhere classified |
| 279.8–279.9 |
Disorders involving the immune mechanism |
| 282.7 |
Other hemoglobinopathies |
| 283.2 |
Hemoglobinuria due to hemolysis from external causes |
| 284.01 |
Constitutional red blood cell aplasia |
| 284.09 |
Other constitutional aplastic anemia |
| 284.1-284.2 |
Aplastic anemia and other bone marrow failure syndromes |
| 284.8-284.9 |
Aplastic anemia and other bone marrow failure syndromes |
| 285.0 |
Sideroblastic anemia |
| 285.22 |
Anemia in neoplastic disease |
| 285.8-285.9 |
Other and unspecified anemias |
| 287.30–287.33 |
Primary thrombocytopenia |
| 287.39 |
Other primary thrombocytopenia |
| 287.5 |
Thrombocytopenia, unspecified |
| 288.00-288.04 |
Neutropenia |
| 288.09 |
Other neutropenia |
| 288.1–288.4 |
Diseases of white blood cells |
| 288.3 |
Eosinophilia |
| 288.4 |
Hemophagocytic syndromes |
| 288.50-288.51 |
Decreased white blood cell count |
| 288.59 |
Other decreased white blood cell count |
| 288.60-288.65 |
Elevated white blood cell count |
| 288.69 |
Other elevated white blood cell count |
| 288.8–288.9 |
Other specified disease of white blood cells |
| 289.4 |
Hypersplenism |
| 289.50- 289.53 |
Other diseases of spleen |
| 289.59 |
Other diseases of spleen |
| 289.83 |
Myelofibrosis |
| 289.9 |
Unspecified diseases of blood and blood-forming organs |
| 785.6 |
Enlargement of lymph nodes |
| 789.2 |
Splenomegaly |
| 791.0 |
Proteinuria |
| 795.4 |
Other nonspecific abnormal histological findings |
| 996.80-996.87 |
Complications of transplanted organ |
| 996.89 |
Complications of transplanted organ, other specified transplanted organ |
| V08 |
Asymptomatic human immunodeficiency virus (HIV) infection status |
| V10.60-V10.63 |
Personal history of malignant neoplasm , leukemia |
| V10.69 |
Personal history of malignant neoplasm, leukemia, other |
| V10.91 |
Personal history of malignant neuroendocrine tumor |
| V42.0-V42.7 |
Organ or tissue replaced by transplant |
| V42.3 |
Organ or tissue replaced by transplant |
| V42.4 |
Organ or tissue replaced by transplant |
| V42.5 |
Organ or tissue replaced by transplant |
| V42.6-V42.7 |
Organ or tissue replaced by transplant |
| V42.81-V42.84 |
Organ or tissue replaced by transplant, other specified organ or tissue |
| V42.89 |
Organ or tissue replaced by transplant, other |
| V42.9 |
Unspecified organ or tissue replaced by transplant |
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