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CMSManualSystemDepartmentofHealth&HumanServices(DHHS)Pub100-04MedicareClaimsProcessingCentersforMedicare&MedicaidServices(CMS)Transmittal1258Date:MAY29,2007ChangeRequest5614SUBJECT:JulyUpdatetothe2007MedicarePhysicianFeeScheduleDatabaseI.
SUMMARYOFCHANGES:PaymentfileswereissuedtocarriersbasedupontheDecember1,2006,MedicarePhysicianFeeScheduleFinalRule.
Thischangerequestamendsthosepaymentfilesandincludesnew/revisedcodesforthePhysicianQualityReportingInitiative.
New/RevisedMaterialEffectiveDate:January1,2007ImplementationDate:July2,2007Disclaimerformanualchangesonly:Therevisiondateandtransmittalnumberapplyonlytoreditalicizedmaterial.
Anyothermaterialwaspreviouslypublishedandremainsunchanged.
However,ifthisrevisioncontainsatableofcontents,youwillreceivethenew/revisedinformationonly,andnottheentiretableofcontents.
II.
CHANGESINMANUALINSTRUCTIONS:(N/Aifmanualisnotupdated)R=REVISED,N=NEW,D=DELETED-OnlyOnePerRow.
R/N/DChapter/Section/Subsection/TitleN/AIII.
FUNDING:NoadditionalfundingwillbeprovidedbyCMS;ContractoractivitiesaretobecarriedoutwithintheirFY2007operatingbudgets.
IV.
ATTACHMENTS:RecurringUpdateNotification*Unlessotherwisespecified,theeffectivedateisthedateofservice.
Attachment–RecurringUpdateNotificationPub.
100-04Transmittal:1258Date:May29,2007ChangeRequest:5614SUBJECT:JulyUpdatetothe2007MedicarePhysicianFeeScheduleDatabaseEffectiveDate:January1,2007ImplementationDate:July2,2007I.
GENERALINFORMATIONA.
Background:PaymentfileswereissuedtocarriersbasedupontheDecember1,2006,MedicarePhysicianFeeScheduleFinalRule.
Thischangerequestamendsthosepaymentfilesandincludesnew/revisedcodesforthePhysicianQualityReportingInitiative.
B.
Policy:Section1848(c)(4)oftheSocialSecurityActauthorizestheSecretarytoestablishancillarypoliciesnecessarytoimplementrelativevaluesforphysicians'services.
II.
BUSINESSREQUIREMENTSTABLEUse"Shall"todenoteamandatoryrequirementNumberRequirementResponsibility(placean"X"ineachapplicablecolumn)A/DMFICADMRHShared-SystemMaintainersOTHERBMACEMACRRIERERCHIFISSMCSVMSCWF5614.
1EffectivefordatesofserviceonorafterJanuary1,2007,contractorsshallmanuallyupdatetheirsystemstoreflect11baseunitsforCPTcode00797.
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2ContractorsshallmanuallyupdatetheirHCPCSfiletoreflectacoverageindicatorof"C"fornewCategoryIIcodesincludedinthistransmittal.
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3EffectivefordatesofserviceonorafterJuly1,2007,thefollowingCategoryIImodifierwillberecognizedinadditiontoCategoryIImodifiers1P,2Pand3P.
(NOTE:Thesearestatisticalmodifiers):8P–Performancemeasurereportingmodifier–actionnotperformed,reasonnototherwisespecified(NOTE:Modifier8Pisintendedtobeusedasa"reportingmodifier"toallowtheXXCMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page1NumberRequirementResponsibility(placean"X"ineachapplicablecolumn)A/DMFICADMRHShared-SystemMaintainersOTHERBMACEMACRRIERERCHIFISSMCSVMSCWFreportingofcircumstanceswhenanactiondescribedinameasure'snumeratorisnotperformedandthereasonisnototherwisespecified.
)5614.
3.
1CarriersshallmanuallyupdatetheirsystemstoreflectthisnewCategoryIImodifier(8P).
