Alert 10004 (CPT Age Edits)

Description:

Errors in this edit may be generated only if patient age is known and patient age is not matching the CPT Age Edit.

Edit ID: 10004

Error type: ERROR

Error message example 1:

This example is provided for the following scenario:

  1. CPT code = 39503.
  2. Patient Age = 1 year.

CPT code 39503 may not be used for patient with age = 1 year.

DESCRIPTION

CPT code 39503 = Repair, Neonatal Diaphragmatic Hernia, With Or Without Chest Tube Insertion And With Or Without Creation Of Ventral Hernia

Error message example 2:

This example is provided for the following scenarios:

  1. CPT code = 77076.
  2. Patient Age = 3 years.

CPT code 77076 may not be used for patient with age = 3 years.

DESCRIPTION

CPT code 77076 = Radiologic Examination, Osseous Survey, Infant

Error message example 3:

This example is provided for the following scenarios:

  1. CPT code = 59140.
  2. Patient Age = 5 years.

CPT code 59140 may not be used for patient with age = 5 years.

DESCRIPTION

CPT code 59140 = Surgical Treatment Of Ectopic Pregnancy; Cervical, With Evacuation

Error message example 4:

This example is provided for the following scenarios:

  1. CPT code = 99385.
  2. Patient Age = 45 years.

CPT code 99385 may not be used for patient with age = 45 years.

DESCRIPTION

CPT code 99385 = Initial Comprehensive Preventive Medicine Evaluation And Management Of An Individual Including An Age And Gender Appropriate History, Examination, Counseling/Anticipatory Guidance/Risk Factor Reduction Interventions, And The Ordering Of Laboratory/Diagnostic Procedures, New Patient; 18-39 Years

Owner object: Activity

Owner object property name: Code

Owner object property value: Value of Activity.Code

Reference object: Claim

Reference object property name: ID

Reference object property value: Value of Claim.ID