Miscellaneous Provider Services and Supplies HCPCS Code range S0630-S3722

Fetoscopic laser therapy for treatment of twin-to-twin transfusion syndrome

Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)

Diabetic indicator; retinal eye exam, dilated, bilateral

Performance measurement, evaluation of patient self assessment, depression

STAT laboratory request (situations other than S3601)

Emergency STAT laboratory charge for patient who is homebound or residing in a nursing facility

Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-D; phenylanine (PKU); and thyroxine, total)

Eosinophil count, blood, direct

HIV-1 antibody testing of oral mucosal transudate

Saliva test, hormone level; during menopause