California Children S Services (CCS) Program Service Code Groupings (Cal Child Ser)
California Children’s Services (CCS) Program cal child ser
Service Code Groupings 1
This section identifies California Children’s Services (CCS) Service Code Groupings (SCGs). These code groupings allow providers to submit a single code on a Service Authorization Request (SAR) that represents a wide range of services. If the SAR is approved, all the codes in the SCG group identified on the SAR are reimbursable.
The following effective dates are listed throughout the section:
^ July 1, 2006 / ## December 1, 2006 / c July 1, 2007* September 1, 2006 / a January 1, 2007 / d August 1, 2007
# November 1, 2006 / b April 1, 2007 / e September 1, 2007
Physician Service The following is a list of codes that comprise SCG 01 for physicians.
Code Group 01
Authorized HCPCS Codes in Physician SCG 01
2 – California Children’s Services (CCS) Program Service Code Groupings
September 2007
California Children’s Services (CCS) Program cal child ser
Service Code Groupings 1
HCPCS
Codes
A9542
A9543
A9544 #
A9545 #
C9225 d
C9232 c
C9233 d
C9234 c
J0129 c
J0132–J0133 #
J0135
J0180
J0348 d
J0480 #
J0795 #
J0881–J0882 #
J0885–J0886 #
J0894 d
J1162 #
J1265 #
J1451 #
J1458 c
J1640 #
J1675 #
J1740 d
J1751–J1752 #
J1785
J1931
J1945 #
J2248 d
J2278 #
J2315 c
J2325 #
J2357
J2425 #
J2469
J2503–J2504 #
J2794
J2805 #
J2850 #
J3243 d
J3285 #
J3396
J3490 ##
J3590 ##
J7187 d
J7311 d
J7611 d
J7613 d
J9001 a
J9025
J9027 #
J9035 d
J9041
J9045 a
J9175 #
J9201 d
J9261 d
J9263 e
J9264 #
J9266 c
J9305
J9310 a
J9350 #
Q4079 #
Q4084–Q4086 d
Q9945–Q9957 #
S0116 d
S0145 #
S0164
S0265 #
X4522
X5500–X5501
X5503
X5505
X5507
X5509
X5514
X5516
X5518
X5520
X5522
X5528
X5530
X5534
X5536
X5540
X5550
X5552
X5554
X5556
X5558
X5560
X5562
X5564
X5566
X5572
X5576
X5578
X5580
X5582
X5584
X5586
X5588
X5598
X5600
X5602
X5604
X5606
X5608
X5610
X5612
X5614
X5618
X5620
X5622
X5626
X5628
X5630
X5632
X5634
X5636
X5640
X5642
X5644
X5646
X5648
X5650
X5652
X5654
X5656
X5658
X5660
X5662
X5666
X5668
X5672
X5674
X5676
X5678
X5680
X5682
X5694
X5698
X5700
X5702
X5704
X5708
X5710
X5712
X5714
X5716
X5718
X5720
X5722
X5724
X5726
X5728
X5738
X5740
X5744
X5750
X5752
X5756
X5762
X5764
X5766
X5768
X5770
X5772
X5774
X5776
X5778
X5780
X5782
X5784
X5786
X5790
X5792
X5794
X5796
X5798
X5800
X5802
X5804
X5808
X5810
X5818
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
California Children’s Services (CCS) Program cal child ser
Service Code Groupings 1
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
3
Authorized HCPCS Codes in Physician SCG 01 (continued)
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
11
X5820
X5822
X5824
X5826
X5828
X5840
X5842
X5844
X5846
X5848
X5850
X5852
X5854
X5856
X5858
X5860
X5862
X5864
X5866
X5868
X5872
X5876
X5878
X5880
X5882
X5888
X5890
X5892
X5894
X5896
X5898
X5904
X5906
X5908
X5910
X5912
X5914
X5918
X5920
X5922
X5924
X5926
X5928
X5930
X5932
X5934
X5942
X5944
X5956
X5958
X5960
X5962
X5964
X5966
X5970
X5972
X5974
X5976
X5980
X5984
X5988
X5992
X6002
X6004
X6006
X6008
X6012
X6014
X6018
X6020
X6022
X6024
X6026
X6030
X6036
X6038
X6040
X6042
X6046
X6048
X6051
X6058
X6060
X6062
X6064
X6070
X6080
X6082
X6084
X6086
X6090
X6092
X6106
X6108
X6110
X6112 #
X6114
X6116
X6118
X6122
X6126
X6136
X6138
X6140
X6146
X6158
X6160
X6162
X6164
X6166
X6168
X6174
X6178
X6196
X6198
X6204
X6206
X6208
X6210 #
X6214
X6216
X6220
X6222
X6226
X6228
X6236
X6240
X6242
X6252
X6254
X6258
X6262
X6264