XX5614.
4CarriersshalleithermanuallyupdatethePerformancePaymentIndicatorforthecodeslistedinAttachment3orloadtheseparatefileandmanuallyre-loadanycarrierpricedfeestheymayhaveestablished.
XX5614.
5Contractorsshall,inaccordancewithPub100-4,Chapter23,Section30.
1,giveproviders30daysnoticebeforeimplementingthechangesidentifiedinAttachment1.
Unlessotherwisestatedinthistransmittal,changeswillberetroactivetoJanuary1,2007.
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6Contractorsneednotsearchtheirfilestoeitherretractpaymentforclaimsalreadypaidortoretroactivelypayclaims.
However,contractorsshalladjustclaimsbroughttotheirattention.
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7Contractorsshallretrievetherevisedpaymentfiles,asidentifiedinAttachment2,fromtheCMSMainframeTelecommunicationsSystem.
FileswillbeavailableforretrievalonMay24,2007.
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8CMSwillsendCWFtwofilestofacilitateduplicatebillingedits:1)PurchasedDiagnosticand2)DuplicateRadiologyEditing.
CWFshallinstallthesefilesintotheirsystems.
CWFwillbenotifiedviaemailwhenthesefileshavebeensenttothem.
X5614.
9Notificationofsuccessfulreceiptshallbesentviae-mailtoprice_file_receipt@cms.
hhs.
govstatingthenameofthefilereceivedandtheentityforwhichitwasreceived(e.
g.
,carrier/fiscalintermediarynameandnumber).
XXXIII.
PROVIDEREDUCATIONTABLENumberRequirementResponsibility(placean"X"ineachapplicablecolumn)CMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page2A/BDMEFICARDMERHHShared-SystemMaintainersOTHERFMVCRRIICMWMMICSSSFACACERS5614.
10Aprovidereducationarticlerelatedtothisinstructionwillbeavailableathttp://www.
cms.
hhs.
gov/MLNMattersArticles/shortlyaftertheCRisreleased.
Youwillreceivenotificationofthearticlereleaseviatheestablished"MLNMatters"listserv.
Contractorsshallpostthisarticle,oradirectlinktothisarticle,ontheirWebsiteandincludeinformationaboutitinalistservmessagewithinoneweekoftheavailabilityoftheprovidereducationarticle.
Inaddition,theprovidereducationarticleshallbeincludedinyournextregularlyscheduledbulletin.
ContractorsarefreetosupplementMLNMattersarticleswithlocalizedinformationthatwouldbenefittheirprovidercommunityinbillingandadministeringtheMedicareprogramcorrectly.
XXXIV.
SUPPORTINGINFORMATIONA.
Foranyrecommendationsandsupportinginformationassociatedwithlistedrequirements,usetheboxbelow:Use"Should"todenotearecommendation.
X-RefRecommendationsorothersupportinginformation:RequirementNumberB.
Forallotherrecommendationsandsupportinginformation,usethisspace:V.
CONTACTSPre-ImplementationContact(s):GayshaBrooks,Gaysha.
Brooks@cms.
hhs.
gov,(410)786-9649Post-ImplementationContact(s):AppropriateRegionalOfficeVI.
FUNDINGA.
CMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page3NoadditionalfundingwillbeprovidedbyCMS;contractoractivitiesaretobecarriedoutwithintheirFY2007operatingbudgets.
B.
Thecontractorisherebyadvisedthatthisconstitutestechnicaldirectionasdefinedinyourcontract.
CMSdoesnotconstruethisasachangetotheStatementofWork(SOW).
ThecontractorisnotobligatedtoincurcostsinexcessoftheamountsallottedinyourcontractunlessanduntilspecificallyauthorizedbytheContractingOfficer.
Ifthecontractorconsidersanythingprovided,asdescribedabove,tobeoutsidethecurrentscopeofwork,thecontractorshallwithholdperformanceonthepart(s)inquestionandimmediatelynotifytheContractingOfficer,inwritingorbye-mail,andrequestformaldirectionsregardingcontinuedperformancerequirements.
CMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page4Attachment1ChangesincludedintheJulyUpdatetothe2007MedicarePhysicianFeeScheduleDatabaseareasfollows:ThefollowingcodesareincludedinFileA(changesretroactivetoJanuary1,2007):CPT/HCPCSACTION00797BaseUnits=110115TProcedureStatus=N0116TProcedureStatus=N0117TProcedureStatus=N19301ShortDescriptor=Partialmastectomy33208WorkRVUs=8.
7275635-TCDiagnosticIndicator=0277422TransitionalNon-FacilityPERVU=2.
61FullyImplementedNon-FacilityPERVU=5.
31(InformationalOnly)TransitionalFacilityPERVU=2.
61FullyImplementedFacilityPERVU=5.
31(InformationalOnly)77423TransitionalNon-FacilityPERVU=3.
57FullyImplementedNon-FacilityPERVU=7.
51(InformationalOnly)TransitionalFacilityPERVU=3.
57FullyImplementedFacilityPERVU=7.
51(InformationalOnly)G9041TransitionalNon-FacilityPERVU=0.
29FullyImplementedNon-FacilityPERVU=0.
29(InformationalOnly)TransitionalFacilityPERVU=0.
29FullyImplementedFacilityPERVU=0.
29(InformationalOnly)G9042TransitionalNon-FacilityPERVU=0.
29FullyImplementedNon-FacilityPERVU=0.
29(InformationalOnly)TransitionalFacilityPERVU=0.
29FullyImplementedFacilityPERVU=0.
29(InformationalOnly)G9043TransitionalNon-FacilityPERVU=0.
29FullyImplementedNon-FacilityPERVU=0.
29(InformationalOnly)TransitionalFacilityPERVU=0.
29FullyImplementedFacilityPERVU=0.
29(InformationalOnly)G9044TransitionalNon-FacilityPERVU=0.
23FullyImplementedNon-FacilityPERVU=0.
23(InformationalOnly)TransitionalFacilityPERVU=0.
23FullyImplementedFacilityPERVU=0.
23(InformationalOnly)ThefollowingcodesareincludedinFileB(changeseffectivefordatesofserviceonorafterJuly1,2007):0024TProcedureStatus=IEffectivefordatesofserviceonorafterJuly1,20070133TProcedureStatus=IEffectivefordatesofserviceonorafterJuly1,2007EffectivefordatesofserviceonorafterJuly1,2007,thefollowingCategoryIImodifierwillberecognizedinadditiontoCategoryIImodifiers1P,2Pand3P.
(NOTE:Thesearestatisticalmodifiers):8P–Performancemeasurereportingmodifier–actionnotperformed,reasonnototherwisespecified(NOTE:Modifier8Pisintendedtobeusedasa"reportingmodifier"toallowthereportingofcircumstanceswhenanactiondescribedinameasure'snumeratorisnotperformedandthereasonisnototherwisespecified.
)EffectivefordatesofserviceonorafterJuly1,2007,thefollowingG-codeswillnolongerbeusedforthePQRIprogram.
ThestatusindicatorfortheseG-codeswillbechangedto"I"ontheMPFSDB.
G8158G8160G8161G8163G8191G8192G8194G8195G8197G8198G8199G8201G8202G8203G8205G8206G8207G8208G8210G8211G8212G8213G8215G8216G8218G8222G8224G8225G8227G8228G8229G8230G8232G8235G8236G8237G8239G8241G8242G8245G8247G8249G8250G8252G8253G8255G8256G8258G8259G8261G8262G8264G8265G8267G8269G8270G8272G8273G8275G8277G8278G8280G8281G8283G8284G8286G8287G8288G8290G8291G8292G8294G8295G8297G8300G8301G8309G8311G8312G8313G8315G8316G8317G8319G8320G8321G8323G8324G8325G8327G8328G8329G8331G8332G8333G8335G8336G8337G8339G8340G8342G8343G8344G8346G8347G8348G8349G8350G8351G8352G8353G8355G8356G8358G8359G8361G8363G8364G8366G8368NewCategoryIIcodesforthePhysicianQualityReportingInitiative(PQRI)EffectivefordatesofserviceonorafterJuly1,2007,thefollowingCategoryIIcodeswillbeaddedtotheMPFSDBwithastatusindicatorof"M".
