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Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013

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Start Preamble Start Printed Page 48996

AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Correction of final rule with comment period.

SUMMARY:

This document corrects technical errors that appeared in the final rule with comment period published in the Federal Register on November 16, 2012, entitled “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013.”

DATES:

The correcting document is effective August 12, 2013 and is applicable beginning January 1, 2013.

Start Further Info

FOR FURTHER INFORMATION CONTACT:

Elliott Isaac, (410) 786-4735.

End Further Info End Preamble Start Supplemental Information

SUPPLEMENTARY INFORMATION:

I. Background

In FR Doc. 2012-26900 of November 16, 2012 (77 FR 68892 through 69373), there were a number of technical errors that are identified and corrected in the Correction of Errors section below. These corrections are effective January 1, 2013. We note that the Addenda A through H for the CY 2013 PFS final rule with comment period as corrected in this correction notice are available on the CMS Web site at www.cms.gov/​/PhysicianFeeSched/​.

II. Summary of Errors

A. Summary of Errors in the Preamble

On pages 68904 through 68906, in Table 3: Calculation of PE RVUs under Methodology for Selected Codes, the PE RVUs listed in the table are incorrect.

On page 68907, in our discussion of the changes to direct PE inputs for specific services, we made a typographical error in identifying the calendar years.

On page 68957, in our discussion of Medicare telehealth services, we inadvertently omitted a discussion of psychotherapy services.

On page 68958, in our discussion of therapy services, we inadvertently omitted language regarding the claims-based data collection strategy for therapy services.

On page 68965, we inadvertently omitted language in our discussion on non-payable G-codes on beneficiary functional status.

On page 68966, we inadvertently included language.

On pages 68967 and 68968, we inadvertently made errors in the descriptors for G-codes in Table 21: G-Codes for Claims-Based Functional Reporting for CY 2013.

On page 69033, we inadvertently omitted a code-specific direct PE input.

On pages 69042 and 69043, in our discussion of the global period for CPT code 22586, we made a typographical error in the code descriptor.

On page 69051,

a. We inadvertently used the wrong descriptor for CPT 36221.

b. We inadvertently omitted two paragraphs regarding our treatment of CPT codes 37197 and 37214.

On pages 69071 through 69073, we made clerical errors in table references.

On page 69074, in our discussion of pricing supply and equipment items, we inadvertently omitted a paragraph detailing the items for which we did not receive adequate information and therefore could not price them for the interim final values in the CY 2013 rule.

On pages 69077 through 69128, we made numerous typographical errors and technical errors in Table 74: CPT Codes with Refined direct PE Recommendations for CY 2013 Interim Codes and therefore are correcting the table.

On page 69138, we made typographical errors in the CY 2013 PFS conversion factor (CF).

On page 69138, we made typographical errors in the CY 2013 PFS CF in Table 87: Calculation of the CY 2013 PFS CF.

On page 69139, in Table 88: Calculation of the CY 2013 Anesthesia CF, we inadvertently listed the incorrect anesthesia CF.

On page 69145, we inadvertently referred to “physician's order” instead of “valid prescription.”

On page 69212, due to a typographical error, the title of PQRS Measure 190 referred to in the comment bullet was not correct.

On pages 69215 through 69267, the notes after Table 95: Individual Quality Measures for the Physician Quality Reporting System Proposed to be Available for Reporting via Claims, Registry, EHR, or GRPO Web Interface Beginning in 2013 or 2014* were inadvertently omitted.

On page 69237, in Table 95: Individual Quality Measures for the Physician Quality Reporting System Proposed to be Available for Reporting via Claims, Registry, EHR, or GRPO Web Interface Beginning in 2013 or 2014*, due to a typographical error, Measures #189 and 190 were incorrectly listed as available for reporting under PQRS.

On page 69269, in Table 96: PQRS Quality Measures Available for Reporting for Group Practices Using the GPRO Web Interface for 2013 and Beyond, due to a typographical error, the description of the measure “Medication Reconciliation” is incorrect.

On page 69277, in Table 108: HIV/AIDS Measures Group, due to a clerical error, there are measures listed that have lost their NQF endorsement and are therefore no longer being maintained by the respective measure owner.

On page 69300, due to a clerical error, we stated the deadlines for requesting an informal review for the 2012 and 2013 eRx incentives incorrectly. The regulation at § 414.92(g) correctly states that eligible professionals and group practices must submit an informal review request for the 2012 and 2013 incentives within 90 days of the release of the feedback reports. The preamble does not reflect this same regulation text. Therefore, we are revising the preamble to reflect the regulation text at § 414.92(g).

On pages 69344 through 69345, in Table 134: CY 2013 PFS Final Rule with Comment Period Estimated Impact on Total Allowed Charges by Specialty, due to technical errors in the calculations of the impacts, there were errors in the total estimated impacts and the estimated impacts for the following specialties: 01—ALLERGY/IMMUNOLOGY, 02—ANESTHESIOLOGY, 10—FAMILY PRACTICE, 13—GENERAL SURGERY, 18—INTERNAL MEDICINE, 19—INTERVENTIONAL PAIN MANAGEMENT, 21—MULTISPECIALTY CLINIC/OTHER PHY, 34—PLASTIC SURGERY, 41—UROLOGY, 49—NURSE ANES/ANES ASST.

On page 69345, at the end of Table 134: CY 2013 PFS Final Rule with Comment Period Estimated Impact on Total Allowed Charges by Specialty, we made clerical errors in the first footnote.

On pages 69347 through 69348, in Table 135: CY 2013 PFS Final Rule with Start Printed Page 48997Comment Period Estimated Impact on Total Allowed Charges by Specialty by Selected Policy, due to technical errors in calculations of the impacts, there were errors in the estimates of the total impact and on the impact for the following specialties: 01—ALLERGY/IMMUNOLOGY, 02—ANESTHESIOLOGY, 13—GENERAL SURGERY, 18—INTERNAL MEDICINE, 19—INTERVENTIONAL PAIN MANAGEMENT, 21—MULTISPECIALTY CLINIC/OTHER PHY, 41—UROLOGY, 49—NURSE ANES/ANES ASST.

On page 69348, at the end of Table 135: CY 2013 PFS Final Rule with Comment Period Estimated Impact on Total Allowed Charges by Specialty by Selected Policy, we made a clerical error in the first footnote.

On page 69350 through 69351, in Table 136: Impact of Final Rule with Comment Period on CY 2013 Payment for Selected Procedures, we made technical errors in the calculation of the impacts.

On page 69351, in footnotes 3 and 4 at the end of Table 136: Impact of Final Rule with Comment Period on CY 2013 Payment for Selected Procedures, we inadvertently listed the incorrect 2012 conversion factor.

B. Summary and Correction of Errors in the Addenda on the CMS Web site

Technical errors in the creation of the direct practice expense database resulted in incorrect direct PE inputs for CPT codes: 11307, 11313, 13100, 13101, 13102, 13120, 13121, 13122, 13131, 13132, 13133, 13150, 13151, 13152, 31231, 32554, 32555, 32556, 32557, 35475, 35476, 36221, 36222, 36223, 36224, 36225, 36226, 37197, 52224, 64612, 65800, 72040, 72050, 72052, 72069, 72193, 72194, 74160, 74170, 74177, 74178, 76872, 77301, 92081, 92082, 92083, 92235, 92286, 93925, 93970, 95010, 95015, 95017, 95018, 95782, 95783, and 97150. As a result of these errors, the budget neutrality adjustment used in calculating PE RVUs was incorrect, resulting in incorrect values for other PE RVUs in Addenda B and C. These errors are corrected in the revised Direct PE Input Database available on the CMS Web site at www.cms.gov/​/PhysicianFeeSched/​. Resulting changes to PE RVUs are reflected in the corrected Addenda B and C posted on the CMS Web site at www.cms.gov/​/PhysicianFeeSched/​.

Due to a technical error, although the physician time records for CPT codes 22841, 51798, 95990, 96913, and 97602 were properly removed from the physician time file per final policy discussed in the CY 2013 final rule with comment period (77 FR 68926), these time records were inadvertently used in the creation of the PE RVUs. This technical error is corrected in the revised CY 2013 Addendum B posted to the CMS Web site at www.cms.gov/​/PhysicianFeeSched/​.

Due a technical error in applying a change made in the final rule in calculating the impact of the ophthalmology MPPR used in the PE methodology, as described on page 68901, the “CY 2012 Utilization data Crosswalk to CY 2013” file posted on the CMS Web site contained errors. This also resulted in errors in Addenda B and C files posted on the CMS Web site. These addenda have been corrected as a result of the changes made in this correction notice and the corrected Addenda B and C files are posted on the CMS Web site. www.cms.gov/​/PhysicianFeeSched/​.

Due to a technical error in calculating the anesthesia inputs, the PE RVUs for all services reflected in Addenda B and C posted on the CMS Web site were inaccurate. Resulting changes to the PE RVUs are reflected in the corrected Addenda B and C.

Due to a technical error, in Addendum B, row 8744 containing CPT/HCPC 92287 did not list RVUs for use with both the TC and 26 modifiers. The corrected Addendum B, which is posted on the CMS Web site at www.cms.gov/​/PhysicianFeeSched/​, includes these services and related information.

Due to a technical error in Addendum B, row 9180 containing CPT/HCPC 93657 did not list a PE RVU. The corrected Addendum B, which is posted on the CMS Web site at www.cms.gov/​/PhysicianFeeSched/​ reflects this change.

Due to a technical error in the posting of Addendum C, the “NA” flags did not display for services when either the facility or nonfacility setting did not contain a value. The corrected Addendum C, which is posted on the CMS Web site at www.cms.gov/​/PhysicianFeeSched/​, reflects the “NA” flags for services that are not valued in the indicated setting.

III. Waiver of Proposed Rulemaking

We ordinarily publish a notice of proposed rulemaking in the Federal Register to provide a period for public comment before the provisions of a rule take effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive this notice and comment procedure if the Secretary finds, for good cause, that the notice and comment process is impracticable, unnecessary, or contrary to the public interest, and incorporates a statement of the finding and the reasons therefore in the notice.

Section 553(d) of the APA ordinarily requires a 30-day delay in the effective date of final rules after the date of their publication in the Federal Register. This 30-day delay in effective date can be waived, however, if an agency finds for good cause that the delay is impracticable, unnecessary, or contrary to the public interest, and the agency incorporates a statement of the findings and its reasons in the rule issued.

This document merely corrects typographical and technical errors in the preamble and addenda of the CY 2013 Physician Fee Schedule final rule with comment period. The provisions of that final rule with comment period have been subjected to notice and comment procedures. The corrections contained in this document are consistent with, and do not make substantive changes to, the policies and payment methodologies that were adopted in the CY 2013 PFS final rule with comment period. As a result, the corrections made through this correcting document are intended to ensure that the CY 2013 PFS final rule with comment period accurately reflects the policies adopted in that rule. Therefore, we find for good cause that it is unnecessary and would be contrary to the public interest to undertake further notice and comment procedures to incorporate the corrections in this document into the CY 2013 PFS final rule with comment period. For the same reasons, we find that there is good cause to waive the 30-day delay in the effective date for these corrections.

Further, we believe that it is in the public interest to ensure that the CY 2013 PFS final rule with comment period accurately reflects our policies as of the date they take effect. Therefore, we find that delaying the effective date of these corrections beyond the effective date of the final rule with comment period would be contrary to the public interest. In so doing, we find good cause to waive the 30-day delay in effective date.

