top of page

Medications, Labs & Devices

Labs

May require a CLIA certificate. May not be reimbursed by Alaska Medicaid. 

36415 - Routine Venipuncture 

36416 - Capillary Blood Collection (finger, heel, ear) - Included in PKU reimbursement. 

81005 - URINALYSIS

81025 - URINE PREGNANCY TEST

Administration / Diagnostic

May not be reimbursed separately from professional E/M level service or surgical procedure (delivery). 

Separate from the medication being administered. 

51701 - Insertion of non-dwelling bladder catheter

59025 - Fetal non-stress test

12001 - Simple Repair of Superficial Wounds of External Genitalia 2.5cm or less

12002 - Simple Repair of Superficial Wounds of External Genitalia 2.6cm to 7.5cm

12004 - Simple Repair of Superficial Wounds of External Genitalia 7.6cm to 12.5cm

92558 - Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis

94640 - Pressurized or nonpressurized Oxygen Therapy, up to 1 hour

94760 - Noninvasive ear or pulse oximetry for oxygen saturation; single determination.

96360 - Intravenous Infusion, hydration; initial, 30min to 1 hour

96361 - Intravenous Infusion, hydration; each additional hour (add on)

96365 - Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

96366 - Intravenous infusion, for therapy; prophylaxis, or diagnosis (specify specific substance or drug); each additional hour

96367 - Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional subsequential infusion of a new drug/substance up to 1 hour

96372 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

96374 - Therapeutic Prophylactic or Diagnostic Injection (See specific substance or Drug); intravenous push, single or initial substance/drug

S3620 - PKU -NEWBORN METABOLIC SCREENING * Includes PKU test slip

Medications

Requires NDC & NDC Formatting. 

More info on NDC

The NDC, or National Drug Code, is a unique 10-digit or 11-digit, 3-segment number, and a universal product identifier for human drugs in the United States located on the medication labeling.

Will require the number of Billable* units. Ex: 10IU of Pitocin is 1 billable unit. 

J0171 - EPINEPHRINE

J0290 - AMPICILLIN

J1000 - DEPO-ESTRADIOL CYPIONATE INJ

J2001 - LIDOCAINE

J2210 - METHLERGONOVIN

J2590 - PITOCIN

J2790 - RHOGAM

J3430 - VITAMIN K1

J7120 - RINGERS LACTATE 1000CC

S0191 - CYTOTEC, MISOPROSTOL

Devices / Supplies

Not always reimbursed on a professional claim form. Insurance may not cover all supplies. 

S8415 - Supply kit for home delivery of newborn

A4266 - DIAPHRAGM

J7298 - MIRENA IUD, 52 MG

J7300 - IUD COPPER- PARAGARD

J7301 - IUD-SKYLA

A4355 - Irrigation tubing set for continuous bladder irrigation through a 3-way indwelling Foley catheter, each

A4355 - Irrigation tubing set for continuous bladder irrigation through a 3-way indwelling Foley catheter, each

C1758 - Catheter, ureteral

bottom of page