Types of Service Codes


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Wellmark Data Dictionary

Type Of Service Codes

¾ The type of service value is system generated from the procedure code on the claim and helps describe the procedure code.
The types of service values are listed below by each value and by the procedure code ranges.

Code

Description

0 Surgery Assistant (80 modifier)

Code
G

1 Not Used

H

2 Surgery

J

3 Maternity

K

4 Anesthesia (ASA codes or AA

L

Modifier)

5 Diagnostic X-ray

M

6 Medical Care (Includes Chemical

N

Dependency)

7 Dental (ADA Codes Only)

P

8 Laboratory (No Modifier)

Q

9 Consultation

T

A Medical Emergency

V

B Concurrent Medical Care

W

C Psychiatric Medical Care

X

D Physical Medicine

Y

E X-ray; Therapeutic (Radiation

Z

Therapy)

F Ambulance

Procedure Code Ranges and Type of Service

Description
Home Medical Equipment (Purchase) Home Medical Equipment (Rental) Not Used Drugs (IPSC/Drug Card CMM Drugs) Private Duty Nursing Services
Vision Care Not Used
Professional Component (26 modifier) Chemotherapy Technical Component (TC modifier) Hearing Second Opinion Accommodations (Facility) Ancillaries (Facility) Drugs and Injections

Note: Procedure codes ending in ‘T’ (i.e. 0001T, 0002T, 0044T) are CPT-Category III codes. They are temporary codes for emerging technology, services and procedures (experimental/investigational). The type of service is assigned to these based on the procedure performed. You will need to look these codes up in the CPT book to determine the type of service that should be used on these. These codes can be found after the Medicine section just before Appendix A.

Code Code

TOS

A0000

7

A0001 A0002

2

Actuarial Services/AS

10/23/2007

1

Wellmark Data Dictionary

Code Code

TOS

A0003

Y

A0010 A0999

F

A2000

6

A4000 A4260

G

A4261

6

A4262 A4263

2

A4264 A4265

G

A4266 A4269

6

A4270 A4299

G

A4300 A4301

2

A4302 A4549

G

A4550

2

A4554 A4640

G

A4641 A4647

5

A4648 A6010

G

A6011

2

A6012 A7039

G

A7040 A7043

2

A7044 A7509

G

A9010 A9130

6

A9140 A9150

Z

A9160 A9299

6

A9300 A9300

G

A9500 A9700

5

A9900 A9901

G

B0001 B4149

G

B4150 B5200

Z

B5201 B8999

G

B9000 B9006

G,H

B9007 B9999

G

Actuarial Services/AS

10/23/2007

2

Wellmark Data Dictionary

Code Code

TOS

C1000 C1022

8

C1031

G

C1045 C1087

5

C1088

G

C1089 C1122

5

C1146

G

C1166 C1167

Z

C1170 C1177

G

C1178

Z

C1188 C1202

5

C1207

Z

C1300 C1304

6

C1305

2

C1321 C1329

G

C1348

5

C1360

6

C1368

G

C1713 C1715

G

C1716 C1720

2

C1721 C1773

G

C1774

Z

C1775

5

C1776 C1778

2

C1779

G

C1780

M

C1781 C1782

G

C1783

2

C1784

M

C1785 C1817

G

C1818

6

Actuarial Services/AS

10/23/2007

3

Wellmark Data Dictionary

Code Code

TOS

C1819 C2612

G

C2614

2

C2615 C8830

G

C8900 C8999

5

C9000 C9003

Z

C9004 C9010

G

C9013

5

C9019 C9020

Z

C9100 C9103

5

C9105 C9204

Z

C9205 C9499

G

C9500 C9505

8

C9506 C9700

G

C9701

2

C9702 C9999

G

D0000 D9999

7

E0001 E0116

G,H

E0117

H

E0118 E0423

G,H

E0424

H

E0425 E0430

G,H

E0431 E0434

H

E0435 E0438

G,H

E0439

H

E0440 E0444

G,H

E0445

H

E0446 E0482

G,H

E0483 E0484

H

E0485 E0615

G,H

E0616

2

Actuarial Services/AS

10/23/2007

4

Wellmark Data Dictionary

Code E0617 E0618 E0620 E0749 E0754 E0756 E0758 E0782 E0784 E0785 E0787 E1037 E1039 G0001 G0002 G0003 G0027 G0028 G0030 G0051 G0103 G0104 G0106 G0107 G0108 G0120 G0121 G0122 G0123 G0125