IV. Correction of Errors

In FR Doc. 2012-26900 of November 16, 2012 (77 FR 68892), make the following corrections:

A. Correction of Errors in the Preamble

1. On pages 68904 through 68906, in Table 3: Calculation of PE RVUs Under Methodology for Selected Codes, the table is corrected to read as follows:Start Printed Page 48998

Table 3—Calculation of PE RVUS Under Methodology for Selected Codes

StepSourceFormula99213 Office visit, est nonfacility33533 CABG, arterial, single facility71020 Chest x-ray nonfacility71020-TC Chest x-ray nonfacility71020-26 Chest x-ray nonfacility93000 ECG, complete nonfacility93005 ECG, tracing nonfacility93010 ECG, report nonfacility
(1) Labor cost (Lab)Step 1AMA13.3277.525.745.740.006.126.120.00
(2) Supply cost (Sup)Step 1AMA2.980.003.393.390.001.191.190.00
(3) Equipment cost (Eqp)Step 1AMA0.170.587.247.240.000.110.110.00
(4) Direct cost (Dir)Step 1=(1)+(2)+(3)16.4878.1016.3816.380.007.427.420.00
(5) Direct adjustment (Dir. Adj.)Steps 2-4See footnote*0.59730.59730.59730.59730.59730.59730.59730.5973
(6) Adjusted LaborSteps 2-4=Labor * Dir Adj=(1)*(5)7.9646.303.433.430.003.663.660.00
(7) Adjusted SuppliesSteps 2-4=Eqp * Dir Adj=(2)*(5)1.780.002.032.030.000.710.710.00
(8) Adjusted EquipmentSteps 2-4=Sup * Dir Adj=(3)*(5)0.100.354.334.330.000.060.060.00
(9) Adjusted DirectSteps 2-4=(6)+(7)+(8)9.8446.659.789.780.004.434.430.00
(10) Conversion Factor (CF)Step 5PFS34.037634.037634.037634.037634.037634.037634.037634.0376
(11) Adj. labor cost convertedStep 5=(Lab * Dir Adj)/CF=(6)/(10)0.231.360.100.100.000.110.110.00
(12) Adj. supply cost convertedStep 5=(Sup * Dir Adj)/CF=(7)/(10)0.050.000.060.060.000.020.020.00
(13) Adj. equipment cost convertedStep 5=(Eqp * Dir Adj)/CF=(8)/(10)0.000.010.130.130.000.000.000.00
(14) Adj. direct cost convertedStep 5=(11)+(12)+(13)0.291.370.290.290.000.130.130.00
(15) Work RVUSetup FilePFS0.9733.750.220.000.220.170.000.17
(16) Dir_pctSteps 6,7Surveys0.310.180.310.310.310.310.310.31
(17) Ind_pctSteps 6,7Surveys0.690.820.690.690.690.690.690.69
(18) Ind. Alloc. Formula (1st part)Step 8See Step 8((14)/(16)*(17)((14)/(16)*(17)((14)/(16)*(17)((14)/(16)*(17)((14)/(16)*(17)((14)/(16)*(17)((14)/(16)*(17)((14)/(16)*(17)
(19) Ind. Alloc.(1st part)Step 8See 180.876.410.70.700.320.320
(20) Ind. Alloc. Formula (2nd part)Step 8See Step 8(15)(15)(15+11)(11)(15)(15+11)(11)(15)
(21) Ind. Alloc.(2nd part)Step 8See 200.9733.750.320.100.220.280.110.17
(22) Indirect Allocator (1st + 2nd)Step 8=(19)+(21)1.8440.161.030.810.220.600.430.17
(23) Indirect Adjustment (Ind. Adj.)Steps 9-11See Footnote**0.400.400.400.400.400.400.400.40
Start Printed Page 48999
(24) Adjusted Indirect AllocatorSteps 9-11=Ind Alloc * Ind Adj0.7516.250.420.330.090.240.170.07
(25) Ind. Practice Cost Index (IPCI)Steps 12-161.080.790.920.920.920.920.920.92
(26) Adjusted IndirectStep 17= Adj.Ind Alloc * PCI=(24)*(25)0.8112.760.380.300.080.220.160.06
(27) PE RVUStep 18=(Adj Dir + Adj Ind) * budn=((14)+(26)) * budn1.1014.150.670.590.080.350.290.06
Start Printed Page 49000

2. On page 68907, first column, first paragraph,

a. Line 6, the phrase “CY 2012” is corrected to read “CY 2013.”

b. Line 8, the phrase “CY 2012” is corrected to read “CY 2013.”

3. On page 68957, second column, following Table 18 is corrected by adding the following:

“6. Psychiatry Services

For CY 2013, the CPT Editorial Panel replaced the current psychiatry/psychotherapy CPT codes with a new structure that allows for the separate reporting of E/M codes, eliminates codes based upon the site-of-service, establishes CPT codes for crisis, and creates a series of psychotherapy add-on CPT codes to describe interactive complexity and medication management. Many of these services are included in the list of Medicare telehealth services. For CY 2013, we did not propose any changes in Medicare telehealth payment policies related to the existing services described by these new codes. Therefore, the new codes describing services currently included on the CY 2012 list of Medicare telehealth services will be included on the CY 2013 list of Medicare telehealth services.

In the case of pharmacologic management services, currently on the CY 2012 list of Medicare telehealth services, we note that the CPT Editorial Panel deleted CPT code 90862 (Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy), and that for CY 2013, psychiatrists will bill the appropriate E/M code when furnishing pharmacologic management services. In order to maintain current telehealth policy for these services when furnished to inpatients, we are establishing a new HCPCS G-code, G0459 (Inpatient telehealth, pharmacologic management, including prescription use and review of medication with no more than minimal medical psychotherapy), on an interim basis for CY 2013 that will describe the pharmacologic management service when furnished via telehealth to inpatients.

We will address any other change in telehealth policy regarding psychiatry services in future rulemaking.”.

4. On page 68959, first column, partial line 5, before the phrase “Between 1998-2008,” is corrected to read as follows: “We note that this number does not represent a discrete number of beneficiaries; rather, it represents the total number of beneficiaries receiving therapy services under plans of care from different disciplines and different providers.”.

5. On page 68965, third column, third paragraph, lines 4 and 5, the phrase “a composite score” is corrected to read “an overall composite score.”

6. On page 68966, third column, second full paragraph, lines 19 through 21, the phrase “…functional measures, such as is done with the FOTO Patient tool, for example.” is corrected to read “functional measures.”

7. On page 68967 and 68968, in Table 21: G-Codes for Claims-Based Functional Reporting for CY 2013, the listed entries are corrected to read as follows:

Other PT/OT Primary Functional Limitation
G8990Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals.
G8991Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting.
G8992Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting.
Other PT/OT Primary Functional Limitation
G8993Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals.
G8994Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting.
G8995Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting.
Swallowing
G8996Swallowing functional limitation, current status at therapy episode outset and at reporting intervals.
G8997Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting.
G8998Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting.
Motor Speech
G8999Motor speech functional limitation, current status at therapy episode outset and at reporting intervals.
G9186Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.
Spoken Language Comprehension
G9159Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals.
G9160Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.
G9161Spoken language comprehension functional limitation, discharge status at discharge from therapy or to end reporting.
Spoken Language Expression
G9162Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals.
G9163Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.
Start Printed Page 49001
G9164Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting.
Attention
G9165Attention functional limitation, current status at therapy episode outset and at reporting intervals.
G9166Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.
G9167Attention functional limitation, discharge status at discharge from therapy or to end reporting.
Memory
G9168Memory functional limitation, current status at therapy episode outset and at reporting intervals.
G9169Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.
G9170Memory functional limitation, discharge status at discharge from therapy or to end reporting.
Voice
G9171Voice functional limitation, current status at therapy episode outset and at reporting intervals.
G9172Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.
G9173Voice functional limitation, discharge status at discharge from therapy or to end reporting.
Other SLP Functional Limitation
G9174Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals.
G9175Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.
G9176Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting.

8. On page 69033, in the third column, after second full paragraph, is corrected by adding the following:

“(14) Needle EMG: Electromyography (CPT Codes 95886, 95887)

In establishing interim final direct PE inputs for 2012, CMS refined the AMA RUC's recommendation for CPT codes 95886 (Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for primary procedure)) and 95887 (Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)) by reducing the number of service period clinical labor minutes to account for preparatory clinical labor tasks associated with both the base and add-on codes. CMS also refined the corresponding equipment minutes.

Comment: Several commenters explained that clinical labor typically requires additional time to prepare the distinct equipment used in furnishing the services described by the add-on codes.

Response: After reviewing the information provided by the commenters, we agree that it would be appropriate to incorporate additional minutes for these codes. Therefore, we are finalizing the direct PE inputs for CPT codes 95886 and 95887 with the additional refinement of adding two minutes to both the service period clinical labor time and the corresponding equipment time. The direct PE inputs are displayed in the final CY 2013 direct PE input database, available on the CMS Web site under downloads for the CY 2013 PFS final rule at www.cms.gov/​PhysicianFeeSched/​.”.

9. On page 69042, bottom half of the page, last paragraph, last line, the phrase CPT code 99231 visits is corrected to read “99231 (subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; a problem focused examination; medical decision making that is straightforward or of low complexity) visits,”.

10. On page 69043, top of page, first column, first partial paragraph, lines 1 and 2, the phrase 99323 visit is corrected to read “99232 (subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; an expanded problem focused examination; medical decision making of moderate complexity) visit, 1 CPT code 99238 (hospital discharge day management; 30 minutes or less) visit, and 4 CPT code 99213 (office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity) visits.”.

11. On page 69051,

a. First column, first full paragraph, lines 2 through 10, the parenthetical ((Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed).), is corrected to read: “((Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed).)”.

b. Third column, after last full paragraph, is corrected by adding the following:

“CPT codes 37620, 75940, and 36010 were identified as potentially misvalued through the Codes Reported Together 75 percent or More screen. In response, the CPT Editorial Panel created CPT codes 37191 through 37193 and 37197 to bundle the services together. After clinical review of CPT code 37197 (Transcatheter retrieval, percutaneous, of intravascular foreign body (for example, fractured venous or arterial Start Printed Page 49002catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed), along with the other related bundled services, we believe a work RVU of 6.29 accurately reflects the work involved in furnishing this service. We believe CPT code 37197 involves similar work as CPT code 36247 (Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family) and should be valued the same. Furthermore, we believe a work RVU of 6.29 appropriately reflects the relative difference in work between this service and related CPT codes 37191, 37192, and 37193. The AMA RUC recommended a work RVU of 6.72 for CPT code 37197, a direct crosswalk to CPT code 36475 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated). On an interim final basis for CY 2013, we are assigning a work RVU of 6.29 to CPT code 37197.”.

12. On page 69071, lower half of the page, third column,

a. Lines 3 and 4, the phrase “Table KK6 is corrected to read “Table 73.”.

b. Line 10, the phrase “Table KK7” is corrected to read “Table 74.”.

13. On page 69072,

a. First column, first full paragraph, line 1, the phrase “Table KK7” is corrected to read “Table 74.”

b. Second column,

(1) First full paragraph, last line, the phrase “Table 73” is corrected to read “Table 74.”.

(2) Second full paragraph, last line, the phrase “Table 73” is corrected to read “Table 74.”.

c. Third column,

(1) First paragraph, last line, the phrase “Table 73” is corrected to read “Table 74.”.

(2) Second paragraph, lines 23 and 24, the phrase “Table 73” is corrected to read “Table 74.”

14. On page 69073, second column, second full paragraph, last line, the phrase “Table 73” is corrected to read, “Table 74.”

15. On page 69074, first column, following first partial paragraph, is corrected to read as follows:

“We note that we did not receive adequate information for pricing the following new supply and equipment items included in the AMA RUC's CY 2013 direct PE input recommendations: SD276 (Indicator powder), SK115 (Reproduced patient worksheet), SL464 (Atomizer tips, disposable), and ER088 (Infrared illuminator). Therefore, for CY 2013, these supply and equipment items have no price inputs associated with them in the direct PE database. We will consider any newly submitted information regarding appropriate pricing for these supply items as part of our annual supply and equipment price update process.”

16. On pages 69077 through 69128, in Table 74: CPT Codes with Refined Direct PE Recommendations for CY 2013 Interim Codes is corrected to read as follows:

TABLE 74—CPT Codes With Refined Direct PE Recommendations for CY 2013 Interim Codes