X6274
X6282
X6284
X6286
X6288
X6296
X6298
X6302
X6304
X6306
X6308
X6320
X6326
X6328
X6330
X6332
X6334
X6336
X6352
X6354
X6366
X6408
X6410
X6422
X6424
X6426
X6432
X6434
X6436
X6438
X6440
X6442
X6444
X6446
X6452
X6454
X6456
X6458
X6460
X6462
X6464
X6466
X6470
X6474
X6476
X6478
X6480
X6482
X6486
X6488
X6490
X6492
X6494
X6496
X6504
X6506
X6512
X6514
X6516
X6520
X6522
X6524
X6526
X6528
X6530
X6532
X6534
X6550
X6552
X6556
X6558
X6560
X6562
X6566
X6578
X6580
X6582
X6588
X6592
X6594
X6596
X6598
X6600
X6604
X6606
X6610
X6612
X6614
X6616
X6618
X6620
X6622
X6624
X6626
X6628
X6630
X6632
X6634
X6636
X6638
X6640
X6642
X6644
X6646
X6648
X6656
X6658
X6660
X6664
X6666
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
11
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
3
Authorized HCPCS Codes in Physician SCG 01 (continued)
2 – California Children’s Services (CCS) Program Service Code Groupings
September 2007
cal child ser
5
X6670
X6672
X6700
X6702
X6704
X6706
X6714
X6716
X6718
X6720
X6728
X6730
X6732
X6734
X6736
X6738
X6740
X6742
X6754
X6758
X6760
X6764
X6776
X6778
X6780
X6782
X6784
X6792
X6794
X6810
X6816
X6826
X6828
X6830
X6832
X6836 #
X6856
X6862
X6864
X6870
X6888
X6890
X6892
X6894
X6896
X6912
X6920
X6942
X6944
X6968
X6970
X6972
X6974
X6976
X6978
X6980
X6984
X6996
X6998
X7010
X7025–X7027
X7030 #
X7046
X7048
X7050
X7052
X7060–X7061
X7104–X7105
X7122
X7364
X7366
X7420
X7434
X7436
X7444
X7456
X7458
X7460
X7462
X7464
X7470
X7478–X7480
X7482
X7484 d
X7486
X7488
X7490
X7492
X7493 #
X7496
X7498
X7500
X7502
X7504
X7506
X7508
X7510
X7512
X7514
X7516
X7518
X7520
X7522
X7524
X7526
X7528
X7530
X7532
X7536
X7540
X7542
X7544
X7546
X7548
X7550–X7552
X7556
X7558
X7560
X7562
X7564
X7566
X7568
X7570
X7572
X7574
X7576
X7578
X7580
X7582 a
X7584
X7586
X7588 a
X7624
X7630 d
X7632
X7634 a
X7636
X7638
X7640
X7642
X7644
X7646
X7648
X7650
X7652
X7654
X7658 e
X7660 #
X7662 #
X7700
X7702
X7704
X7706
X7708
X7710
X7716
X7718
X7720
X7724
X7726
X9922
X9924
X9926
X9928
X9930
X9932
X9934
X9936
X9938
X9940
X9942
X9944
X9946
X9948
X9950
X9952
X9954
X9956
X9958
X9960
X9962
X9964
X9966
X9968
X9970
Z0002 #
Z0004 #
Z0006 #
Z0100
Z0102
Z0104
Z0106
Z0108
Z0200 #
Z0202 #
Z0204 #
Z0206 #
Z0208 #
Z0210 #
Z0306
Z0316
Z1030 #
Z1032 #
Z5200
Z5202
Z5204
Z5206
Z5218
Z5220
Z5226
Z5228
Z7500
Z7502
Z7504
Z7506
Z7508
Z7510
Z7512
Z7514
Z7610
Z7612
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
5
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
5
Authorized CPT-4 Codes in Physician SCG 01 (continued)
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
5
CPT-4
Codes
00100
00102–00104
00120
00124
00126
00140
00142
00144–00145
00147–00148
00160
00162
00164
00170
00172
00174
00176
00190
00192
00210
00212
00214–00216
00218
00220
00222
00300
00320
00322
00326
00350
00352
00400
00402
00404
00406
00410
00450
00452
00454
00470
00472
00474
00500
00520
00522
00524
00528
00529
00530
00532
00534
00537
00539–00542
00546
00548
00550
00560
00561
00562–00563
00566
00580
00600
00604
00620
00622
00625–00626 d
00630
00632
00634–00635
00640
00670
00700
00702
00730
00740
00750
00752
00754
00756
00770
00790
00792
00794
00796–00797
00800
00802
00810
00820
00830
00832
00834
00836
00840
00842
00844
00846
00848
00851
00860
00862
00864–00866
00868
00870
00872–00873
00880
00882
00902
00904
00906
00908
00910
00912
00914
00916
00918
00920–00922
00924
00926
00928
00930
00932
00934
00936
00938
00940
00942
00944
00948
00950
00952
01112
01120
01130
01140
01150
01160
01170
01173
01180