Code
E0619 E0748 E0753 E0755 E0757 E0781 E0783
E0786 E1036 E1038 E9999
G0026
G0029 G0050 G0102
G0105
G0119
G0124 G0126

TOS G,H H G,H
2 G,H
2 G,H
2 G,H
2 G,H H G,H
8 2 6 8 6 5,T,P 6 8 2 5 8 6 5 2 5 8 5,T,P

Actuarial Services/AS

10/23/2007

5

Wellmark Data Dictionary

Code G0127 G0128 G0129 G0130 G0133 G0151 G0153 G0159 G0161 G0166 G0168 G0172 G0173 G0175 G0176 G0178 G0179 G0184 G0188 G0190 G0193 G0195 G0196 G0197 G0202 G0237 G0242 G0244 G0251 G0255

Code
G0132 G0150 G0152 G0156 G0160 G0165 G0167 G0171
G0174
G0177
G0183 G0187 G0189 G0192 G0194
G0201 G0236 G0241 G0243 G0250 G0254

TOS 2 6 D
5,T,P 8 D 6 2
5,T,P 6 2 6 E 6 C E 6 2
5,T,P 6 2 6 5 6
5,T,P 6 5 6
5,T,P 6,T,P

Actuarial Services/AS

10/23/2007

6

Wellmark Data Dictionary

Code Code

TOS

G0256

2

G0257 G0258

6

G0259 G0261

2

G0262

5

G0263 G0264

6

G0265 G0266

8

G0267 G0269

2

G0270 G0271

6

G0272

2

G0273

5

G0274

E

G0275 G0278

2

G0279 G0282

6

G0283

D

G0284 G0288

5

G0289 G0291

2

G0292

6

G0293 G0294

2

G0295

6

G0296

5

G0297 G9999

6

H0001 H0030

6

H0031 H0046

C

H0047 H0099

6

H1000 H1005

3

H1006 H2011

6

H2012 H2013

C

H2014 H2016

6

H2017 H2020

C

H2021 H2026

6

Actuarial Services/AS

10/23/2007

7

Wellmark Data Dictionary

Code H2027 H4000 H5010 H5210 J0001 J7150 J7151 J7300 J7301 J7302 J7303 J7340 J7351 J9000 K0001 K0415 K0417 K0548 K0549 K0560 K0561 K0601 L0001 M0001
M0600 M0700 M0800 P0001 Q0001 Q0035

Code H3000 H4001 H5030 H5300 J7149
J7299
J7339 J7350 J8999 J9999 K0414 K416 K0547
K0559
K0600 K0626 L9999 M0599 M0699 M0799 M0999 P9999 Q0034

TOS C L C D Z,K Q Z 6 Z 6 Z 2 Z Q
G,H Z
G,H Z
G,H 2,H G,H G G 6,4,P
C,4 D 6,4,P 8,P 6 6,T

Actuarial Services/AS

10/23/2007

8

Wellmark Data Dictionary

Code Q0036 Q0083 Q0086 Q0087 Q0091 Q0092 Q0093 Q0116 Q0136 Q0163 Q0182 Q0186 Q0187 Q0188 Q1001 Q2000 Q3000 Q3013 Q3017 Q3021 Q3031 Q3032 Q4000 Q4052 Q4078 Q4079 R0001 S0009 S0199 S0200

Code Q0082 Q0085
Q0090
Q0115 Q0135 Q0162 Q0181 Q0185
Q1000 Q1999 Q2999 Q3012 Q3016 Q3020 Q3030
Q3999 Q4051 Q4077
Q9999 R5999 S0198
S0206

TOS 6 Q D 6 6 5 8 6 Z Q 2 6 Z 6 M Z 5 6 F Z G 6 2 Z 5 Z
5,T,4,P Z 2 6

Actuarial Services/AS

10/23/2007

9

Wellmark Data Dictionary

Code S0207 S0216 S0390 S0401 S0500 S0600 S0602 S0620 S0622 S0623 S0820 S0830 S0831 S1000 S1025 S1026 S1031 S1032 S2000 S2107 S2108 S2260 S2268 S3000 S3001 S3800 S3900 S3906 S3907 S4000

Code S0215 S0389 S0400 S0499 S0599 S0601 S0619 S0621
S0819 S0829
S0999 S1024
S1030
S1999 S2106
S2259 S2267 S2999
S3799 S3899 S3905
S3999 S4016

TOS F 6 2 6 M 2 6 M 6 2 6 5 6 G 6 G H G 2,0 6,0 2,0 3,0 2,0
6,T,P 8,T,P
8 6 2 6 2

Actuarial Services/AS

10/23/2007

10

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Types of Service Codes