CPT CodeCPT Code descriptionCMS CodeCMS Code descriptionNonFac/FacLabor activity (if applicable)RUC recommendation or current value (min or qty)CMS refinement (min or qty)Comment
11300Shave skin lesion 0.5 cm/<ED004camera, digital (6 mexapixel)NF2914Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF2914Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF2914Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF2914Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF290CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF2924Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator(tubing, covering, etc.) with standNF2914Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
Start Printed Page 49003
SC029needle, 18-27gNF10CMS clinical review.
11301Shave skin lesion 0.6-1.0 cmED004camera, digital (6 mexapixel)NF3217Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF3217Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3217Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3217Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF320CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF3227Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3217Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11302Shave skin lesion 1.1-2.0 cmED004camera, digital (6 mexapixel)NF3720Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF3720Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3720Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3720Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF370CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF3730Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49004
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3720Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11303Shave skin lesion >2.0 cmED004camera, digital (6 mexapixel)NF4122Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF4122Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF4122Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4122Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF410CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF4132Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4122Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11305Shave skin lesion 0.5 cm/<ED004camera, digital (6 mexapixel)NF2917Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF2917Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF2917Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49005
EF031table, powerNF2917Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF290CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF2927Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF2917Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11306Shave skin lesion 0.6-1.0 cmED004camera, digital (6 mexapixel)NF3125Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF3125Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3125Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3125Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF310CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF3135Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3125Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFAssist physician in performing procedure1018Conforming to physician time.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Start Printed Page 49006
11307Shave skin lesion 1.1-2.0 cmED004camera, digital (6 mexapixel)NF3721Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF3721Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3721Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3721Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF370CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF3731Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3721Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11308Shave skin lesion >2.0 cmED004camera, digital (6 mexapixel)NF4224Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF4224Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF4224Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4224Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF420CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF4234Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49007
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4224Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11310Shave skin lesion 0.5 cm/<ED004camera, digital (6 mexapixel)NF3420Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF3420Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3420Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3420Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF340CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF3430Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3420Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11311Shave skin lesion 0.6-1.0 cmED004camera, digital (6 mexapixel)NF3424Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF3424Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3424Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49008
EF031table, powerNF3424Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF340CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF3434Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3424Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFAssist physician in performing procedure1117Conforming to physician time.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11312Shave skin lesion 1.1-2.0 cmED004camera, digital (6 mexapixel)NF4317Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF4317Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF4317Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4317Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF430CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF4337Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4317Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Start Printed Page 49009
11313Shave skin lesion >2.0 cmED004camera, digital (6 mexapixel)NF4830Refined equipment time to reflect typical use exclusive to patient.
EF014light, surgicalNF4830Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF4830Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4830Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF480CMS clinical review; not described as typical in work vignette.
EQ137instrument pack, basic ($500-$1499)NF4840Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4830Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package110Standardized time input.
SB003cover, probe (cryosurgery)NF10CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB033mask, surgicalNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
11719Trim nail(s) any numberL037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available31CMS clinical review.
L037DRN/LPN/MTANFProvide pre-service education/obtain consent21CMS clinical review.
L037DRN/LPN/MTANFPrepare room, equipment, supplies21CMS clinical review.
L037DRN/LPN/MTANFClean room/equipment by physician staff31CMS clinical review.
SJ028hydrogen peroxideNF100CMS clinical review.
SJ053swab-pad, alcoholNF100CMS clinical review.
13100Cmplx rpr trunk 1.1-2.5 cmEF014light, surgicalNF3227Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3239Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49010
EF023table, examNF3227Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3239Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF3239Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF3246Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3239Refined equipment time to reflect typical use exclusive to patient.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
13101Cmplx rpr trunk 2.6-7.5 cmEF014light, surgicalNF4527Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF4547Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF4527Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4547Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF4547Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF4554Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4547CMS clinical review.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
Start Printed Page 49011
SB027gown, staff, imperviousF20CMS clinical review.
SB034mask, surgical, with face shieldNF21Duplicative.
SB034mask, surgical, with face shieldF21CMS clinical review.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF100Duplicative.
13102Cmplx rpr trunk addl 5cm/<EF015mayo standNF3020Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3020Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF3020Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF3020Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3020Refined equipment time to reflect typical use exclusive to patient.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
13120Cmplx rpr s/a/l 1.1-2.5 cmEF014light, surgicalNF8627Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF8641Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF8627Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF8641Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF8641Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF8648Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF8641Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49012
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB027gown, staff, imperviousF20CMS clinical review.
SB034mask, surgical, with face shieldNF21Duplicative.
SB034mask, surgical, with face shieldF21CMS clinical review.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
13121Cmplx rpr s/a/l 2.6-7.5 cmEF014light, surgicalNF12927Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF12948Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF12927Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF12948Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF12948Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF12955Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF12948Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFClean Surgical Instrument Package1510Standardized time input.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF100Duplicative.
13122Cmplx rpr s/a/l addl 5 cm/>EF015mayo standNF3020Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49013
EF031table, powerNF3020Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF3020Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF3020Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3020Refined equipment time to reflect typical use exclusive to patient.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
13131Cmplx rpr f/c/c/m/n/ax/g/h/fEF014light, surgicalNF4527Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF4548Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF4527Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4548Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF4548Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF4555Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4548Refined equipment time to reflect typical use exclusive to patient.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
Start Printed Page 49014
13132Cmplx rpr f/c/c/m/n/ax/g/h/fEF014light, surgicalNF5027Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF5051Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF5027Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF5051Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF5051Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF5058Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF5051Refined equipment time to reflect typical use exclusive to patient.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF100Duplicative.
13133Cmplx rpr f/c/c/m/n/ax/g/h/fEF015mayo standNF3523Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3523Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF3523Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF3523Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3523Refined equipment time to reflect typical use exclusive to patient.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
Start Printed Page 49015
SJ041povidone soln (Betadine)NF50Duplicative.
13150Cmplx rpr e/n/e/l 1.0 cm/<EF014light, surgicalNF3027Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF3044Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF3027Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF3044Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF3044Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF3051Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF3044Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFAssist physician in performing procedure2026Conforming to physician time.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
13151Cmplx rpr e/n/e/l 1.1-2.5 cmEF014light, surgicalNF4527Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF4548Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF4527Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4548Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49016
EQ114electrosurgical generator, up to 120 wattsNF4548Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF4555Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4548Refined equipment time to reflect typical use exclusive to patient.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
SC029needle, 18-27gNF10CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
13152Cmplx rpr e/n/e/l 2.6-7.5 cmEF014light, surgicalNF5027Refined equipment time to reflect typical use exclusive to patient.
EF015mayo standNF5051Refined equipment time to reflect typical use exclusive to patient.
EF023table, examNF5027Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF5051Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF5051Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF5058Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF5051Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANF1510Standardized time input.
SB016drape-cover, sterile, OR light handleNF21CMS clinical review.
SB027gown, staff, imperviousNF20Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF100Duplicative.
Start Printed Page 49017
13153Cmplx rpr e/n/e/l addl 5cm/<EF015mayo standNF4530Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF4530Refined equipment time to reflect typical use exclusive to patient.
EQ114electrosurgical generator, up to 120 wattsNF4530Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF4530Refined equipment time to reflect typical use exclusive to patient.
EQ351Smoke Evacuator (tubing, covering, etc.) with standNF4530Refined equipment time to reflect typical use exclusive to patient.
SC029needle, 18-27gNF20CMS clinical review.
Electrocautery Supply PackNF10Non-standard direct practice expense input.
SJ041povidone soln (Betadine)NF50Duplicative.
20600Drain/inject joint/bursaEF023table, examNF1916Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF1916Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTAFDischarge day management60CMS clinical review.
L037DRN/LPN/MTAFConduct phone calls/call in prescriptions03CMS clinical review.
SC029needle, 18-27gNF42CMS clinical review.
SC055syringe 3mlNF21CMS clinical review.
20605Drain/inject joint/bursaEF023table, examNF1916Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF1916Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTAFDischarge day management60CMS clinical review.
L037DRN/LPN/MTAFConduct phone calls/call in prescriptions03CMS clinical review.
SC029needle, 18-27gNF42CMS clinical review.
SC055syringe 3mlNF21CMS clinical review.
20610Drain/inject joint/bursaEF023table, examNF1916Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49018
EQ168light, examNF1916Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTAFDischarge day management60CMS clinical review.
