Glossary

A - H

CDT - Current Dental Terminology
This is the code your dentist will use to let us know what service she provided. The code is a five digit alphanumeric representation of the service provided, a couple of examples are:
  • D0120 Periodic Oral Evaluation - Established Patient: An evaluation performed on a patient of record to determine any changes in the patient's dental and medical health status since a previous comprehensive or periodic evaluation.
  • D1110 (Cleaning) Prophylaxis - Adult: A dental prophylaxis performed on transitional or permanent dentition, which includes scaling and polishing procedures to remove coronal plaque, calculus, and stains. Some patients may require more than one appointment or one extended appointment to complete a prophylaxis.
CPT - Current Procedural Terminology
This is the code your doctor will use to let us know what service she provided. The code is a five digit numerical representation of the service provided, a couple of examples are:
  • 99213 - Office or the other outpatient visit for the evaluation and management of an established patient.
  • 87880 - Rapid Strep Test - a throat culture test to check whether the patient has Group A Streptococcus.
Dependents
A member of your extended family that you as a member of SingleCare have attached to your account so that they may use your account to see SingleCare providers and access the same savings as you. You must have the legal right to add dependents to your account.

I - L

ICD-10 (Diagnosis Code)
This is a classification code your doctor uses to describe the disease, illness and injuries you have presented. This is not a code you will need to know in order to look up pricing on the SingleCare website. The code is an alphanumeric representation of the diagnosis, a couple of examples are:
  • S52 - Fracture of forearm
  • S52.0 - Fracture of upper end of ulna
  • S52.1 - Fracture of upper end of radius
J Code
This is the code used by your doctor to report injectable drugs that ordinarily cannot be self-administered; chemotherapy, immunosuppressive drugs and inhalation solutions as well as some orally administered drugs. The code is a five digit alphanumeric representation of the service provided, a couple of examples are:
  • J0920 - injection, ampicillin sodium 500mg
  • J0800 - injection, corticotropin, up to 40 units

M - Q

National drug code (NDC)
This is the code used by your pharmacist to describe the drug on your prescription. The code is a 10-digit, 3-segment number, a couple of examples are:
  • 0777-3105-02: a 100 tablet count bottle of Prozac 20mg
  • 0009-0057-07: a 60 tablet count, extended release Xanax 0.5mg
Network
A list of healthcare providers that are contracted to offer services to see SingleCare members.
Primary Care Provider
Your family doctor or pediatrician.
Providers
Health care professionals that offer services to SingleCare members such as Doctors, Dentists, Nurse-practitioners, Pharmacists.

R - Z

Specialty Provider
Your primary care provider may refer you to professionals in various specialties when necessary, such as:
  • Allergy/Immunology — disorders of the immune system
  • Asthma — respiratory
  • Anesthesiology — general anesthesia or spinal block for surgeries and some forms of pain control
  • Audiology — hearing
  • Cardiology — heart disorders
  • Chiropractic — mechanical disorders, especially of the spine (part of the neuromuscular medicine specialty)
  • Dermatology — skin disorders
  • Endocrinology — hormonal and metabolic disorders, including diabetes
  • Gastroenterology — digestive system disorders
  • General surgery — common surgeries involving any part of the body
  • Hematology — blood disorders
  • Immunology — disorders of the immune system
  • Infectious disease — infections affecting the tissues of any part of the body
  • Mental health — behavioral health; psychological and emotional well-being
  • Nephrology — kidney disorders
  • Neurology — nervous system disorders
  • Obstetrics/gynecology (OB/GYN) — pregnancy and women's reproductive disorders
  • Oncology — cancer treatment
  • Ophthalmology — vision; eye disorders and surgery
  • Orthopaedics — bone and connective tissue disorders
  • Otorhinolaryngology — ear, nose, and throat (ENT) disorders
  • Pathology/Laboratory — diagnosis of disease based on bodily fluids and tissues
  • Physical therapy and rehabilitative medicine — for disorders such as low back injury, spinal cord injuries, and stroke
  • Podiatry — treatment of feet
  • Psychiatry — emotional or mental disorders
  • Pulmonary (lung) — respiratory tract disorders
  • Radiology/Imaging — x-rays and related procedures (such as ultrasound, CT and MRI)
  • Rheumatology — pain and other symptoms related to joints and other parts of the musculoskeletal system
  • Urology — disorders of the male reproductive and urinary tracts and the female urinary tract

Codes Reference List

This is not a complete list of codes.

