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

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.