L037DRN/LPN/MTAFConduct phone calls/call in prescriptions03CMS clinical review.
SC029needle, 18-27gNF42CMS clinical review.
SC057syringe 5-6mlNF21CMS clinical review.
23472Reconstruct shoulder jointSA052pack, post-op incision care (staple)F01CMS clinical review.
SA053pack, post-op incision care (suture & staple)F10CMS clinical review.
23473Revis reconst shoulder jointSA052pack, post-op incision care (staple)F01CMS clinical review.
SA053pack, post-op incision care (suture & staple)F10CMS clinical review.
23474Revis reconst shoulder jointSA052pack, post-op incision care (staple)F01CMS clinical review.
SA053pack, post-op incision care (suture & staple)F10CMS clinical review.
24363Replace elbow jointSA052pack, post-op incision care (staple)F01CMS clinical review.
SA053pack, post-op incision care (suture & staple)F10CMS clinical review.
24370Revise reconst elbow jointSA052pack, post-op incision care (staple)F01CMS clinical review.
SA053pack, post-op incision care (suture & staple)F10CMS clinical review.
24371Revise reconst elbow jointSA052pack, post-op incision care (staple)F01CMS clinical review.
SA053pack, post-op incision care (suture & staple)F10CMS clinical review.
31231Nasal endoscopy dxED032printer, laser, paperNF4335Refined equipment time to reflect typical use exclusive to patient.
EF008chair with headrest, exam, recliningNF4335Refined equipment time to reflect typical use exclusive to patient.
EQ138instrument pack, medium ($1500 and up)NF047Refined equipment time to reflect typical use exclusive to patient.
EQ167light source, xenonNF4335Refined equipment time to reflect typical use exclusive to patient.
EQ170light, fiberoptic headlight w-sourceNF4335Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49019
EQ234suction and pressure cabinet, ENT (SMR)NF4335Refined equipment time to reflect typical use exclusive to patient.
ES013endoscope, rigid, sinoscopyNF6342Refined equipment time to reflect typical use exclusive to patient.
ES013endoscope, rigid, sinoscopyNF630CMS clinical review.
ES031video system, endoscopy (processor, digital capture, monitor, printer, cart)NF4335Refined equipment time to reflect typical use exclusive to patient.
ES036Nasal Endoscopy Instrument PackageNF630Non-standard direct practice expense input.
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available20CMS clinical review.
L037DRN/LPN/MTANFObtain vital signs10CMS clinical review.
L037DRN/LPN/MTANFClean Surgical Instrument Package1015Standardized time input.
L037DRN/LPN/MTANFReview/read X-ray, lab, and pathology reports50CMS clinical review.
SB027gown, staff, imperviousNF21Duplicative.
SB034mask, surgical, with face shieldNF21Duplicative.
31647Bronchial valve init insertL047CRN/Respiratory TherapistFComplete pre-service diagnostic & referral forms35CMS clinical review.
L047CRN/Respiratory TherapistFCoordinate pre-surgery services53CMS clinical review.
32554Aspirate pleura w/o imagingEF023table, examNF5652Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF052Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFComplete pre-service diagnostic & referral forms50CMS clinical review.
L037DRN/LPN/MTANFCoordinate pre-surgery services31CMS clinical review.
L037DRN/LPN/MTANFMonitor pt. following service/check tubes, monitors, drains510CMS clinical review.
SA048pack, minimum multi-specialty visitNF01CMS clinical review.
SA067tray, shave prepNF01CMS clinical review.
kit, thoracentesisNF10CMS clincial review.
SA070tray, thoracentesisNF01CMS clincial review.
SA077kit, pleural catheter insertionNF01CMS clinical review.
SB001cap, surgicalNF02CMS clinical review.
Start Printed Page 49020
SB006drape, non-sterile, sheet 40in x 60inNF10CMS clinical review.
SB024gloves, sterileNF12CMS clinical review.
SB034mask, surgical, with face shieldNF02CMS clinical review.
SB039shoe covers, surgicalNF02CMS clinical review.
SB044underpad 2ft x 3ft (Chux)NF01CMS clinical review.
SG056gauze, sterile 4in x 4in (10 pack uou)NF10CMS clinical review.
32555Aspirate pleura w/imagingED024film processor, dry, laserNF587Refined equipment time to reflect typical use exclusive to patient.
EF019stretcher chairNF1510CMS clinical review.
EL015room, ultrasound, generalNF3330Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF587Refined equipment time to reflect typical use exclusive to patient.
L041BRadiologic TechnologistNFComplete pre-service diagnostic & referral forms50CMS clinical review.
L041BRadiologic TechnologistNFCoordinate pre-surgery services31CMS clinical review.
L041BRadiologic TechnologistNFMonitor pt. following service/check tubes, monitors, drains1510CMS clinical review.
L041BRadiologic TechnologistNFProcess images, complete data sheet, present images and data to the interpreting physician52CMS clinical review.
kit, thoracentesisNF10CMS clinical review.
SA070tray, thoracentesisNF01CMS clinical review.
SA077kit, pleural catheter insertionNF01CMS clinical review.
SB001cap, surgicalNF03CMS clinical review.
SB027gown, staff, imperviousNF01CMS clinical review.
SB039shoe covers, surgicalNF03CMS clinical review.
SB044underpad 2ft x 3ft (Chux)NF01CMS clinical review.
SG078tape, surgical occlusive 1in (Blenderm)NF015CMS clinical review.
SM012disinfectant spray (Transeptic)NF100CMS clinical review.
SM021sanitizing cloth-wipe (patient)NF20CMS clinical review.
32556Insert cath pleura w/o imageEQ168light, examNF076Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFComplete pre-service diagnostic & referral forms50CMS clinical review.
Start Printed Page 49021
L037DRN/LPN/MTANFCoordinate pre-surgery services31CMS clinical review.
SA044pack, moderate sedationNF01CMS clinical review.
SA048pack, minimum multi-specialty visitNF01CMS clinical review.
SA067tray, shave prepNF01CMS clinical review.
SB001cap, surgicalNF02CMS clinical review.
SB006drape, non-sterile, sheet 40in x 60inNF10CMS clinical review.
SB034mask, surgical, with face shieldNF02CMS clinical review.
SB039shoe covers, surgicalNF02CMS clinical review.
SB044underpad 2ft x 3ft (Chux)NF01CMS clinical review.
SC010closed flush system, angiographyNF01CMS clinical review.
SG056gauze, sterile 4in x 4in (10 pack uou)NF10CMS clinical review.
SH065sodium chloride 0.9% flush syringeNF01CMS clinical review.
SH069sodium chloride 0.9% irrigation (500-1000ml uou)NF01CMS clinical review.
SL157cup, sterile, 8 ozNF01CMS clinical review.
32557Insert cath pleura w/imageED024film processor, dry, laserNF587CMS clinical review.
EF019stretcher chairNF1510CMS clinical review.
EL007room, CTNF4340Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF6040Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF587CMS clinical review.
L046ACT TechnologistNFComplete pre-service diagnostic & referral forms50CMS clinical review.
L046ACT TechnologistNFCoordinate pre-surgery services31CMS clinical review.
L046ACT TechnologistNFCheck dressings & wound/home care instructions/coordinate office visits/prescriptions35CMS clinical review.
L046ACT TechnologistNFAssist physician in performing procedure2830Conforming to physician time.
SA071kit, AccuStick II Introducer System with RO MarkerNF10CMS clinical review.
SA077kit, pleural catheter insertionNF01CMS clinical review.
SB001cap, surgicalNF23CMS clinical review.
SB011drape, sterile, fenestrated 16in x 29inNF10CMS clinical review.
Start Printed Page 49022
SB014drape, sterile, three-quarter sheetNF10CMS clinical review.
SB019drape-towel, sterile 18in x 26inNF40CMS clinical review.
SB024gloves, sterileNF21CMS clinical review.
SB027gown, staff, imperviousNF01CMS clinical review.
SB039shoe covers, surgicalNF23CMS clinical review.
SC049stop cock, 3-wayNF10CMS clinical review.
SC056syringe 50-60mlNF20CMS clinical review.
SC058syringe w-needle, OSHA compliant (SafetyGlide)NF10CMS clinical review.
SD043dilator, vessel, angiographicNF10CMS clinical review.
SD088guidewireNF10CMS clinical review.
SD146catheter percutaneous fastener (Percu-Stay)NF10CMS clinical review.
SD161drainage catheter, all purposeNF10CMS clinical review.
SD163drainage pouch, nephrostomy-biliaryNF10CMS clinical review.
SF007blade, surgical (Bard-Parker)NF10CMS clinical review.
SG009applicator, sponge-tippedNF40CMS clinical review.
SG078tape, surgical occlusive 1in (Blenderm)NF025CMS clinical review.
SH047lidocaine 1%-2% inj (Xylocaine)NF100CMS clinical review.
SJ041povidone soln (Betadine)NF600CMS clinical review.
SL036cup, biopsy-specimen sterile 4ozNF10CMS clinical review.
SL156cup, sterile, 12-16 ozNF10CMS clinical review.
33361Replace aortic valve perqL037DRN/LPN/MTAFCoordinate pre-surgery services4010Standardized time input.
L037DRN/LPN/MTAFSchedule space and equipment in facility85Standardized time input.
L037DRN/LPN/MTAFProvide pre-service education/obtain consent207Standardized time input.
L037DRN/LPN/MTAFFollow-up phone calls & prescriptions73Standardized time input.
33362Replace aortic valve openL037DRN/LPN/MTAFCoordinate pre-surgery services4010Standardized time input.
L037DRN/LPN/MTAFSchedule space and equipment in facility85Standardized time input.
L037DRN/LPN/MTAFProvide pre-service education/obtain consent207Standardized time input.
L037DRN/LPN/MTAFFollow-up phone calls & prescriptions73Standardized time input.
33363Replace aortic valve openL037DRN/LPN/MTAFCoordinate pre-surgery services4010Standardized time input.
L037DRN/LPN/MTAFSchedule space and equipment in facility85Standardized time input.
L037DRN/LPN/MTAFProvide pre-service education/obtain consent207Standardized time input.
L037DRN/LPN/MTAFFollow-up phone calls & prescriptions73Standardized time input.
Start Printed Page 49023
33364Replace aortic valve openL037DRN/LPN/MTAFCoordinate pre-surgery services4010Standardized time input.
L037DRN/LPN/MTAFSchedule space and equipment in facility85Standardized time input.
L037DRN/LPN/MTAFProvide pre-service education/obtain consent207Standardized time input.
L037DRN/LPN/MTAFFollow-up phone calls & prescriptions73Standardized time input.
33365Replace aortic valve openL037DRN/LPN/MTAFCoordinate pre-surgery services4010Standardized time input.
L037DRN/LPN/MTAFSchedule space and equipment in facility85Standardized time input.
L037DRN/LPN/MTAFProvide pre-service education/obtain consent207Standardized time input.
L037DRN/LPN/MTAFFollow-up phone calls & prescriptions73Standardized time input.
33366#N/AL037DRN/LPN/MTAFCoordinate pre-surgery services4010Standardized time input.
L037DRN/LPN/MTAFSchedule space and equipment in facility85Standardized time input.
L037DRN/LPN/MTAFProvide pre-service education/obtain consent207Standardized time input.
L037DRN/LPN/MTAFFollow-up phone calls & prescriptions73Standardized time input.
33405Replacement of aortic valveL051ARNFOther Clinical Activity—specify: for reference code 33406 and codes 33405 and 33430: Additional coordination between multiple specialties for complex procedures (tests, meds, scheduling, etc) prior to patient arrival at site of service.150CMS clinical review.
L051ARNFOther Clinical Activity—specify: for reference code 33406 and codes 33405 and 33430: Additional coordination between multiple specialties for complex procedures (tests, meds, scheduling, etc) prior to patient arrival at site of service.150CMS clinical review.
35475Repair arterial blockageEL011room, angiographyNF5152Refined equipment time to reflect typical use exclusive to patient.
EQ011ECG, 3-channel (with SpO2, NIBP, temp, resp)NF212285Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
Start Printed Page 49024
EQ032IV infusion pumpNF212285Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
EQ168light, examNF12052Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTAFComplete pre-service diagnostic & referral forms53CMS clinical review.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
L041BRadiologic TechnologistNFPrepare room, equipment, supplies42Standardized time input.
SB019drape-towel, sterile 18in x 26inNF42CMS clinical review.
35476Repair venous blockageEf027table, instrument, mobileNF302277Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
EL011room, angiographyNF4344Refined equipment time to reflect typical use exclusive to patient.
EQ011ECG, 3-channel (with SpO2, NIBP, temp, resp)NF137277Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
EQ032IV infusion pumpNF137277Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
EQ168light, examNF12044Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTAFSchedule space and equipment in facility35CMS clinical review.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
L041BRadiologic TechnologistNFPrepare room, equipment, supplies42Standardized time input.
SB019drape-towel, sterile 18in x 26inNF42CMS clinical review.
36221Place cath thoracic aortaEF018stretcherNF2720CMS Code correction.
EF027table, instrument, mobileNF0272CMS Code correction.
EL011room, angiographyNF4945Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49025
EQ088contrast media warmerNF4945Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF4945Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available53Standardized time input.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
L041AAngio TechnicianNFImage Post Processing50CMS clinical review.
L041BRadiologic TechnologistNFPrepare room, equipment, supplies27CMS clinical review.
L041BRadiologic TechnologistNFPrepare and position patient/monitor patient/set up IV27CMS clinical review.
SD249Sterile Radio-opaque ruler (le Maitre, documentation available)NF10CMS clinical review.
36222Place cath carotid/inom artEF018stretcherNF2820CMS Code correction.
EF027table, instrument, mobileNF0282CMS Code correction.
EL011room, angiographyNF5955Refined equipment time to reflect typical use exclusive to patient.
EQ088contrast media warmerNF5955Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF5955Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available53Standardized time input.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
SD147catheter, (Glide)NF10CMS clinical review.
SD249Sterile Radio-opaque ruler (le Maitre, documentation available)NF10CMS clinical review.
36223Place cath carotid/inom artEF018stretcherNF2870CMS Code correction.
EF027table, instrument, mobileNF0287CMS Code correction.
EL011room, angiographyNF6460Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49026
EQ088contrast media warmerNF6460Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF6460Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available53Standardized time input.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
SD249Sterile Radio-opaque ruler (le Maitre, documentation available)NF10CMS clinical review.
36224Place cath carotd artEF018stretcherNF2920CMS Code correction.
EF027table, instrument, mobileNF0292CMS Code correction.
EL011room, angiographyNF6965Refined equipment time to reflect typical use exclusive to patient.
EQ088contrast media warmerNF6965Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF6965Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available53Standardized time input.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
36225Place cath subclavian artEF018stretcherNF2870CMS Code correction.
EF027table, instrument, mobileNF0287CMS Code correction.
EL011room, angiographyNF6460Refined equipment time to reflect typical use exclusive to patient.
EQ088contrast media warmerNF6460Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF6460Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available53Standardized time input.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
Start Printed Page 49027
36226Place cath vertebral artEF018stretcherNF2920CMS Code correction.
EF027table, instrument, mobileNF0292CMS Code correction.
EL011room, angiographyNF6965Refined equipment time to reflect typical use exclusive to patient.
