Service Type Codes

CodeDescription
1Medical Care74Private Duty Nursing
2Surgical75Prosthetic Device
3Consultation76Dialysis
4Diagnostic X-Ray77Otological Exam
5Diagnostic Lab78Chemotherapy
5Radiation Therapy79Allergy Testing
7Anesthesia80Immunizations
8Surgical Assistance81Routine Physical
9Other Medical82Family Planning
10Blood Charges83Infertility
11Used Durable Medical Equipment84Abortion
12Durable Medical Equipment Purchase85AIDS
13Ambulatory Service Center Facility86Emergency Services
14Renal Supplies in the Home87Cancer
15Alternate Method Dialysis88Pharmacy
16Chronic Renal Disease (CRD) Equipment89Free Standing Prescription Drug
17Pre-Admission Testing90Mail Order Prescription Drug
18Durable Medical Equipment Rental91Brand Name Prescription Drug
19Pneumonia Vaccine92Generic Prescription Drug
20Second Surgical Opinion93Podiatry
21Third Surgical Opinion94Podiatry – Office Visits
22Social Work95Podiatry – Nursing Home Visits
23Diagnostic Dental96Professional ( Physician )
24Periodontics97Anesthesiologist
25Restorative98Professional ( Physician ) Visit – Office
26Endodontics99Professional ( Physician ) Visit – Inpatient
27Maxillofacial ProstheticsA0 Professional ( Physician ) Visit – Outpatient
28Adjunctive Dental ServicesA1 Professional ( Physician ) Visit – Nursing Home
30Health Benefit Plan Coverage If Only a Single Category of Inquiry Can Be Supported, Use This CodeA2Professional ( Physician ) Visit – Skilled Nursing Facility
32Plan Waiting PeriodA3 Professional ( Physician ) Visit – Home
33ChiropracticA4 Psychiatric
34Chiropractic Office VisitsA5 Psychiatric – Room and Board
35Dental CareA6 Psychotherapy
36Dental CrownsA7 Psychiatric – Inpatient
37Dental AccidentA8 Psychiatric – Outpatient
38OrthodonticsA9 Rehabilitation
39ProsthodonticsAA Rehabilitation – Room and Board
40Oral SurgeryAB Rehabilitation – Inpatient
41Routine (Preventive) DentalAC Rehabilitation – Outpatient
42Home Health CareAD Occupational Therapy
43Home Health PrescriptionsAE Physical Medicine
44Home Health VisitsAF Speech Therapy
45HospiceAG Skilled Nursing Care
46Respite CareAH Skilled Nursing Care – Room and Board
47HospitalAI Substance Abuse
48Hospital – InpatientAJ Alcoholism
49Hospital – Room and BoardAK Drug Addiction
50Hospital – OutpatientAL Vision ( Optometry )
51Hospital – Emergency AccidentAM Frames
52Hospital – Emergency MedicalAN Routine Exam
53Hospital – Ambulatory SurgicalAO Lenses
54Long Term CareAQ Nonmedically Necessary Physical
55Major MedicalAR Experimental Drug Therapy
56Medically Related TransportationBA Independent Medical Evaluation
57Air TransportationBB Partial Hospitalization ( Psychiatric )
58AmbulanceBC Day Care ( Psychiatric )
59Licensed AmbulanceBD Cognitive Therapy
60General BenefitsBE Massage Therapy
61In-Vitro FertilizationBF Pulmonary Rehabilitation
62MRI/CAT ScanBG Cardiac Rehabilitation
63Donor ProceduresBH Pediatric
64AcupunctureBI Nursery
65Newborn CareBJ Skin
66PathologyBK Orthopedic
67Smoking CessationBL Cardiac
68Well Baby CareBM Lymphatic
69MaternityBN Gastrointestinal
70TransplantsBP Endocrine
71Audiology ExamBQ Neurology
72Inhalation TherapyBR Eye
73Diagnostic MedicalBS Invasive Procedures