CCI
GAP
A-Codes
7-Codes
Provider Table
100

2.ZZ.02

MD Loss Assessment or Examination


100

HXXMR

S25 Assessment - Map to MD Loss

100

AXXTT

Travel Time provider to Treatment

100

7.SC.02

Home Assessment/Work Assessment which will map to MD Loss

100

DC

Chiropractor

200

6.VA.02

Therapeutic MD Loss


200

IXXPW

S44 Assessment - Map to EE Loss

200

AXXMT

Missed Treatment Appointment

200

7.SF.15

Service Brokerage - Map to RV Loss

200

MT

Massage Therapist


300

3.SC.10

Map to MD Loss for Diagnostic Imaging

300

IXXCA

S44 Assessment - Map to EE Loss

300

AXXKM

Provider Treatment Mileage

300

Session Code - OCF18 form fee - Map to MD Loss

300

OT

Occupational Therapist

400

2.SG.08

Diagnostic Interventions (Assessments, Tests), Map to MD Loss

400

MIG02

Map to MD Loss - Minor Injury Guideline

400

AXXOT

Other (description required:  parking, photocopying)

400

7.SF.12

Service Planning for assessment or examination - Map to MD Loss

400

SW

Social Worker

500

1.SC.04

Therapeutic Interventions (physical/psychological) - MD Loss

500

GXX06

Map to MD Loss - assistive devices

500

AXXTI

Customer Transportation to IE

500

7.SP.10

Counselling or Potential Condition - Map to MD Loss

500

MD

Other Medical/Surgical Practitioner