EQ088contrast media warmerNF6965Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF6965Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available53Standardized time input.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
36228Place cath intracranial artL041BRadiologic TechnologistNFPrepare room, equipment, supplies10CMS clinical review.
L041BRadiologic TechnologistNFAssisting with flouroscopy/image acquisition (75%)2322CMS clinical review.
SC057syringe 5-6mlNF40CMS clinical review.
37197Remove intrvas foreign bodyEF027table, instrument, mobileNF305302Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
EL011room, angiographyNF7772Refined equipment time to reflect typical use exclusive to patient.
EQ011ECG, 3-channel (with SpO2, NIBP, temp, resp)NF305302Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
EQ032IV infusion pumpNF305302Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.
EQ088contrast media warmerNF770CMS clinical review.
EQ250ultrasound unit, portableNF770CMS clinical review.
ER029film alternator (motorized film viewbox)NF7772Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49028
L037DRN/LPN/MTANFGreet patient, provide gowning, assure appropriate medical records are available53Standardized time input.
L037DRN/LPN/MTANFObtain vital signs53CMS clinical review.
L041BRadiologic TechnologistNFPrepare room, equipment, supplies (including imaging equipment)75CMS clinical review.
L041BRadiologic TechnologistNFPrepare and position patient/monitor patient/set up IV52Standardized time input.
SB005cover-condom, transducer or ultrasound probeNF10CMS clinical review.
SB048sheath-cover, sterile, 96in x 6in (transducer)NF10CMS clinical review.
SD147catheter, (Glide)NF10CMS clinical review.
SD252guidewire, Amplatz wire 260 cmNF10CMS clinical review.
SH065sodium chloride 0.9% flush syringeNF20CMS clinical review.
47600Removal of gallbladderSA053pack, post-op incision care (suture & staple)F10CMS clinical review.
SA054pack, post-op incision care (suture)F01CMS clinical review.
47605Removal of gallbladderSA053pack, post-op incision care (suture & staple)F10CMS clinical review.
SA054pack, post-op incision care (suture)F01CMS clinical review.
50590Fragmenting of kidney stoneEL014room, radiographic-fluoroscopicNF860Consistent with the AMA RUC's CY2011 recommendation.
EQ175lithotriptor, with C-arm (ESWL)NF8667Refined equipment time to reflect typical use exclusive to patient.
52214Cystoscopy and treatmentEF027table, instrument, mobileNF10065Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF10065Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF10065Refined equipment time to reflect typical use exclusive to patient.
EQ153laser (gs, uro, obg, ge) (Indigo Optima)NF10065Refined equipment time to reflect typical use exclusive to patient.
EQ167light source, xenonNF10065Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49029
ES006endoscope forceps, biopsyNF10065Refined equipment time to reflect typical use exclusive to patient.
ES007endoscope forceps, graspingNF10065Refined equipment time to reflect typical use exclusive to patient.
ES018fiberscope, flexible, cystoscopyNF10092Refined equipment time to reflect typical use exclusive to patient.
ES031video system, endoscopy (processor, digital capture, monitor, printer, cart)NF10065Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFReview Chart30CMS clinical review.
SB019drape-towel, sterile 18in x 26inNF10Duplicative.
SB024gloves, sterileNF01CMS clinical review.
SD270Penis clampNF10Not a disposable according to submitted invoice.
SH047lidocaine 1%-2% inj (Xylocaine)NF500Duplicative.
52224Cystoscopy and treatmentEF027table, instrument, mobileNF10567Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF10567Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF10567Refined equipment time to reflect typical use exclusive to patient.
EQ153laser (gs, uro, obg, ge) (Indigo Optima)NF10567Refined equipment time to reflect typical use exclusive to patient.
EQ167light source, xenonNF10567Refined equipment time to reflect typical use exclusive to patient.
ES006endoscope forceps, biopsyNF10567Refined equipment time to reflect typical use exclusive to patient.
ES007endoscope forceps, graspingNF10567Refined equipment time to reflect typical use exclusive to patient.
ES018fiberscope, flexible, cystoscopyNF10594Refined equipment time to reflect typical use exclusive to patient.
ES031video system, endoscopy (processor, digital capture, monitor, printer, cart)NF10567Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49030
L037DRN/LPN/MTANFReview Chart30CMS clinical review.
L037DRN/LPN/MTANFPrepare biopsy Specimen52CMS clinical review.
SB019drape-towel, sterile 18in x 26inNF10Duplicative.
SB024gloves, sterileNF31CMS clinical review.
SD270Penis clampNF10Not a disposable according to submitted invoice.
SH047lidocaine 1%-2% inj (Xylocaine)NF500Duplicative.
SL036cup, biopsy-specimen sterile 4ozNF63CMS clinical review.
52287Cystoscopy chemodenervationEF027table, instrument, mobileNF7849Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF7849Refined equipment time to reflect typical use exclusive to patient.
EQ170light, fiberoptic headlight w-sourceNF7849Refined equipment time to reflect typical use exclusive to patient.
ES018fiberscope, flexible, cystoscopyNF7876Refined equipment time to reflect typical use exclusive to patient.
ES031video system, endoscopy (processor, digital capture, monitor, printer, cart)NF7849Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFAssist physician in performing procedure2021Conforming to physician time.
SH048lidocaine 2% jelly, topical (Xylocaine)NF100Duplicative.
53850Prostatic microwave thermotxEF020stretcher, endoscopyNF9985Refined equipment time to reflect typical use exclusive to patient.
EF027table, instrument, mobileNF9985Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF169152Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerF169152Refined equipment time to reflect typical use exclusive to patient.
EQ037TUMT system control unitNF9985Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF169152Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49031
EQ168light, examF169152Refined equipment time to reflect typical use exclusive to patient.
EQ250ultrasound unit, portableNF9985Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFPrepare room, equipment, supplies24CMS clinical review.
L037DRN/LPN/MTANFSetup ultrasound probe50CMS clinical review.
L037DRN/LPN/MTANFSetup TUMT machine50CMS clinical review.
L037DRN/LPN/MTANFClean TUMT machine30CMS clinical review.
SB022gloves, non-sterileNF32CMS clinical review.
SB024gloves, sterileNF32CMS clinical review.
SH047lidocaine 1%-2% inj (Xylocaine)NF330CMS clinical review.
64612Destroy nerve face muscleEL006lane, screening (oph)F3927Refined equipment time to reflect typical use exclusive to patient.
EL006lane, screening (oph)NF4845Refined equipment time to reflect typical use exclusive to patient.
SC031needle, 30gF01CMS clinical review.
64615Chemodenerv musc migraineEF023table, examNF2418Refined equipment time to reflect typical use exclusive to patient.
65800Drainage of eyeEL006Lane, ScreeningNF2122Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF2122Refined equipment time to reflect typical use exclusive to patient.
67810Biopsy eyelid & lid marginEF014light, surgicalNF2022Refined equipment time to reflect typical use exclusive to patient.
EF031table, powerNF2022Refined equipment time to reflect typical use exclusive to patient.
EQ110electrocautery-hyfrecator, up to 45 wattsNF122Refined equipment time to reflect typical use exclusive to patient.
EQ137instrument pack, basic ($500-$1499)NF130Refined equipment time to reflect typical use exclusive to patient.
SB011drape, sterile, fenestrated 16in x 29inNF01CMS clinical review.
SB019drape-towel, sterile 18in x 26inNF41CMS clinical review.
Start Printed Page 49032
SC029needle, 18-27gNF10Standardized time input.
72040X-ray exam neck spine 3/<vwsED025film processor, wetNF204Refined equipment time to reflect typical use exclusive to patient.
EL012room, basic radiologyNF2013Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF204Refined equipment time to reflect typical use exclusive to patient.
Film jacket or jacket insertNF10Non-standard direct practice expense input.
72050X-ray exam neck spine 4/5vwsED025film processor, wetNF286Refined equipment time to reflect typical use exclusive to patient.
EL012room, basic radiologyNF2819Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF286Refined equipment time to reflect typical use exclusive to patient.
Film jacket or jacket insertNF10Non-standard direct practice expense input.
72052X-ray exam neck spine 6/>vwsED025film processor, wetNF368Refined equipment time to reflect typical use exclusive to patient.
EL012room, basic radiologyNF3625Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF368Refined equipment time to reflect typical use exclusive to patient.
Film jacket or jacket insertNF10Non-standard direct practice expense input.
72191Ct angiograph pelv w/o&w/dyeEL007room, CTNF10140Refined equipment time to reflect typical use exclusive to patient.
L041BRadiologic TechnologistNFRetrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information05CMS clinical review.
L041BRadiologic TechnologistNFGreet patient, provide gowning, assure appropriate medical records are available03CMS clinical review.
Start Printed Page 49033
L041BRadiologic TechnologistNFEducation/instruction/counseling/obtain consent02CMS clinical review.
L041BRadiologic TechnologistNFPrepare room, equipment, supplies02Standardized time input.
L041BRadiologic TechnologistNFPrepare and position patient/monitor patient/set up IV07CMS clinical review.
L041BRadiologic TechnologistNFAquire images028CMS clinical review.
L041BRadiologic TechnologistNFClean room/equipment by physician staff03CMS clinical review.
L046ACT TechnologistNFRetrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information50CMS clinical review.
L046ACT TechnologistNFGreet patient, provide gowning, assure appropriate medical records are available30CMS clinical review.
L046ACT TechnologistNFEducation/instruction/counseling/obtain consent20CMS clinical review.
L046ACT TechnologistNFPrepare room, equipment, supplies50CMS clinical review.
L046ACT TechnologistNFPrepare and position patient/monitor patient/set up IV70CMS clinical review.
L046ACT TechnologistNFAquire images280CMS clinical review.
L046ACT TechnologistNFClean room/equipment by physician staff30CMS clinical review.
SK016computer media, optical disk 2.6gbNF10.1CMS clinical review.
72192Ct pelvis w/o dyeED024film processor, dry, laserNF50CMS clinical review.
ED032printer, laser, paperNF05CMS clinical review.
EL007room, CTNF4522CMS clinical review.
L046ACT TechnologistNFPre-Service Period64CMS clinical review.
SK013computer media, dvdNF10CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK091x-ray envelopeNF10CMS clinical review.
SK098film, x-ray, laser printNF48CMS clinical review.
72193Ct pelvis w/dyeED024film processor, dry, laserNF50CMS clinical review.
ED032printer, laser, paperNF05CMS clinical review.
EL007room, CTNF4032CMS clinical review.
L046ACT TechnologistNFPre-Service Period74CMS clinical review.
L046ACT TechnologistNFService Period4043CMS clinical review.
Start Printed Page 49034
SB006drape, non-sterile, sheet 40in x 60inNF10CMS clinical review.
SB014drape, sterile, three-quarter sheetNF01CMS clinical review.
SC001angiocatheter 14g-24gNF10CMS clinical review.
SC002angiocatheter setNF01CMS clinical review.
SC025needle, 14-20g, biopsyNF01CMS clinical review.
SC029needle, 18-27gNF10CMS clinical review.
SC059syringe, 25ml (MRI power injector)NF01CMS clinical review.
SG068plaster bandage (4in x 5yd uou)NF10CMS clinical review.
SG075tape, elastic, 1in (Elastoplast, Elasticon) (5yd uou)NF06CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF60CMS clinical review.
SH065sodium chloride 0.9% flush syringeNF015CMS clinical review.
SK013computer media, dvdNF10CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK091x-ray envelopeNF10CMS clinical review.
72194Ct pelvis w/o & w/dyeED024film processor, dry, laserNF107CMS clinical review.
EL007room, CTNF5439CMS clinical review.
ER029film alternator (motorized film viewbox)NF107CMS clinical review.
L046ACT TechnologistNFPre-Service Period74CMS clinical review.
L046ACT TechnologistNFService Period5452CMS clinical review.
SC025needle, 14-20g, biopsyNF01CMS clinical review.
SC029needle, 18-27gNF10CMS clinical review.
SK013computer media, dvdNF10CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK091x-ray envelopeNF10CMS clinical review.
SK098film, x-ray, laser printNF08CMS clinical review.
73221Mri joint upr extrem w/o dyeED024film processor, dry, laserNF6333Refined equipment time to reflect typical use exclusive to patient.
EL008room, MRNF6333Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF6333Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49035
L047AMRI TechnologistNFPrepare room, equipment, supplies53CMS clinical review.
L047AMRI TechnologistNFPrepare and position patient/monitor patient/set up IV32Standardized time input.
L047AMRI TechnologistNFEscort patient from exam room due to magnetic sensitivity20Non-standard direct practice expense input.
Insert folderNF10Non-standard direct practice expense input.
73721Mri jnt of lwr extre w/o dyeED024film processor, dry, laserNF6333Refined equipment time to reflect typical use exclusive to patient.
EL008room, MRNF6333Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF6333Refined equipment time to reflect typical use exclusive to patient.
L047AMRI TechnologistNFPrepare room, equipment, supplies53CMS clinical review.
L047AMRI TechnologistNFPrepare and position patient/monitor patient/set up IV32Standardized time input.
L047AMRI TechnologistNFEscort patient from exam room due to magnetic sensitivity20Non-standard direct practice expense input.
Insert folderNF10Non-standard direct practice expense input.
74150Ct abdomen w/o dyeED024film processor, dry, laserNF50CMS clinical review.
ED032printer, laser, paperNF05CMS clinical review.
EL007room, CTNF3222CMS clinical review.
L046ACT TechnologistNFPre-Service Period64CMS clinical review.
SK013computer media, dvdNF10CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK091x-ray envelopeNF10CMS clinical review.
SK098film, x-ray, laser printNF48CMS clinical review.
74160Ct abdomen w/dyeED024film processor, dry, laserNF70CMS clinical review.
ED032printer, laser, paperNF05CMS clinical review.
EL007room, CTNF4732CMS clinical review.
ER029film alternator (motorized film viewbox)NF75CMS clinical review.
L046ACT TechnologistNFPre-Service Period74CMS clinical review.
L046ACT TechnologistNFService Period4743CMS clinical review.
SB006drape, non-sterile, sheet 40in x 60inNF10CMS clinical review.
Start Printed Page 49036
SB014drape, sterile, three-quarter sheetNF01CMS clinical review.
SC001angiocatheter 14g-24gNF10CMS clinical review.
SC002angiocatheter setNF01CMS clinical review.
SC025needle, 14-20g, biopsyNF01CMS clinical review.
SC029needle, 18-27gNF10CMS clinical review.
SC059syringe, 25ml (MRI power injector)NF01CMS clinical review.
SG075tape, elastic, 1in (Elastoplast, Elasticon) (5yd uou)NF06CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF60CMS clinical review.
SH065sodium chloride 0.9% flush syringeNF015CMS clinical review.
SH068sodium chloride 0.9% inj bacteriostatic (30ml uou)NF10CMS clinical review.
SK013computer media, dvdNF10CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK091x-ray envelopeNF10CMS clinical review.
SK098film, x-ray, laser printNF64CMS clinical review.
74170Ct abdomen w/o & w/dyeED024film processor, dry, laserNF157Refined equipment time to reflect typical use exclusive to patient.
EL007room, CTNF6539Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF157Refined equipment time to reflect typical use exclusive to patient.
