HCPCS Code Section: HCPCS G Codes

Salicylate Short Description: Assay of salicylate Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Nortriptyline Short Description: Assay of nortiptyline Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Assay of imipramine Short Description: Assay of imipramine Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 …

Flurazepam Short Description: Assay of flurazepam Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Gold Short Description: Assay of gold Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Ethchlorvynol Short Description: Assay of ethchlorvynol Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Doxepin Short Description: Assay of doxepin Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Epiandrosterone Short Description: Asssay of epiandrosterone Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Desipramine Short Description: Assay of desipramine Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …

Dimethadione Short Description: Assay of dimethadione Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2015 Effective Date: January 1, 2016 Termination Date: …