Universal Codes

Established Patient
Procedure CPT Code
Office Visit - Level 1 99211
Office Visit - Level 2 99212
Office Visit - Level 3 99213
Office Visit - Level 4 99214
Office Visit - Level 5 99215
New Patient
Procedure CPT Code
Office Visit - Level 1 99201
Office Visit - Level 2 99202
Office Visit - Level 3 99203
Office Visit - Level 4 99204
Office Visit - Level 5 99205
Outpatient Consultations
Procedure CPT Code
Office Consultations - 15 mins 99241
Office Consultations - 30 mins 99242
Office Consultations - 40 mins 99243
Office Consultations - 60 min 99244
Office Consultations - 80 min 99245

Medical

Established Patient
Procedure CPT Code
PM E/M patient infant 99391
PM E/M patient 1-4 years 99392
PM E/M patient 5-11 years 99393
PM E/M patient 12-17 years 99394
PM E/M patient 18-39 years 99395
PM E/M patient 40-64 years 99396
PM E/M patient 65+ years 99397
New Patient
Procedure CPT Code
PM E/M patient infant 99381
PM E/M patient 1-4 years 99382
PM E/M patient 5-11 years 99383
PM E/M patient 12-17 years 99384
PM E/M patient 18-39 years 99385
PM E/M patient 40-64 years 99386
PM E/M patient 65+ years 99387
Hourly Critical Care and Add-on Services
Procedure CPT Code
Medical services after hours 99050
Out of office emergency med services 99060
Critical care first hour 99291
Critcal care addt'l 30 min 99292
Immunization Administration
Procedure CPT Code
Immunization Admin 90471
Immunization Admin Each Add 90472
Immunization Admin Oral/Nasal 90473
Immunization Admin Oral/Nasal Addt'l 90474
Immunizations
Procedure CPT Code
Flu vaccine no prsv 3 val 6-35 mths 90655
Flu vaccine no prsv 3 & > 3 yrs 90656
Flu vaccine 3 yrs IM 90657
Flu vaccine 3+ years IM 90658
Tetanus vaccine IM 90703
Mumps vaccine IM 90704
Measles vaccine IM 90705
Rubella vaccine IM 90706
Hep A vaccine ped/adol 2 dose 90633
Hep A vaccine ped/adon 3 dose 90634
Hib vaccine prp-Omp IM 90647
Hib vaccine prp-T IM 90648
DTAP vaccine > 7 yrs IM 90700
DT vaccine > 7 yrs IM 90702
MMR vaccine SC 90707
Poliovirus IPV SC/IM 90713
TD vaccine no prsrv 7+ yrs IM 90714
Tdap Vaccine 7+ yrs IM 90715
Chicken pox vaccine SC 90716
DTAP/Hib vaccine IM 90721
DTAP-HEP B-IPV vaccine IM 90723
Pneumococcal vaccine 90732
Meningococcal polysac vaccine subcutaneous 90733
Hep B vaccine ill pat 3 dose IM 90740
Hep B vaccine adol 2 dose IM 90743
Hep B vaccine ped/adol 3 dose IM 90744
Hep B vacc adult 3 dose IM 90746
Hep B vacc ill pat 4 dose IM 90747
Hep B/Hib vaccine IM 90748
Laboratory
Procedure CPT Code
Blood draw < 3 yrs scalp vein 36405
Blood draw < 3 yrs other vein 36406
Non-routine blood draw 3+ yrs 36410
Routine Venipuncture 36415
Capillary Blood Draw 36416
Tissue exam by pathologist - Level 3 88304
Tissue exam by pathologist - Level 4 88305
General health panel 80050
Comprehensive metabolic panel 80053
Lipid panel 80061
Complete CBC w/auto diff WBC 85025
Cytopath C/V auto fluid redo 88175
Urinalysis nonauto w/scope 81000
Urinalysis nonauto w/scope 81002
Glucose blood reagent strip 82948
Glucose blood 82962
Blood count hemoglobin 85018
Heterophile antibodies screen 86308
Skin test tuberculosis intradermal 86580
Culture other specimen aerobic 87070
Urine culture/colony count 87086
Strep A ag eia 87430
Chlamydia screening 87491
Strep B assay w/optic 87802
Influenza assay w/optic 87804
Strep A assay w/optic 87880
Specimen handling office - lab 99000
Hearing (Audiology)
Procedure CPT Code
Speech/hearing therapy 92507
Hearing screening test, pure tone only 92551
Pure tone audiometry (threshold); air only 92552
Comprehensive hearing test 92557
Tympanometry (middle ear test); air only 92567
Auditor evoke potent limit 92586
Nonsurgical Procedures
Procedure CPT Code
Breathing capacity test 94010
Evaluation of wheezing 94060
Airway inhalation treatment 94640
Evaluate patient use of inhaler 94664
Measure blood oxygen level 94760
Developmental screen 96110
Outpatient Surgical Procedures
Procedure CPT Code
Incision & drainage abscess simple 10060
Incision & removal foreign body subq tiss simple 10120
Initial treatment of burn(s) 16000
Dress/debrid p-thick burn(s) 16020
Destruct B9 lesion 1-14 17110
Destruct lesion 15 or more 17111
Chemical cautery tissue 17250
Treat elbow dislocation 24640
Removal foreign body foot subcutaneous 28190
Removal foreign body intranasal office procedure 30300
Control of nosebleed 30901
Insert bladder catheter 51701
Remove foreign body from eye 65205
Clear outer ear canal 69200
Remove impacted ear wax 69210
Injections, Injected Medications, and Other Medications (non-pharmacy)
Procedure CPT Code
Immunotherapy one injection 95115
Immunotherapy injections 95117
Ceftriaxone Sodium injection J0696
Corticotropin injection J0800
Ampicillin sodium 500mg injection J0920
Methylprednisolone 80mg injection J1040
Dexamethasone Sodium injection J1100
Diphenhydramine Hcl injection J1200
Promethazine Hcl injection J2550
Prednisone, oral, per 5 mg J7506
Prednisolone, oral, per 5 mg J7510