L046ACT TechnologistNFRetrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information and confirm contrast protocol with interpreting MD74CMS clinical review.
L046ACT TechnologistNFAssist physician in performing procedure3227CMS clinical review.
L046ACT TechnologistNFImage Post Processing157CMS clinical review.
SB006drape, non-sterile, sheet 40in x 60inNF10CMS clinical review.
SB014drape, sterile, three-quarter sheetNF01CMS clinical review.
Start Printed Page 49037
SC001angiocatheter 14g-24gNF10CMS clinical review.
SC002angiocatheter setNF01CMS clinical review.
SC025needle, 14-20g, biopsyNF01CMS clinical review.
SC029needle, 18-27gNF10CMS clinical review.
SC059syringe, 25ml (MRI power injector)NF01CMS clinical review.
SG050gauze, non-sterile 2in x 2inNF01CMS clinical review.
SG075tape, elastic, 1in (Elastoplast, Elasticon) (5yd uou)NF06CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF60CMS clinical review.
SH016barium suspension (Polibar)NF9000CMS clinical review.
SH065sodium chloride 0.9% flush syringeNF015CMS clinical review.
SH068sodium chloride 0.9% inj bacteriostatic (30ml uou)NF10CMS clinical review.
SK013computer media, dvdNF10CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK091x-ray envelopeNF10CMS clinical review.
SK098film, x-ray, laser printNF148CMS clinical review.
74175Ct angio abdom w/o & w/dyeEL007room, CTNF10140Refined equipment time to reflect typical use exclusive to patient.
L041BRadiologic TechnologistNFRetrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information05CMS clinical review.
L041BRadiologic TechnologistNFGreet patient, provide gowning, assure appropriate medical records are available03CMS clinical review.
L041BRadiologic TechnologistNFEducation/instruction/counseling/obtain consent02CMS clinical review.
L041BRadiologic TechnologistNFPrepare room, equipment, supplies02Standardized time input.
L041BRadiologic TechnologistNFPrepare and position patient/monitor patient/set up IV07CMS clinical review.
L041BRadiologic TechnologistNFAquire images028CMS clinical review.
L041BRadiologic TechnologistNFClean room/equipment by physician staff03CMS clinical review.
Start Printed Page 49038
L046ACT TechnologistNFRetrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information50CMS clinical review.
L046ACT TechnologistNFGreet patient, provide gowning, assure appropriate medical records are available30CMS clinical review.
L046ACT TechnologistNFEducation/instruction/counseling/obtain consent20CMS clinical review.
L046ACT TechnologistNFPrepare room, equipment, supplies50CMS clinical review.
L046ACT TechnologistNFPrepare and position patient/monitor patient/set up IV70CMS clinical review.
L046ACT TechnologistNFAquire images280CMS clinical review.
L046ACT TechnologistNFClean room/equipment by physician staff30CMS clinical review.
SK016computer media, optical disk 2.6gbNF10.1CMS clinical review.
74176Ct abd & pelvisED032printer, laser, paperNF87CMS clinical review.
ER029film alternator (motorized film viewbox)NF277CMS clinical review.
L046ACT TechnologistNFService Period4039CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
74177Ct abd & pelv w/contrastED032printer, laser, paperNF107CMS clinical review.
EL007room, CTNF4239CMS clinical review.
ER029film alternator (motorized film viewbox)NF427CMS clinical review.
L046ACT TechnologistNFPre-Service Period76CMS clinical review.
L046ACT TechnologistNFService Period5852CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK098film, x-ray, laser printNF108CMS clinical review.
74178Ct abd & pelv 1/> regnsED032printer, laser, paperNF2010CMS clinical review.
EL007room, CTNF5748CMS clinical review.
ER029film alternator (motorized film viewbox)NF5710CMS clinical review.
L046ACT TechnologistNFPre-Service Period76CMS clinical review.
L046ACT TechnologistNFService Period8364CMS clinical review.
SK016computer media, optical disk 2.6gbNF00.1CMS clinical review.
Start Printed Page 49039
SK076slide sleeve (photo slides)NF01CMS clinical review.
SK098film, x-ray, laser printNF2316CMS clinical review.
76830Transvaginal us non-obED024film processor, dry, laserNF50CMS clinical review.
ED032printer, laser, paperNF10CMS clinical review.
EF027table, instrument, mobileNF036Refined equipment time to reflect typical use exclusive to patient.
EF034table, ultrasoundNF036Refined equipment time to reflect typical use exclusive to patient.
EL015room, ultrasound, generalNF370CMS clinical review.
EQ250ultrasound unit, portableNF036Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF100CMS clinical review.
ER086ultrasound probeNF037Refined equipment time to reflect typical use exclusive to patient.
L051BRN/Diagnostic Medical SonographerNFClean room/equipment by physician staff32CMS clinical review.
SB026gown, patientNF01CMS clinical review.
SJ033lubricating jelly (Surgilube)NF10CMS clinical review.
76872Us transrectalEF027table, instrument, mobileNF6834Refined equipment time to reflect typical use exclusive to patient.
EF034table, ultrasoundNF6834Refined equipment time to reflect typical use exclusive to patient.
EQ250ultrasound unit, portableNF6834Refined equipment time to reflect typical use exclusive to patient.
ER086ultrasound probeNF6835Refined equipment time to reflect typical use exclusive to patient.
L051BRN/Diagnostic Medical SonographerNFRetrieve prior images for comparison:03CMS clinical review.
L051BRN/Diagnostic Medical SonographerNFReview Chart30CMS clinical review.
L051BRN/Diagnostic Medical SonographerNFObtain vital signs30CMS clinical review.
L051BRN/Diagnostic Medical SonographerNFPrepare room, equipment, supplies23CMS clinical review.
L051BRN/Diagnostic Medical SonographerNFPrepare ultrasound probe50CMS clinical review.
L051BRN/Diagnostic Medical SonographerNFObtain vital signs30CMS clinical review.
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L051BRN/Diagnostic Medical SonographerNFClean room/equipment by physician staff32CMS clinical review.
SB012drape, sterile, for Mayo standNF10CMS clinical review.
SC019iv tubing (extension)NF10CMS clinical review.
SH048lidocaine 2% jelly, topical (Xylocaine)NF100CMS clinical review.
SJ001alcohol isopropyl 70%NF50CMS clinical review.
SJ032lubricating jelly (K-Y) (5gm uou)NF20CMS clinical review.
SM018glutaraldehyde 3.4% (Cidex, Maxicide, Wavicide)NF320CMS clinical review.
SM019glutaraldehyde test strips (Cidex, Metrex)NF10CMS clinical review.
SM022sanitizing cloth-wipe (surface, instruments, equipment)NF20CMS clinical review.
77003Fluoroguide for spine injectED025film processor, wetNF32Refined equipment time to reflect typical use exclusive to patient.
EL014room, radiographic-fluoroscopicNF918Refined equipment time to reflect typical use exclusive to patient.
ER029film alternator (motorized film viewbox)NF32Refined equipment time to reflect typical use exclusive to patient.
L041BRadiologic TechnologistNFClean room/equipment by physician staff21CMS clinical review.
L041BRadiologic TechnologistNFProcess films, hang films and review study with interpreting MD prior to patient discharge32CMS clinical review.
77080Dxa bone density axialER078phantom, spine, DXA calibration checkNF12Refined equipment time to reflect typical use exclusive to patient.
77301Radiotherapy dose plan imrtED011computer system, record and verifyNF200CMS clinical review.
ED033treatment planning system, IMRT (Corvus w-Peregrine 3D Monte Carlo)NF376330CMS clinical review.
ER005IMRT CT-based simulatorNF5847CMS clinical review.
ER014chamber, Farmer-typeNF4547Refined equipment time to reflect typical use exclusive to patient.
ER028electrometer, PC-based, dual channelNF4547Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49041
ER050phantom, solid water calibration checkNF4547Refined equipment time to reflect typical use exclusive to patient.
ER089IMRT acceleratorNF4547CMS clinical review.
L037DRN/LPN/MTANFObtain vital signs30CMS clinical review.
78012Thyroid uptake measurementEF010chair, thyroid imagingNF4030Refined equipment time to reflect typical use exclusive to patient.
ER063thyroid uptake systemNF4030Refined equipment time to reflect typical use exclusive to patient.
78013Thyroid imaging w/blood flowER032gamma camera system, single-dual headNF4838Refined equipment time to reflect typical use exclusive to patient.
78014Thyroid imaging w/blood flowEF010chair, thyroid imagingNF6555Refined equipment time to reflect typical use exclusive to patient.
ER032gamma camera system, single-dual headNF6550Refined equipment time to reflect typical use exclusive to patient.
ER063thyroid uptake systemNF6555Refined equipment time to reflect typical use exclusive to patient.
78070Parathyroid planar imagingER032gamma camera system, single-dual headNF7368Refined equipment time to reflect typical use exclusive to patient.
78071Parathyrd planar w/wo subtrjER032gamma camera system, single-dual headNF8681Refined equipment time to reflect typical use exclusive to patient.
86153Cell enumeration phys interpEP106CELLSEARCH systemNF160Laboratory physician interpretation code.
EP107Laboratory Information SystemNF40Laboratory physician interpretation code.
L045ACytotechnologistNFCollate images and review with Pathologist50Laboratory physician interpretation code.
88120Cytp urne 3-5 probes ea specEP088ThermoBriteNF107321CMS clinical review.
EP092Olympus BX41 Fluorescent Microscope (without filters or camera )NF1.3373.00CMS clinical review.
88121Cytp urine 3-5 probes cmptrEP088ThermoBriteNF26.75160.50CMS clinical review.
EP090IkoniLan SoftwareNF2.9729.70CMS clinical review.
EP091IkoniScopeNF2.9729.70CMS clinical review.
88300Surgical path grosscourier transportation costNF2.020Indirect Practice Expense.
Copath System with maintenance contractNF30Indirect Practice Expense.
Copath softwareNF30Indirect Practice Expense.
Start Printed Page 49042
88302Tissue exam by pathologistspecimen, solvent, and formalin disposal costNF0.180Indirect Practice Expense.
courier transportation costNF2.020Indirect Practice Expense.
equipment maintenance costNF0.610Included in equipment cost per minute calculation.
Copath System with maintenance contractNF30Indirect Practice Expense.
Copath softwareNF30Indirect Practice Expense.
88304Tissue exam by pathologistspecimen, solvent, and formalin disposal costNF0.350Indirect Practice Expense.
courier transportation costNF2.020Indirect Practice Expense.
equipment maintenance costNF0.610Included in equipment cost per minute calculation.
Copath System with maintenance contractNF50Indirect Practice Expense.
Copath softwareNF50Indirect Practice Expense.
88305Tissue exam by pathologistspecimen, solvent, and formalin disposal costNF0.350Indirect Practice Expense.
courier transportation costNF2.020Indirect Practice Expense.
equipment maintenance costNF0.610Included in equipment cost per minute calculation.
Copath System with maintenance contractNF40Indirect Practice Expense.
Copath softwareNF40Indirect Practice Expense.
88307Tissue exam by pathologistspecimen, solvent, and formalin disposal costNF1.850Indirect Practice Expense.
courier transportation costNF2.020Indirect Practice Expense.
equipment maintenance costNF0.610Included in equipment cost per minute calculation.
Copath System with maintenance contractNF100Indirect Practice Expense.
Copath softwareNF100Indirect Practice Expense.
88309Tissue exam by pathologistspecimen, solvent, and formalin disposal costNF1.850Indirect Practice Expense.
courier transportation costNF2.020Indirect Practice Expense.
equipment maintenance costNF0.610Included in equipment cost per minute calculation.
Copath System with maintenance contractNF120Indirect Practice Expense.
Copath softwareNF120Indirect Practice Expense.
90791Psych diagnostic evaluationNF2012 Fully Implemented PE RVUs maintained.
90832Psytx pt&/family 30 minutesNF2012 Fully Implemented PE RVUs maintained.
Start Printed Page 49043
90834Psytx pt&/family 45 minutesNF2012 Fully Implemented PE RVUs maintained.
90836Psytx pt&/fam w/e&m 45 minNF2012 Fully Implemented PE RVUs maintained.
91112Gi wireless capsule measureActivation FixtureNF50CMS clinical review.
Docking StationNF400CMS clinical review.
MotiliGI softwareNF400CMS clinical review.
EQ352Data receiverNF7,2202,880CMS clinical review.
SA048pack, minimum multi-specialty visitNF10CMS clinical review.
SmartBarNF10CMS clinical review.
92081Visual field examination(s)SA050pack, ophthalmology visit (no dilation)NF10CMS clinical review.
EL006lane, screening (oph)NF1217Refined equipment time to reflect typical use exclusive to patient.
EQ029Humphrey field analyzerNF1217Refined equipment time to reflect typical use exclusive to patient.
EQ165lens set, trial, full diameter, w-frameNF1217CMS clinical review.
92082Visual field examination(s)SA050pack, ophthalmology visit (no dilation)NF10CMS clinical review.
EL006lane, screening (oph)NF2227Refined equipment time to reflect typical use exclusive to patient.
EQ029Humphrey field analyzerNF2227Refined equipment time to reflect typical use exclusive to patient.
EQ165lens set, trial, full diameter, w-frameNF2227CMS clinical review.
92083Visual field examination(s)SA050pack, ophthalmology visit (no dilation)NF10CMS clinical review.
EL006lane, screening (oph)NF3237Refined equipment time to reflect typical use exclusive to patient.
EQ029Humphrey field analyzerNF3237Refined equipment time to reflect typical use exclusive to patient.
EQ165lens set, trial, full diameter, w-frameNF3237CMS clinical review.
92235Eye exam with photosED008camera, retinal (TRC 50IX, w-ICG, filters, motor drives)NF6035Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49044
EF030table, motorized (for instruments-equipment)NF6035Refined equipment time to reflect typical use exclusive to patient.
EL005lane, exam (oph)NF6035Refined equipment time to reflect typical use exclusive to patient.
L038ACOMT/COT/RN/CSTNFMonitor pt. following service/check tubes, monitors, drains52CMS clinical review.
L039ACertified Retinal AngioNFAssist physician in performing procedure4020CMS clinical review.
93015Cardiovascular stress testEF023table, examNF5846Refined equipment time to reflect typical use exclusive to patient.
EQ078cardiac monitor w-treadmill (12-lead PC-based ECG)NF5846Refined equipment time to reflect typical use exclusive to patient.
L051ARNNFAssist physician in performing procedure2014CMS clinical review.
93017Cardiovascular stress testEF023table, examNF5846Refined equipment time to reflect typical use exclusive to patient.
EQ078cardiac monitor w-treadmill (12-lead PC-based ECG)NF5846Refined equipment time to reflect typical use exclusive to patient.
L051ARNNFAssist physician in performing procedure2014CMS clinical review.
L051ARNNFComplete diagnostic forms, lab & X-ray requisitions04CMS clinical review.
93925Lower extremity studyED011computer system, record and verifyNF100CMS clinical review.
ED021computer, desktop, w-monitorNF957Refined equipment time to reflect typical use exclusive to patient.
ED025film processor, wetNF107Refined equipment time to reflect typical use exclusive to patient.
ED034video SVHS VCR (medical grade)NF950CMS clinical review.
EL016room, ultrasound, vascularNF9576Refined equipment time to reflect typical use exclusive to patient.
ER067x-ray view box, 4 panelNF107Refined equipment time to reflect typical use exclusive to patient.
L054AVascular TechnologistNFProvide pre-service education/obtain consent32CMS clinical review.
L054AVascular TechnologistNFPrepare room, equipment, supplies32Standardized time input.
Start Printed Page 49045
L054AVascular TechnologistNFPrepare and position patient32Standardized time input.
L054AVascular TechnologistNFOther Clinical Activity: Collate preliminary data, arrange images, archive107CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: Record patient history10CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: QA documentation40CMS clinical review.
