Targeted Probe and Educate: September 2021 to September 2022 Planned Reviews
Railroad Medicare has resumed Targeted Probe and Educate (TPE) reviews as of September 1, 2021. We plan to conduct provider-specific TPE reviews for the services listed in the table below.
September 2021 to September 2022 Planned TPE Reviews
Type of Service |
CPT/HCPCS Code |
Code Description |
|---|---|---|
Ambulance Services (Emergent) |
A0427 |
ALS1, emergency |
|
A0429 |
BLS, emergency |
|
|
A0425 |
Ground Mileage |
|
Ambulance Services(Non-Emergent) |
A0426 |
ALS1, non-emergency |
|
A0428 |
BLS, non-emergency |
|
|
A0425 |
Ground Mileage |
|
Diagnostic Services: Radiology |
71045 |
X-ray exam chest 1 view |
|
71046 |
X-ray exam chest 2 views | |
|
77080 |
DXA bone density axial |
|
|
Q0092 |
Set up portable X-ray equipment |
|
|
R0070 |
Transport portable x-ray | |
|
R0075 |
Transport portable x-ray, multiple patients | |
Diagnostic Services: Clinical Labs |
G0480 |
Drug Test, definitive, 1-7 classes |
|
G0481 |
Drug Test, definitive, 8-14 classes |
|
|
G0482 |
Drug Test, definitive, 15-21 classes |
|
|
G0483 |
Drug Test, definitive, 22 or more classes |
|
Diagnostic Services: Surgical Pathology |
88305–88309 |
Tissue exam by pathologist |
|
88312 |
Special stain including interpretation and report; group 1 |
|
Drugs and Biologicals |
J2778 |
Ranibizumab injection |
|
J1745 |
Infliximab (Remicade®), not biosimilar, injection |
|
|
J9312 |
Rituximab (Rituxan®) injection |
|
|
J0178 |
Aflibercept Injection |
CPT codes begin with a numeric character and HCPCS codes begin with an alpha character. CPT codes, descriptors and other data only are copyright ©2020 American Medical Association®. All rights reserved.