01190
01200
01202
01210
01212
01214–01215
01220
01230
01232
01234
01250
01260
01270
01272
01274
01320
01340
01360
01380
01382
01390
01392
01400
01402
01404
01420
01430
01432
01440
01442
01444
01462
01464
01470
01472
01474
01480
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
5
2 – California Children’s Services (CCS) Program Service Code Groupings
December 2006
cal child ser
5
Authorized CPT-4 Codes in Physician SCG 01 (continued)
2 – California Children’s Services (CCS) Program Service Code Groupings
July 2007
cal child ser
5
01482
01484
01486
01490
01500
01502
01520
01522
01610
01620
01622
01630
01632
01634
01636
01638
01650
01652
01654
01656
01670
01680
01682
01710
01712
01714
01716
01730
01732
01740
01742
01744
01756
01758
01760
01770
01772
01780
01782
01810
01820
01829–01830
01832
01840
01842
01844
01850
01852
01860
01905
01916
01920
01922
01924–01926
01930–01933
01951–01953
01958
01960–01963
01964 #
01965–01966 #
01967–01969
01990–01992
01995 d
01996
01999
10021–10022 #
10040
10060–10061
10120
10121
10140
10160
10180
11000–11001
11004–11006
11008
11055–11057
11100–11101
11200–11201
11400–11404
11406
11420–11424
11426
11440–11444
11446
11600–11604
11606
11620–11624
11626
11640–11644
11646
11720–11721
11730
11732
11740
11750
11752 #
11756 #
11760 #
11762 #
11765 #
12001–12002
12004–12007
12011
12013–12018
12020–12021
12031–12032
12034–12037
12041–12042
12044–12047
12051–12057
13100–13102
13120–13122
13131–13133
13150–13153
13160
14000–14001
14020–14021
14040–14041
14060–14061
14300
14350
15851
16000
16020
17000
17003–17004
17106–17107
17110–17111
17250
21300 d
26010–26011
29049
29055
29058
29065
29075
29085
29105
29125–29126
29130–29131
29200
29220
29240
29260
29280
29305
29325
29345
29355
29358
29365
29405
29425
29435
29440
29445
29450
29505
29515
29520
29530
29540
29550
29580
29590
29700
29705
29710
29715
29720
29730
29740
29750
30000
30020
30200
30300
30901
30903
30905–30906
31000
31002
31231 #
31500
31502 #
31603
31605
31620
31622–31625
31628–31633
31635–31638
31640–31641
31643
31645–31646
31656
32000
32002
32005
32019
32020
36000
36400
36405–36406
36410
36420
36425
36500
36510
36540
36550
36555–36558
36560–36561
36563
36565–36566
36568–36571
36575–36576
36578
36580–36585
36589–36590
36595–36597
36598 #
36600
36620
36625
36640
36660
36680
38220–38221
38300
38500
38505
40800
40804
40808
2 – California Children’s Services (CCS) Program Service Code Groupings
July 2007
cal child ser
5
2 – California Children’s Services (CCS) Program Service Code Groupings
July 2007
cal child ser
5
Authorized CPT-4 Codes in Physician SCG 01 (continued)
2 – California Children’s Services (CCS) Program Service Code Groupings
July 2007
cal child ser
5
40819–40820
40830–40831
41000
41005
41800
42000
43234–43237
43239
43760–43761
46600
49080
51000
51005
51010
51600
51605
51610
51700
51701–51703
51705
51710
51725–51726
51736
51741
51772
51784–51785
51792
51795
51797–51798
53600–53601
53620–53621
53660–53661
54000
54050
54055
54056
54057
54060
54065
54500
56442 d
57400
57410
57415
61000–61001
61070
62270
62272
62284
62290–62291
62310–62311
62318–62319
64450
65205
65210
65220
65222
65430
65435
65800
65805
67500
67515
67700
67710
67715
67800
67801
67805
67810
67820
67840
67850
67930
67935
67938
68020
68040
68100
68110
68200
68801
68810
68840
69000
69020
69100
69105
69200
69210
69420
70010
70015
70030
70100
70110
70120
70130
70134
70140
70150
70160
70170
70190
70200
70210
70220
70240
70250
70260
70300
70310
70320
70328