SK086video tape, VHSNF10CMS clinical review.
93926Lower extremity studyED011computer system, record and verifyNF100CMS clinical review.
ED021computer, desktop, w-monitorNF594Refined equipment time to reflect typical use exclusive to patient.
ED025film processor, wetNF104Refined equipment time to reflect typical use exclusive to patient.
ED034video SVHS VCR (medical grade)NF590CMS clinical review.
EL016room, ultrasound, vascularNF5942Refined equipment time to reflect typical use exclusive to patient.
ER067x-ray view box, 4 panelNF104Refined equipment time to reflect typical use exclusive to patient.
L054AVascular TechnologistNFProvide pre-service education/obtain consent32CMS clinical review.
L054AVascular TechnologistNFPrepare room, equipment, supplies32Standardized time input.
L054AVascular TechnologistNFPrepare and position patient32Standardized time input.
L054AVascular TechnologistNFOther Clinical Activity: Collate preliminary data, arrange images, archive84CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: Record patient history10CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: QA documentation40CMS clinical review.
SK086video tape, VHSNF10CMS clinical review.
93970Extremity studyED011computer system, record and verifyNF100CMS clinical review.
ED021computer, desktop, w-monitorNF717Refined equipment time to reflect typical use exclusive to patient.
ED025film processor, wetNF107Refined equipment time to reflect typical use exclusive to patient.
ED034video SVHS VCR (medical grade)NF710CMS clinical review.
Start Printed Page 49046
EL016room, ultrasound, vascularNF7152Refined equipment time to reflect typical use exclusive to patient.
ER067x-ray view box, 4 panelNF107Refined equipment time to reflect typical use exclusive to patient.
L054AVascular TechnologistNFProvide pre-service education/obtain consent32CMS clinical review.
L054AVascular TechnologistNFPrepare room, equipment, supplies32Standardized time input.
L054AVascular TechnologistNFPrepare and position patient32Standardized time input.
L054AVascular TechnologistNFOther Clinical Activity: Collate preliminary data, arrange images, archive107CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: Record patient history10CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: QA documentation40CMS clinical review.
SK086video tape, VHSNF10CMS clinical review.
93971Extremity studyED011computer system, record and verifyNF100CMS clinical review.
ED021computer, desktop, w-monitorNF454Refined equipment time to reflect typical use exclusive to patient.
ED025film processor, wetNF104Refined equipment time to reflect typical use exclusive to patient.
ED034video SVHS VCR (medical grade)NF450CMS clinical review.
EL016room, ultrasound, vascularNF4530CMS clinical review.
ER067x-ray view box, 4 panelNF104Refined equipment time to reflect typical use exclusive to patient.
L054AVascular TechnologistNFProvide pre-service education/obtain consent32CMS clinical review.
L054AVascular TechnologistNFPrepare room, equipment, supplies32Standardized time input.
L054AVascular TechnologistNFPrepare and position patient32Standardized time input.
L054AVascular TechnologistNFOther Clinical Activity: Collate preliminary data, arrange images, archive64CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: Record patient history10CMS clinical review.
L054AVascular TechnologistNFOther Clinical Activity: QA documentation40CMS clinical review.
SB006drape, non-sterile, sheet 40in x 60inNF21CMS clinical review.
SK086video tape, VHSNF10CMS clinical review.
Start Printed Page 49047
95076Ingest challenge ini 120 minEF023table, examNF141133Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF141133Refined equipment time to reflect typical use exclusive to patient.
L037DRN/LPN/MTANFPrepare testing doses157CMS clinical review.
95115Immunotherapy one injectionEF040refrigerator, vaccine, commercial grade, w-alarm lockNF150CMS clinical review.
95117Immunotherapy injectionsEF041x-ray machine, portableNF170CMS clinical review.
95782Polysom <6 yrs 4/> paramtrsEF003bedroom furniture (hospital bed, table, reclining chair)NF660602Refined equipment time to reflect typical use exclusive to patient.
CribNF6600CMS clinical review.
EQ134impedance meter, 32-channelNF660602Refined equipment time to reflect typical use exclusive to patient.
EQ272sleep diagnostic system, attended (w-acquisition station, review master, computer)NF660662Refined equipment time to reflect typical use exclusive to patient.
CapnographNF6600Duplicative.
ER088Infrared illuminatorNF660602Refined equipment time to reflect typical use exclusive to patient.
L047BREEGTNFProvide pre-service education/obtain consent53CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Set up and calibrate all monitoring and recording equipment (initial), including capnograph (for child)65CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Measure and mark head and face. Apply and secure electrodes to head and face. Check impedances. Reapply electrodes as needed. (1.5 min per electrode for child, 1 min per electrode for adult)3020CMS clinical review.
Start Printed Page 49048
L047BREEGTNFOther Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning and snoring015CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning, snoring and capnography200CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Daytime tech reviews and edits recording, marks artifacts, scores sleep stages, performs evaluation of physiological changes10097CMS clinical review.
95783Polysom <6 yrs cpap/bilvlEF003bedroom furniture (hospital bed, table, reclining chair)NF660647Refined equipment time to reflect typical use exclusive to patient.
CribNF6600CMS clinical review.
EQ134impedance meter, 32-channelNF660647Refined equipment time to reflect typical use exclusive to patient.
EQ272sleep diagnostic system, attended (w-acquisition station, review master, computer)NF660707Refined equipment time to reflect typical use exclusive to patient.
CapnographNF6600Duplicative.
ER088Infrared illuminatorNF660647Refined equipment time to reflect typical use exclusive to patient.
L047BREEGTNFProvide pre-service education/obtain consent53CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Set up and calibrate all monitoring and recording equipment (initial), including capnograph (for child)65CMS clinical review.
Start Printed Page 49049
L047BREEGTNFOther Clinical Activity—specify: Measure and mark head and face. Apply and secure electrodes to head and face. Check impedances. Reapply electrodes as needed. (1.5 min per electrode for child, 1 min per electrode for adult)3020CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning and snoring015CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning, snoring and capnography200CMS clinical review.
L047BREEGTNFOther Clinical Activity—specify: Daytime tech reviews and edits recording, marks artifacts, scores sleep stages, performs evaluation of physiological changes10097CMS clinical review.
95861Muscle test 2 limbsEF023table, examNF4441Refined equipment time to reflect typical use exclusive to patient.
EQ024EMG-NCV-EP system, 8 channelNF4441Refined equipment time to reflect typical use exclusive to patient.
L037AElectrodiagnostic TechnologistNFAssist physician in performing procedure1929Conforming to physician time.
95863Muscle test 3 limbsEF023table, examNF5852Refined equipment time to reflect typical use exclusive to patient.
EQ024EMG-NCV-EP system, 8 channelNF5852Refined equipment time to reflect typical use exclusive to patient.
95864Muscle test 4 limbsEF023table, examNF7162Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49050
EQ024EMG-NCV-EP system, 8 channelNF7162Refined equipment time to reflect typical use exclusive to patient.
95868Muscle test cran nerve bilatEF023table, examNF3532Refined equipment time to reflect typical use exclusive to patient.
EQ024EMG-NCV-EP system, 8 channelNF3532Refined equipment time to reflect typical use exclusive to patient.
95907Motor&/sens 1-2 nrv cndj tstSG051gauze, non-sterile 4in x 4inNF04CMS clinical review.
SG055gauze, sterile 4in x 4inNF40CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF120CMS clinical review.
SJ022electrode skin prep gel (NuPrep)NF1000CMS clinical review.
95908Motor&/sens 3-4 nrv cndj tstSG051gauze, non-sterile 4in x 4inNF08CMS clinical review.
SG055gauze, sterile 4in x 4inNF80CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF240CMS clinical review.
SJ022electrode skin prep gel (NuPrep)NF1000CMS clinical review.
95909Motor&/sens 5-6 nrv cndj tstSG051gauze, non-sterile 4in x 4inNF012CMS clinical review.
SG055gauze, sterile 4in x 4inNF120CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF360CMS clinical review.
SJ022electrode skin prep gel (NuPrep)NF1000CMS clinical review.
95910Motor&sens 7-8 nrv cndj testL037AElectrodiagnostic TechnologistNF5040Conforming to physician time.
SG051gauze, non-sterile 4in x 4inNF016CMS clinical review.
SG055gauze, sterile 4in x 4inNF160CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF480CMS clinical review.
SJ022electrode skin prep gel (NuPrep)NF1000CMS clinical review.
95911Motor&sen 9-10 nrv cndj testL037AElectrodiagnostic TechnologistNF6450Conforming to physician time.
SG051gauze, non-sterile 4in x 4inNF020CMS clinical review.
SG055gauze, sterile 4in x 4inNF200CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF600CMS clinical review.
SJ022electrode skin prep gel (NuPrep)NF1000CMS clinical review.
95912Motor&sen 11-12 nrv cnd testL037AElectrodiagnostic TechnologistNF7760Conforming to physician time.
SG051gauze, non-sterile 4in x 4inNF024CMS clinical review.
SG055gauze, sterile 4in x 4inNF240CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF720CMS clinical review.
Start Printed Page 49051
SJ022electrode skin prep gel (NuPrep)NF1000CMS clinical review.
95913Motor&sens 13/> nrv cnd testL037AElectrodiagnostic TechnologistNF8770Conforming to physician time.
SG051gauze, non-sterile 4in x 4inNF026CMS clinical review.
SG055gauze, sterile 4in x 4inNF260CMS clinical review.
SG079tape, surgical paper 1in (Micropore)NF780CMS clinical review.
SJ022electrode skin prep gel (NuPrep)NF1000CMS clinical review.
95921Autonomic nrv parasym inervjEF032table, tilt (w-trendelenberg)NF6455Refined equipment time to reflect typical use exclusive to patient.
EQ051arterial tonometry acquisition system (WR Testworks)NF6455Refined equipment time to reflect typical use exclusive to patient.
EQ052arterial tonometry monitor (Colin Pilot)NF6455Refined equipment time to reflect typical use exclusive to patient.
L037AElectrodiagnostic TechnologistNFGreet patient, provide gowning, assure appropriate medical records are available30CMS clinical review.
L037AElectrodiagnostic TechnologistNFObtain vital signs30CMS clinical review.
L037AElectrodiagnostic TechnologistNFMonitor pt. following service/check tubes, monitors, drains52CMS clinical review.
95922Autonomic nrv adrenrg inervjEF032table, tilt (w-trendelenberg)NF7970Refined equipment time to reflect typical use exclusive to patient.
EQ051arterial tonometry acquisition system (WR Testworks)NF7970Refined equipment time to reflect typical use exclusive to patient.
EQ052arterial tonometry monitor (Colin Pilot)NF7970Refined equipment time to reflect typical use exclusive to patient.
L037AElectrodiagnostic TechnologistNFGreet patient, provide gowning, assure appropriate medical records are available30CMS clinical review.
L037AElectrodiagnostic TechnologistNFObtain vital signs30CMS clinical review.
L037AElectrodiagnostic TechnologistNFMonitor pt. following service/check tubes, monitors, drains52CMS clinical review.
95923Autonomic nrv syst funj testEQ035QSART acquisition system (Q-Sweat)NF7461Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49052
EQ124stimulator, constant current, w-stimulating and grounding electrodes (Grass Telefactor)NF7461Refined equipment time to reflect typical use exclusive to patient.
EQ171light, infra-red, ceiling mountNF7461Refined equipment time to reflect typical use exclusive to patient.
L037AElectrodiagnostic TechnologistNFAssist physician in performing procedure5545CMS clinical review.
L037AElectrodiagnostic TechnologistNFMonitor pt. following service/check tubes, monitors, drains52CMS clinical review.
SJ020electrode conductive gelNF50CMS clinical review.
95924Ans parasymp & symp w/tiltEF032table, tilt (w-trendelenberg)NF7976Refined equipment time to reflect typical use exclusive to patient.
EQ051arterial tonometry acquisition system (WR Testworks)NF7976Refined equipment time to reflect typical use exclusive to patient.
EQ052arterial tonometry monitor (Colin Pilot)NF7976Refined equipment time to reflect typical use exclusive to patient.
L037AElectrodiagnostic TechnologistNFMonitor pt. following service/check tubes, monitors, drains52CMS clinical review.
96920Laser tx skin < 250 sq cmEF031table, powerNF2026Refined equipment time to reflect typical use exclusive to patient.
EQ161laser, excimerNF2026Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF1726Refined equipment time to reflect typical use exclusive to patient.
Annual Laser Service PackageNF10Included in equipment cost per minute calculation.
L037DRN/LPN/MTANFMonitor pt. following service/check tubes, monitors, drains31CMS clinical review.
L037DRN/LPN/MTANFClean room/equipment by physician staff32CMS clinical review.
SF028laser tip (single use)NF10CMS clinical review.
SJ029ice pack, instantNF41CMS Code correction.
96921Laser tx skin 250-500 sq cmEF031table, powerNF2329Refined equipment time to reflect typical use exclusive to patient.
Start Printed Page 49053
EQ161laser, excimerNF2329Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF2329Refined equipment time to reflect typical use exclusive to patient.
Annual Laser Service PackageNF10Included in equipment cost per minute calculation.
L037DRN/LPN/MTANFMonitor pt. following service/check tubes, monitors, drains31CMS clinical review.
L037DRN/LPN/MTANFClean room/equipment by physician staff32CMS clinical review.
SF028laser tip (single use)NF10CMS clinical review.
SJ029ice pack, instantNF42CMS Code correction.
96922Laser tx skin >500 sq cmEF031table, powerNF3339Refined equipment time to reflect typical use exclusive to patient.
EQ161laser, excimerNF3339Refined equipment time to reflect typical use exclusive to patient.
EQ168light, examNF3039Refined equipment time to reflect typical use exclusive to patient.
Annual Laser Service PackageNF10Included in equipment cost per minute calculation.
L037DRN/LPN/MTANFMonitor pt. following service/check tubes, monitors, drains31CMS clinical review.
L037DRN/LPN/MTANFClean room/equipment by physician staff32CMS clinical review.
SF028laser tip (single use)NF10CMS clinical review.
97150Group therapeutic proceduresEQ248ultrasonic biometry, pachymeterNF105Refined equipment time to reflect typical use exclusive to patient.
EQ269blood pressure monitor, ambulatory, w-battery chargerNF10CMS clinical review.
SA007kit, cooking activity ingredients (mac-cheese)NF10CMS clinical review.
99495Trans care mgmt 14 day dischL042ARN/LPNFCommunication (with patient, family members, guardian or caretaker, surrogate decision makers, and/or other professionals) regarding aspects of care, etc.045CMS clinical review.
Start Printed Page 49054
99496Trans care mgmt 7 day dischL042ARN/LPNNFCommunication (with patient, family members, guardian or caretaker, surrogate decision makers, and/or other professionals) regarding aspects of care, etc.6070CMS clinical review.
L042ARN/LPNFCommunication (with patient, family members, guardian or caretaker, surrogate decision makers, and/or other professionals) regarding aspects of care, etc.070CMS clinical review.