Thepaymentindicatorsareidenticalforallservices.
Thus,thepaymentindicatorswillonlybelistedforthefirstservice(CategoryIIcode0509F).
CPTcode:LongDescriptor:ShortDescriptor:ProcedureStatus:WRVU:Non-FacilityPERVU:FacilityPERVU:MalpracticeRVU:PC/TC:SiteofService:GlobalSurgery:MultipleProcedureIndicator:BilateralSurgeryIndicator:AssistantatSurgeryIndicator:Co-SurgeryIndicator:TeamSurgeryIndicator:0509FUrinaryincontinenceplanofcaredocumented(GER)Urineinconplandoc'dM0.
000.
000.
000.
0099XXX99999PhysicianSupervisionDiagnosticIndicator:9TypeofService:1DiagnosticFamilyImagingIndicator:99EffectiveforservicesperformedonorafterJuly1,2007CodeLongDescriptorShortDescriptor1060FDocumentationofpermanentORpersistentORparoxysmalatrialfibrillationDocperm/cont/paroxatr.
fib1061FDocumentationofabsenceofpermanentANDpersistentANDparoxysmalatrialfibrillationDoclackperm+cont+paroxfib1065FIschemicstrokesymptomonsetoflessthan3hourspriortoarrivalIschmstrokesymplt3hrsb/41066FIschemicstrokesymptomonsetgreaterthanorequalto3hourspriortoarrivalIschmstrokesympge3hrsb/41070FAlarmsymptoms(involuntaryweightloss,dysphagia,orgastrointestinalbleeding)assessed;nonepresentAlarmsympassessed-absent1071FAlarmsymptoms(involuntaryweightloss,dysphagia,orgastrointestinalbleeding)assessed;oneormorepresentAlarmsympassessed-1+prsnt1080FSurrogatedecisionmakeroradvancecareplandocumentedinthemedicalrecordDecismkr/advncdplandoc'd1090FPresenceorabsenceofurinaryincontinenceassessedPres/absnurineinconassess1091FUrinaryincontinencecharacterized(egfrequency,volume,timing,typeofsymptoms,howbothersome)Urineinconcharacterized1100FPatientscreenedforfuturefallrisk;documentationoftwoormorefallsinthepastyearoranyfallwithinjuryinthepastyear(GER)Ptfallsassess-doc'dge2+/yr1101FPatientscreenedforfuturefallrisk;documentationofnofallsinthepastyearoronlyonefallwithoutinjuryinthepastyearPtfallsassess-doc'dle1/yr1110FPatientdischargedfromaninpatientfacility(eghospital,skillednursingfacility,orrehabilitationfacility)withinthelast60daysPtlftinptfacw/in60days1111FDischargemedicationsreconciledwiththecurrentmedicationlistinoutpatientmedicalrecordDschrgmed/currentmedmerge3100FCarotidimagingstudyreportincludesdirectorindirectreferencetomeasurementsofdistalinternalcarotiddiameterasthedenominatorforstenosismeasurementImagetestrefcarotdiam3110FPresenceorabsenceofhemorrhageandmasslesionandacuteinfarctiondocumentedinfinalCTorMRIreportPres/absnhmrhg/lesiondoc'd3111FCTorMRIofthebrainperformedwithin24hoursofarrivaltothehospitalCT/MRIbraindonew/in24hrs3112FCTorMRIofthebrainperformedgreaterthan24hoursafterarrivaltothehospitalCT/MRIbraindoneGT24hrs3120F12-LeadECGPerformed12-LeadECGperformed3130FUppergastrointestinalendoscopyperformedUpperGIendoscopyperformed3132FDocumentationofreferralforuppergastrointestinalDocref.
