Medicine – (90281-92700)
1. Three injections of allergen with the provision of the extract and professional service.
CPT Code: ___________________
2. Two photo patch tests.
CPT Code: ___________________ × _______
3. Replacement of contact lenses.
CPT Code: ___________________
4. Patient is fitted for bifocal spectacles.
CPT Code: ___________________
5. Electro-oculography with interpretation and report.
CPT Code: ___________________
6. Optokinetic nystagmus test.
CPT Code: ___________________
7. Positional nystagmus test, with recording, five positions.
CPT Code: ___________________
8. An esophagus acid reflux test with nasal catheter electrode placement for detection of gastroesophageal reflux.
CPT Code: ___________________
9. Peritoneal dialysis with two (repeated) physician evaluations.
CPT Code: ___________________
10. Hypnotherapy.
CPT Code: ___________________
11. Bernstein test for esophagitis.
CPT Code: ___________________
12. Evaluation of auditory rehabilitation status, 1 hour.
CPT Code: ___________________
13. A total of 50 minutes spent on family psychotherapy without the patient present.
CPT Code: ___________________
14. Hemodialysis access flow study to determine blood flow in grafts.
CPT Code: ___________________
15. Puretone audiometry; air and bone.
CPT Code: _______________