17. On page 69138,

a. Top two thirds of the page, first column, first full paragraph, line 1, the phrase “The CY 2013 PFS CF is $25.0008” is corrected to read “The CY 2013 PFS CF is $25.0070.”

b. Third column, first full paragraph, line 19, the phrase CF to be $25.0008” is corrected to read “CF to be $25.0070.”

c. Lower half of the page, in Table 87: Calculation of the CY 2013 PFS CF, the list entry

CY 2013 Conversion Factor$25.0008

is corrected to read as follows:

CY 2013 Conversion Factor$25.0070

18. On page 69139, top quarter of the page, in Table 88: Calculation of the CY 2013 Anesthesia CF, the list entry

CY 2013 Anesthesia Factor$15.93

is corrected to read as follows:

CY 2013 Anesthesia Factor$16.1236

19. On page 69145, second column, first partial paragraph, lines 20 and 21, the phrase that reads “pharmacy for use upon a physician's order” is corrected to read “pharmacy for use upon a valid prescription.”

20. On page 69212, second column, first full paragraph, lines 5-8, the phrase “Measure 190: Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness” is corrected to read “Measure 190: Referral for Otologic Evaluation for Patients with a History of Sudden or Rapidly Progressive Hearing Loss.”

21. On page 69237, in Table 95: Individual Quality Measures for the Physician Quality Reporting System Proposed to be Available for Reporting via Claims, Registry, EHR, or GRPO Web Interface Beginning in 2013 or 2014*, Measures #189 and #190 are deleted.

22. On page 69267, after Table 95: Individual Quality Measures for the Physician Quality Reporting System Proposed to be Available for Reporting via Claims, Registry, EHR, or GRPO Web Interface Beginning in 2013 or 2014*, the following note is added:

*Measures that can be reported using the GPRO web interface.

†These measures can only be reported by participants using the GPRO. They are not available for reporting for individual Eligible Professionals using this reporting method.

¥ Titles and descriptions in this table are aligned with 2013 Physician Quality Reporting System Claims and Qualified Registry measure titles and descriptions, and may differ from existing measures in other programs. Please reference the National Quality Forum (NQF) and Start Printed Page 49055Physician Quality Reporting System numbers for clarification.

⋄Measures to be deleted in 2014.

‡Measures to be added in 2013.

○Measures to be added in 2014.

23. On page 69269, in Table 96: PQRS Quality Measures Available for Reporting for Group Practices Using the GPRO Web Interface for 2013 and Beyond, in the Measure and Title description for NQF/PQRS 0097/46 the phrase that reads “seen within 60 days following discharge” is corrected to read “seen within 30 days following discharge.

24. On page 69277, in Table 108: HIV/AIDS Measures Group, the following measures: HIV/AIDS Measures Group: PQRS Measure #206 (“HIV/AIDS: Screening for High Risk Sexual Behaviors”) and #207 (“HIV/AIDS: Screening for Injection Drug Use”) are deleted.

25. On page 69300,

a. Third column, line 22-23, the phrase “a deadline of February 28, 2013 to request an informal review” is corrected to read “a deadline of 90 days following the receipt of the feedback reports to request an informal review.”

b. Lines 27-28, the phrase “a deadline of February 28, 2014 to request an informal review” is corrected to read “a deadline of 90 days following the receipt of the feedback reports to request an informal review.”

26. On pages 69344 through 69345, we are correcting Table 134: CY 2013 PFS Final Rule with Comment Period Estimated Impact on Total Allowed Charges by Specialty* and the first footnote (*) that reads: *Table 83 shows only the final payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law.” to read as follows:

Table 134—CY 2013 Final Rule With Comment Period Estimated Impact on Total Allowed Charges by Specialty *

[Estimated impact for RVU changes *]

SpecialtyAllowed charges (mil)Impact of work and MP RVU changes %Impact of PE RVU changes %Combined impact %
(A)(B)(C)(D)(E)
TOTAL$86,384000
01-ALLERGY/IMMUNOLOGY200022
02-ANESTHESIOLOGY1,817022
03-CARDIAC SURGERY3690−1−1
04-CARDIOLOGY6,733−1−2−2
05-COLON AND RECTAL SURGERY153022
06-CRITICAL CARE263011
07-DERMATOLOGY3,024000
08-EMERGENCY MEDICINE2,839000
09-ENDOCRINOLOGY437011
10-FAMILY PRACTICE5,943257
11-GASTROENTEROLOGY1,896000
12-GENERAL PRACTICE587011
13-GENERAL SURGERY2,283011
14-GERIATRICS220135
15-HAND SURGERY135011
16-HEMATOLOGY/ONCOLOGY1,909022
17-INFECTIOUS DISEASE629011
18-INTERNAL MEDICINE11,163135
19-INTERVENTIONAL PAIN MGMT538011
20-INTERVENTIONAL RADIOLOGY2040−2−3
21-MULTISPECIALTY CLINIC/OTHER PHY81000
22-NEPHROLOGY2,080000
23-NEUROLOGY1,604−2−5−7
24-NEUROSURGERY687000
25-NUCLEAR MEDICINE490−2−3
27-OBSTETRICS/GYNECOLOGY704000
28-OPHTHALMOLOGY5,645−30−3
29-ORTHOPEDIC SURGERY3,643000
30-OTOLARNGOLOGY1,076022
31-PATHOLOGY1,2100−6−6
32-PEDIATRICS65133
33-PHYSICAL MEDICINE999−1−3−4
34-PLASTIC SURGERY356011
35-PSYCHIATRY1,170−132
36-PULMONARY DISEASE1,703011
37-RADIATION ONCOLOGY1,9880−7−7
38-RADIOLOGY4,8180−3−3
39-RHEUMATOLOGY548000
40-THORACIC SURGERY3430−1−1
41-UROLOGY1,9180−1−2
42-VASCULAR SURGERY8880−2−2
43-AUDIOLOGIST570−4−4
44-CHIROPRACTOR746011
45-CLINICAL PSYCHOLOGIST5751−3−2
46-CLINICAL SOCIAL WORKER4061−3−2
Start Printed Page 49056
47-DIAGNOSTIC TESTING FACILITY8880−7−7
48-INDEPENDENT LABORATORY1,0730−14−14
49-NURSE ANES/ANES ASST1,008022
50-NURSE PRACTITIONER1,623134
51-OPTOMETRY1,061−111
52-ORAL/MAXILLOFACIAL SURGERY45011
53-PHYSICAL/OCCUPATIONAL THERAPY2,636044
54-PHYSICIAN ASSISTANT1,229123
55-PODIATRY1,925022
56-PORTABLE X-RAY SUPPLIER106055
57-RADIATION THERAPY CENTERS720−9−9
98-OTHER19011
* Table 134 shows only the final payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law.

27. On pages 69347 through 69348, we are correcting Table 135: CY 2013 PFS Final Rule with Comment Period Estimated Impact on Total Allowed Charges by Specialty by Selected Policy* and the text in the first footnote (*) for Table 135 that reads “*Table 135 shows only the proposed payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law.” to read as follows:

Table 135—CY 2013 PFS Final Rule With Comment Period Estimated Impact on Total Allowed Charges by Specialty by Selected Policy* Estimated Impact for RVU Changes*

SpecialtyAllowed charges (mil)Impact of end of PPIS transition %New, revised, potentially misvalued codes, MPPR, new utilization and other factors %Updated equipment interest rate assumption %Transitional care management %Input changes for certain radiation therapy procedures %Total (cumulative impact) %
(A)(B)(C)(D)(E)(F)(G)(H)
TOTAL86,384000000
01-ALLERGY/IMMUNOLOGY200002002
02-ANESTHESIOLOGY1,817110002
03-CARDIAC SURGERY369−10000−1
04-CARDIOLOGY6,733−200−10−2
05-COLON AND RECTAL SURGERY153100002
06-CRITICAL CARE263000001
07-DERMATOLOGY3,024001−100
08-EMERGENCY MEDICINE2,839000000
09-ENDOCRINOLOGY437110−101
10-FAMILY PRACTICE5,943110407
11-GASTROENTEROLOGY1,896000000
12-GENERAL PRACTICE587100−101
13-GENERAL SURGERY2,283100001
14-GERIATRICS220110205
15-HAND SURGERY135100−101
16-HEMATOLOGY/ONCOLOGY1,909−131−102
17-INFECTIOUS DISEASE629110001
18-INTERNAL MEDICINE11,163110305
19-INTERVENTIONAL PAIN MGMT538100−101
20-INTERVENTIONAL RADIOLOGY204−20000−3
21-MULTISPECIALTY CLINIC/OTHER PHY81000000
22-NEPHROLOGY2,080000000
23-NEUROLOGY1,6041−8000−7
24-NEUROSURGERY687000000
25-NUCLEAR MEDICINE49−20−100−3
27-OBSTETRICS/GYNECOLOGY704000−100
28-OPHTHALMOLOGY5,6452−4000−3
29-ORTHOPEDIC SURGERY3,643100000
30-OTOLARNGOLOGY1,076111−102
31-PATHOLOGY1,210−1−5000−6
32-PEDIATRICS65100303
33-PHYSICAL MEDICINE9991−50−10−4
Start Printed Page 49057
34-PLASTIC SURGERY$356100001
35-PSYCHIATRY1,170020−102
36-PULMONARY DISEASE1,703010−101
37-RADIATION ONCOLOGY1,988−42−3−1−1−7
38-RADIOLOGY4,818−20−100−3
39-RHEUMATOLOGY548010−100
40-THORACIC SURGERY343−10000−1
41-UROLOGY1,918−200−10−2
42-VASCULAR SURGERY888−1−1000−2
43-AUDIOLOGIST57−30000−4
44-CHIROPRACTOR746100001
45-CLINICAL PSYCHOLOGIST575−21000−2
46-CLINICAL SOCIAL WORKER406−20000−2
47-DIAGNOSTIC TESTING FACILITY888−50−2−10−7
48-INDEPENDENT LABORATORY1,073−2−121−10−14
49-NURSE ANES/ANES ASST1,008200002
50-NURSE PRACTITIONER1,623110204
51-OPTOMETRY1,0612−10001
52-ORAL/MAXILLOFACIAL SURGERY45101−101
53-PHYSICAL/OCCUPATIONAL THERAPY2,636220004
54-PHYSICIAN ASSISTANT1,229100203
55-PODIATRY1,925201−102
56-PORTABLE X-RAY SUPPLIER106141−105
57-RADIATION THERAPY CENTERS72−54−5−1−1−9
98-OTHER19100001
“*Table 135 shows only the final payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law.”

28. On pages 69350 through 69351, we are correcting Table 136 Impact of Final Rule with Comment Period on CY 2013 Payment for Selected Procedures* to read as follows:

Start Printed Page 49058

Start Printed Page 49059

29. On page 69351,

a. Footnote 3 “Payments based on the 2012 conversion factor of 34.0376, adjusted to 34.0066 to include the budget neutrality adjustment” is corrected to read “Payments based on the 2012 conversion factor of 34.0376, adjusted to 34.0230 to include the budget neutrality adjustment.”

b. Footnote 4 for Table 136 “Payments based on the 2013 conversion factor of 25.0008, which includes the budget neutrality adjustment” is corrected to read “Payments based on the 2013 conversion factor of 25.0070, which includes the budget neutrality adjustment.”

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

Start Signature

Dated: August 2, 2013.

Jennifer M. Cannistra,

Executive Secretary to the Department, Department of Health and Human Services.

End Signature End Supplemental Information

[FR Doc. 2013-19378 Filed 8-9-13; 8:45 am]

BILLING CODE 4120-01-P