70330
70332
70360
70370
70373
70380
70390
70450
70460
70470
70480–70482
70486–70488
70490–70492
70540
70542–70549
70551–70553
70557–70559
71010
71015
71020–71023
71030
71034–71035
71040
71060
71090
71100–71101
71110–71111
71120
71130
71250
71260
71270
71275
71550–71552
71555 d
72010
72020
72040
72050
72052
72069–72070
72072
72074
72080
72090
72100
72110
72114
72120
72125–72133
72141–72142
72146–72149
72156–72158
72159 d
72170
72190
72192–72197
72198 d
72200
72202
72220
72240
72255
72265
72270
72275
72285
72291–72292 d
72295
73000
73010
73020
73030
73040
73050
73060
73070
73080
73085
73090
73092
73100
73110
73115
73120
73130
73140
73200–73202
73218–73223
73225 d
73500
73510
73520
73525
73530
73540
73542
73550
73560
73562
73564–73565
73580
73590
73592
73600
73610
2 – California Children’s Services (CCS) Program Service Code Groupings
July 2007
cal child ser
5
2 – California Children’s Services (CCS) Program Service Code Groupings
July 2007
cal child ser
7
Authorized CPT-4 Codes in Physician SCG 01 (continued)
2 – California Children’s Services (CCS) Program Service Code Groupings
August 2007
cal child ser
7
73615
73620
73630
73650
73660
73700–73702
73718–73723
73725 d
74000
74010
74020
74022
74150
74160
74170
74181–74183
74185
74190
74210
74220
74230
74235
74240–74241
74245–74247
74249–74251
74260
74270
74280
74283
74290–74291
74300–74301
74305
74320
74327–74330
74340
74350
74355
74360
74363
74400
74410
74415
74420
74425
74430
74440
74445
74450
74455
74470
74475
74480
74485
74710
74740
74775
75600
75605
75625
75630
75650
75658
75660
75662
75665
75671
75676
75680
75685
75705
75710
75716
75722
75724
75726
75731
75733
75736
75741
75743
75746
75756
75774
75790
75801
75803
75805
75807
75809–75810
75820
75822
75825
75827
75831
75833
75840
75842
75860
75870
75872
75880
75885
75887
75889
75891
75893
75984
75989
75992–75996
75998 d
76000–76001
76003 d
76005–76006 d
76010
76012–76013 d
76020 d
76040 d
76061–76062 d
76065–76066 d
76070–76071 d
76075–76077 d
76080
76086 d
76088 d
76090–76092 d
76096 d
76098
76100–76102
76120
76125
76140
76150
76350
76355 d
76360 d
76362 d
76370 d
76375 #
76376–76377 b
76380
76496–76499
76506
76510
76511–76513
76516
76519
76529
76536
76604
76645
76700
76705
76770
76775
76776 d
76778 d
76800–76802
76805
76810–76812
76815–76817
76820–76821
76825–76828
76830–76831
76856–76857
76870
76872–76873
76880
76885–76886
76930
76932
76937
76940
76941–76942
76946
76950
76965
76970
76975
76986 d
76998 d
76999
77001–77003 d
77011–77014 d
77021–77022 d
77031–77032 d
77051–77059 d
77071–77077 d
77080–77081 d
78000–78001
78003
78006–78007
78010–78011
78015–78016
78018
78020
78070
78075
78099
78102–78104
78110–78111
78120–78122
78130
78135
78140
78160 #
78162 #
78170 #
78172 #
78185
78190–78191
78195
78199
78201–78202
78205–78206
78215–78216
78220
78223
78230–78232
78258
78261–78262
78264
78270–78272
78278
78282
78290–78291
78299–78300
78305–78306
78315
78320
78399
78414
78428
78445
78455 #
78456–78458
78460–78461
78466
78468
78472
78600–78601
78605–78606
78609–78610
78615
78630
78635
78645
78650
78660
78699–78701
78704 d
78707–78709
78715 d
78725
78730
78740
78760 d
78761
2 – California Children’s Services (CCS) Program Service Code Groupings
August 2007
cal child ser
7
2 – California Children’s Services (CCS) Program Service Code Groupings
August 2007
cal child ser
7
Authorized CPT-4 Codes in Physician SCG 01 (continued)
2 – California Children’s Services (CCS) Program Service Code Groupings
August 2007