knowledge/lexical/codes

Source: knowledge/lexical/codes.parquet. Source vintage: Package vintage 2026-10-01; source path partition not dated; inspect record and rule clocks separately. Grain: Packaged source record; inspect schema and linked world method before aggregation. Snapshot: 7a53af6a9beb58928d4a64dc92db09c9db65433f9909f1a10d16e302adaf86ba.

Source records. NULL means missing; empty text is labelled separately.
node_id UInt32	code Utf8	text Utf8	__row_id Int64
3600 Filter to this value Explore graph node	T1015 Filter to this value	T1015 criteria: Only one medical and one behavioral encounter may be submitted per date of service, unless a service authorization has been approved. criteria: Wrap payment is zero because Other Payor payment > Base Rate criteria: along with one or more pertinent procedure codes that identify each criteria: along with one or more pertinent procedure codes that identify each specific service provided during the visit criteria: along with one or more pertinent procedure codes that identify each specific service provided during the visit. criteria: billed with the T1015 along with the specific modifiers for participating Medicaid FQHC/RHCs criteria: including HI and SC modifiers, when appropriate, as defined in Clinical Coverage Policy No: 1D-4 Attachment A criteria: including HI and SC modifiers, when appropriate, as defined in Clinical Coverage Policy No: 1D-4 Attachment A to bill for Core Services. criteria: services are medically necessary and rendered to MA beneficiaries under 21 years of age who are experiencing weight management problems criteria: submitted with just the T1015 disposition: not-reimbursable disposition: payable disposition: payable-with-criteria effective date: August 1, 2024 effective date: December 1, 2024 effective date: July 1, 2023 effective_date: not-stated highmark code-disposition criteria: billed with the T1015 along with the specific modifiers for participating Medicaid FQHC/RHCs highmark code-disposition criteria: services are medically necessary and rendered to MA beneficiaries under 21 years of age who are experiencing weight management problems highmark code-disposition criteria: submitted with just the T1015 highmark code-disposition disposition: not-reimbursable highmark code-disposition disposition: payable-with-criteria medicaid-nc code-disposition code: T1015 medicaid-nc code-disposition criteria: billed by FQHC or RHC for core services medicaid-nc code-disposition criteria: including HI and SC modifiers, when appropriate, as defined in Clinical Coverage Policy No: 1D-4 Attachment A medicaid-nc code-disposition criteria: including HI and SC modifiers, when appropriate, as defined in Clinical Coverage Policy No: 1D-4 Attachment A to bill for Core Services. medicaid-nc code-disposition disposition: payable medicaid-nc code-disposition disposition: payable-with-criteria medicaid-nc code-disposition effective-date: July 1, 2023 medicaid-nc code-disposition effective-date: not-stated medicaid-nh code-disposition criteria: along with one or more pertinent procedure codes that identify each medicaid-nh code-disposition criteria: along with one or more pertinent procedure codes that identify each specific service provided during the visit medicaid-nh code-disposition criteria: submitted with only the medical encounter code medicaid-nh code-disposition disposition: not-reimbursable medicaid-nh code-disposition disposition: payable-with-criteria medicaid-nv code-disposition integral-to-other-service: Drug and vaccine administration costs medicaid-nv code-disposition integral-to-other-service: Pharmaceutical items medicaid-nv code-disposition not-reimbursable: Room and board or other unallowable facility costs medicaid-nv code-disposition prior-authorization-required: false payable-with-criteria: true payable-with-criteria: when appropriate, as defined in Clinical Coverage Policy No: 1D-4 Attachment A payable: true	273

Evidence receipt r8578

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