|
Specialty
|
Laboratory/Pathology
|
Radiology
|
|
All Practitioners/All Specialties
Note: Those codes listed under "All Specialties" will not appear under
each specific specialty heading, but do apply.
|
36415
81000
81001
81002
81003
81005
81025
82044
82270
82272
82274
85013
85014
85018
86580
87804
87880
|
n/a
|
|
Cardiology
|
see "All Specialties"
|
71010
71015
71020
71021
71022
71030
71035
76825
76826
76827
76828
78451
78452
78453
78454
78466
78468
78469
78472
78473
78481
78483
|
|
Dermatology/Dermatopathology
|
87101
87177
87207
87210
87220
88300
88302
88304
88305
88307
88309
88311
88312
88313
88314
|
n/a
|
|
Endocrinology
|
82947
82948
82962
83036
83037
|
76536
76942
77080
77801
78000
78001
78003
78006
78007
78010
78011
78070
78075
78350
78351
|
|
Family Practice
General Practice
Internal Medicine
|
82947
82948
82962
83036
83655
84703
85007
85025
85651
86403 [Serum test, requires Clinical Laboratory Improvement Amendments (CLIA) certification]
87081 [Requires CLIA certification]
87086 [Requires CLIA certification]
87210
87220
|
71010
71015
71020
71021
71022
71030
71035
71100
71101
71110
71111
71120
71130
73000
73010
73020
73030
73040
73050
73060
73070
73080
73085
73090
73092
73100
73115
73120
73130
73140
73500
73510
73520
73525
73540
73542
73550
73560
73562
73564
73565
73580
73590
73592
73600
73610
73615
73620
73630
73650
73660
|
|
Gastroenterology
|
85651
|
76700
76705
78267
78268
|
|
General Surgery
|
see "All Specialties"
|
all radiology except advanced procedures (CT, MRI, PET)
|
|
Hematology/Oncology
|
85004
85007
85008
85009
85025
85027
85032
85044
85060
85097
85610
89050
89051
|
n/a
|
|
Maternal/Fetal Medicine
|
see "All Specialties"
|
76801
76802
76805
76810
76811
76812
76813
76814
76815
76816
76817
76818
76819
76820
76821
76825
76826
76827
76828
|
|
Nephrology
|
85651
|
76770
76775
76776
76942
|
|
Neurosurgery
|
see "All Specialties"
|
all radiology except advanced procedures (CT, MRI, PET)
|
|
Obstetrics/Gynecology
|
82947
82948
82962
84703
85007
85025
85027
87210
89260
89261
89300
89310
89320
89321
89322
89330
|
76801
76802
76805
76810
76811
76812
76813
76814
76815
76816
76817
76818
76819
76830
76831
76856
76857
76945
76946
77051
77052
77055
77056
77057
77080
77081
G0202
G0204
G0206
|
|
Ophthalmology
|
see "All Specialties"
|
76510
76511
76512
76513
76514
76516
76519
76529
|
|
Oral Surgery
|
see "All Specialties"
|
70100
70300
70310
70320
70328
70330
70332
70350
70355
|
|
Orthopedics
|
see "All Specialties"
|
all radiology except advanced procedures (CT, MRI, PET)
|
|
Pain Management
|
see "All Specialties"
|
72285
72295
76942
77002
77003
|
|
Pediatrics
|
82947
82948
82962
83036
83655
84703
85007
85025
85651
86403 [Serum test, requires Clinical Laboratory Improvement Amendments (CLIA) certification]
87081 [Requires CLIA certification]
87086 [Requires CLIA certification]
87210
87220
|
71010
71015
71020
71021
71022
71030
71035
71100
71101
71110
71111
71120
71130
73000
73010
73020
73030
73040
73050
73060
73070
73080
73085
73090
73092
73100
73115
73120
73130
73140
73500
73510
73520
73525
73540
73542
73550
73560
73562
73564
73565
73580
73590
73592
73600
73610
73615
73620
73630
73650
73660
|
|
Plastic Surgery
|
see "All Specialties"
|
all radiology except advanced procedures (CT, MRI, PET)
|
|
Podiatry
|
see "All Specialties"
|
73600
73610
73620
73650
73660
76881
76882
76942
|
|
Pulmonology
|
82803
82805
82810
|
70210
70220
71010
71015
71020
71021
71022
71030
71035
|
|
Reproductive Medicine
|
82947
82948
82962
84702
84703
84830
87210
87220
89250
89254
89255
89257
89260
89261
89300
89310
89320
89321
89322
89325
89329
89330
89352
89353
89354
89356
|
76801
76802
76805
76810
76811
76812
76813
76814
76815
76816
76817
76818
76819
76820
76821
76825
76826
76827
76828
76830
76831
76856
76857
76942
76945
76946
76948
77051
77052
77055
77056
77057
G0202
G0204
G0206
|
|
Rheumatology
|
85007
85025
85027
85651
89060
|
all radilolgy except advanced procedures (CT, MRI, PET)
|
|
Urology
|
81007
81015
81020
81050
82271
87210
89300
89310
89320
89321
89322
89331
|
74400
74410
74415
74420
74425
74430
74440
74445
74450
74455
74470
74475
74480
74485
76700
76705
76770
76775
76776
76856
76857
76870
76872
76873
76942
|
* ConnectiCare reserves the right to use third-party vendors to
administer some benefits, including utilization management services.
Note: Some plans may have different benefits/limits; refer
members to Member Services for verification at 1-800-251-7722.