Dental

General Dentistry
Procedure CPT Code
Periodic oral evaluation (existing patient) D0120
Limited oral evaluation - problem focused D0140
Complete oral evaluation (new or existing patient) D0150
Intraoral complete series (x-rays) D0210
Intraoral periapical, single film (x-rays) D0220
Intraoral periapical, additional film (x-rays) D0230
Bitewings, single film (x-rays) D0270
Bitewings, two films (x-rays) D0272
Bitewings, four films (x-rays) D0274
Prophylaxis, adult (teeth cleaning) D1110
Prophylaxis, child (teeth cleaning) D1120
Topical application of fluoride D1208
Amalgam-one surface (metal filling) D2140
Resin Composite - 1 surface posterior D2391
Resin composite - 2 surfaces posterior D2392
Crown-porcelain/ceramic substrate D2740
Crown-porcelain fused to base metal D2751
Complete denture - maxillary (upper) D5110
Complete denture - mandibular (lower) D5120
Surgical plcmt implant body; endosteal D6010
Orthodontics
Procedure CPT Code
Limited ortho treatment primary dentition D8010
Limited ortho treatment transitional dentition D8020
Limited ortho treatment adolescent dentition D8030
Limited ortho treatment adult dentition D8040
Comprehensive ortho tx transitional dentition D8070
Comprehensive ortho tx adolescent dentition D8080
Removable appliance therapy D8210
Fixed appliance therapy D8220
Repair of orthodontic appliance D8691
Replacement lost or broken retainer D8692
Endodontics
Procedure CPT Code
Pulp cap - direct D3110
Pulp cap - indirect D3120
Vital pulpotomy D3220
Pulpal debridement D3221
Endodontic fill, anterior D3310
Endodontic fill, bicuspid D3320
Endodontc fill, molar D3330
Retreat previous endo fill, anterior D3346
Retreat previous endo fill, bicuspid D3347
Retreat previous endo fill, molar D3348
Periodontics
Procedure CPT Code
Gingivect/Plasty - 4 or more conting teeth D4210
Crown lengthening proc - hard tissue D4249
Osseous surgery - 4 or more coting teeth D4260
Guided tissue regen-resorb barrier, per site D4266
Root planning - 4 or more conting teeth D4341
Root planning - 1-3 teeth D4342
Full mouth debridement (periodic eval) D4355
Controlled release of agents, per site D4381
Periodontal maintenance after therapy D4910
Surgery, Oral & Maxillofacial
Procedure CPT Code
Extract erupted tooth/exposed root D7140
Surg removal erupted tooth, remove bone D7210
Removal impacted tooth - soft tissue D7220
Removal impacted tooth - partly bony D7230
Removal impacted tooth - completely bony D7240
Surg removal residual tooth roots D7250
Surgical access an unerupted tooth D7280
Palliative Treatment - Minor Pain D9110
Deep sedation/general anesthesia - 1st 30 min D9220
Analgesia, anxiolysis, inhalation of nitrous oxide D9230

Chiropractic

Procedure CPT Code
Chiropractic manipulation (1-2 regions) 98940
Chiropractic manipulation (3-4 regions) 98941
Chiropractic manipulation (5 regions) 98942
Extraspinal chiropractic manipulation 98943

Imaging (Radiology)

Procedure CPT Code
X-ray (chest - 1 view frontal) 71010
X-ray (chest - 2 views frontal & lat) 71020
X-ray (abdomen) 74000
Mammogram screening - digital G0202
CT scan, head/brain; w/o contrast 70450
CT angio abdom w/o & w/dye 74175
Electrocardiogram (EKG/ECG) complete 93000
Electrocardiogram (EKG/ECG) report 93010
Ultrasound abdomen complete 76700
Ultrasound 1st trimester single 76801
Ultrasound >= 14 wk 0 day; single 76805
MRI brain stem w/o dye 70551
MRI abdomen w/o dye 74181
EEG (41-60 min) 95812
EEG awake and drowsy 95816
EEG coma or sleep only 95822

Physical Therapy

Procedure CPT Code
PT evaluation 97001
Therapeutic exercise 97110
Therapeutic activities 97530
Neuromuscular reeducation 97112
Manual therapy 1 or more regions 97140

Behavioral Health (Mental Health)

Procedure CPT Code
Health & behavioral assessment (individual) 96150
Health & behavior intervention (individual) 96152
Health & behavior intervention (group) 96153
Psychotherapy, patient &/or family - 30 min 90832
Psychotherapy, patient &/or family - 45 min 90834
Psychotherapy, patient &/or family - 60 min 90837
Family psychotherapy w/patient 90847
Group psychotherapy 90853

Vision

Procedure CPT Code
Eye exam established patient (intermediate) 92012
Eye exam new patient 92004
Established eye exam & treatment (comprehensive) 92014