upperGIendoscopyendoscopy3140FUppergastrointestinalendoscopyreportindicatessuspicionofBarrett'sesophagusUpperGIendoshowsbarrtt's3141FUppergastrointestinalendoscopyreportindicatesnosuspicionofBarrett'sesophagusUpperGIendonotbarrtt's3142FBariumswallowtestorderedBariumswallowtestordered3150FForcepsesophagealbiopsyperformedForcepsesophbiopsydone3155FCytogenetictestingperformedonbonemarrowattimeofdiagnosisorpriortoinitiatingtreatmentCytogentestmarrowb/4tx3160FDocumentationofironstorespriortoinitiatingerythropoietintherapyDocfe+storesb/4epothx3170FFlowcytometrystudiesperformedattimeofdiagnosisorpriortoinitiatingtreatmentFlowcytodoneb/4tx3200FBariumswallowtestnotorderedBariumswallowtestnotreq3210FGroupAStrepTestPerformedGrpAstreptestperformed4041FDocumentationoforderforcefazolinORcefuroximeforantimicrobialprophylaxisDocordercefazolin/cefurox.
4042FDocumentationthatprophylacticantibioticswereneithergivenwithin4hourspriortosurgicalincisionnorgivenintraoperativelyDocantibionotgiven4043FDocumentationthatanorderwasgiventodiscontinueprophylacticantibioticswithin48hoursofsurgicalendtime,cardiacproceduresDocordergivenstopantibio4044FDocumentationthatanorderwasgivenforvenousthromboembolism(VTE)prophylaxistobegivenwithin24hrspriortoincisiontimeor24hoursaftersurgeryendtimeDocordergivenVTEprophylx4046FDocumentationthatprophylacticantibioticsweregivenwithin4hourspriortosurgicalincisionorgivenintraoperativelyDocantibiogivenb/4surg4047FDocumentationoforderforprophylacticantibioticstobegivenwithinonehour(iffluoroquinoloneorvancomycin,twohours)priortosurgicalincision(orstartofprocedurewhennoincisionisrequired)Docantibiogivenb/4surg4048FDocumentationthatprophylacticantibioticwasgivenwithinonehour(iffluoroquinoloneorvancomycin,twohours)priortosurgicalincision(orstartofprocedurewhennoincisionisrequired)Docantibiogivenb/4surg4049FDocumentationthatorderwasgiventodiscontinueprophylacticantibioticswithin24hoursofsurgicalendtime,non-cardiacprocedureDocordergivenstopantibio4070FDeepVeinThrombosis(DVT)prophylaxisreceivedbyendofhospitalday2DVTprophylxrecv'dday24073FOralantiplatelettherapyprescribedatdischargeOralantiplatthxrxdischrg4075FAnticoagulanttherapyprescribedatdischargeAnticoagthxrxatdischrg4077FDocumentationthattissueplasminogenactivator(t-PA)administrationwasconsideredDoct-paadminconsidered4079FDocumentationthatrehabilitationserviceswereconsideredDocrehabsvcsconsidered4084FAspirinreceivedwithin24hoursbeforeemergencydepartmentarrivalorduringemergencydepartmentstayAspirinrecv'dw/in24hrs4090FPatientreceivingerythropoietintherapyPtrcvngepothxpy4095FPatientnotreceivingerythropoietintherapyPtnotrcvngepothxpy4100FBisphosphonatetherapy,intravenous,orderedorreceivedBiphosthxpyveinord/rec'vd4110FInternalmammaryarterygraftperformedforprimary,isolatedcoronaryarterybypassgraftprocedureInt.
