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Targeted Probe and Educate: September 2021 to September 2022 Planned Reviews

Published 08/31/2021

Railroad Medicare has resumed Targeted Probe and Educate (TPE) reviews as of September 1, 2021. We plan to conduct provider-specific TPE reviews for the services listed in the table below.

September 2021 to September 2022 Planned TPE Reviews

Type of Service	CPT/HCPCS Code	Code Description
Ambulance Services (Emergent)	A0427	ALS1, emergency
	A0429	BLS, emergency
	A0425	Ground Mileage
Ambulance Services (Non-Emergent)	A0426	ALS1, non-emergency
	A0428	BLS, non-emergency
	A0425	Ground Mileage
Diagnostic Services: Radiology	71045	X-ray exam chest 1 view
	71046	X-ray exam chest 2 views
	77080	DXA bone density axial
	Q0092	Set up portable X-ray equipment
	R0070	Transport portable x-ray
	R0075	Transport portable x-ray, multiple patients
Diagnostic Services: Clinical Labs	G0480	Drug Test, definitive, 1-7 classes
	G0481	Drug Test, definitive, 8-14 classes
	G0482	Drug Test, definitive, 15-21 classes
	G0483	Drug Test, definitive, 22 or more classes
Diagnostic Services: Surgical Pathology	88305–88309	Tissue exam by pathologist
Diagnostic Services: Surgical Pathology	88312	Special stain including interpretation and report; group 1
Drugs and Biologicals	J2778	Ranibizumab injection
	J1745	Infliximab (Remicade®), not biosimilar, injection
	J9312	Rituximab (Rituxan®) injection
	J0178	Aflibercept Injection

CPT codes begin with a numeric character and HCPCS codes begin with an alpha character. CPT codes, descriptors and other data only are copyright ©2020 American Medical Association®. All rights reserved.

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