mamartusedforcabg4115FBetablockeradministeredwithin24hourspriortosurgicalincisionBetablckradminw/in24hrs4120FAntibioticprescribedordispensedAntibiotrx'd/given4124FAntibioticneitherprescribednordispensedAntibiotnotrx'd/given6010FDysphagiascreeningconductedpriortoorderfororreceiptofanyfoods,fluidsormedicationbymouthDysphagtestdoneb/4eating6015FPatientreceivingoreligibletoreceivefoods,fluidsormedicationbymouthPtrecvng/OKforeating/swal6020FNPO(nothingbymouth)orderedNPO(nothing-mouth)orderedNewG-CodesforPQRIEffectivefordatesofserviceonorafterJuly1,2007,thefollowingG-codes(G8370throughG8389)willbeaddedtotheMPFSDBwithastatusindicatorof"M".
Thepaymentindicatorsareidenticalforallservicesinthiscoderange.
Thus,thepaymentindicatorswillonlybelistedforthefirstservice(HCPCScodeG8370)inthisrange.
HCPCSCode:G8370LongDescriptor:AsthmapatientswithnumericfrequencyofsymptomsorpatientcompletionofanShortDescriptor:ProcedureStatus:WRVU:Non-FacilityPERVU:FacilityPERVU:MalpracticeRVU:PC/TC:SiteofService:GlobalSurgery:MultipleProcedureIndicator:BilateralSurgeryIndicator:asthmaassessmenttool/survey/questionnairenotdocumentedAMIptrecdaspirinatarrivM0.
000.
000.
000.
0099XXX99AssistantatSurgeryIndicator:9Co-SurgeryIndicator:9TeamSurgeryIndicator:9PhysicianSupervisionDiagnosticIndicator:9TypeofService:1DiagnosticFamilyImagingIndicator:99CodeLongDescriptorShortDescriptorG8371ChemotherapydocumentedasnotreceivedorprescribedforStageIIIcoloncancerpatientsChemothernotrecstg3colonG8372ChemotherapydocumentedasreceivedorprescribedforStageIIIcoloncancerpatientsChemotherrecstg3coloncaG8373ChemotherapyplandocumentedpriortochemotherapyadministrationChemoplandocumpriorchemoG8374ChemotherapyplannotdocumentedpriortochemotherapyadministrationChemoplannotdocpriorcheG8375Chroniclymphocyticleukemia(CLL)patientwithnodocumentationofbaselineflowcytometryperformedCLLptw/odocflowcytometrG8376CliniciandocumentationthatbreastcancerpatientwasnoteligiblefortamoxifenoraromatoseinhibitortherapymeasureBrstcaptineligtamoxifenG8377CliniciandocumentationthatcoloncancerpatientisnoteligibleforchemotherapymeasureMDdoccoloncaptineligchG8378CliniciandocumentationthatpatientwasnotaneligiblecandidateforradiationtherapymeasureMDdocptineligradtherapyG8379Documentationofradiationtherapyrecommendedwithin12monthsoffirstofficevisitRadiattxrecomdoc12moovG8380ForpatientswithERorPRpositive,StageIC-IIIbreastcancer,cliniciandidnotdocumentthatthepatientreceivedorwasprescribedtamoxifenoraromataseinhibitorPtwstgIC-3Brstcaw/otamG8381ForpatientswithERorPRpositive,StageIC-IIIbreastcancer,cliniciandocumentedorprescribedPtwstgIC-3BrstcarectamthatthepatientisreceivingtamoxifenoraromataseinhibitorG8382MultipleMyelomapatientswithnodocumentationofprescribedorreceivedintravenousbisphosphonatetherapyMMptw/odocIVbisphophonG8383Nodocumentationofradiationtherapyrecommendedwithin12monthsoffirstofficevisitRadiationrecnotdoc12mooG8384BaselinecytogenetictestingnotperformedinpatientswithMyelodysplasticSyndrome(MDS)orAcuteLeukemiasMDSptw/obasecytogentestG8385DiabeticpatientswithnodocumentationofHemoglobinA1clevel(withinthelast12months)DiabptwnodocHgbA1c12mG8386Diabeticpatientswithnodocumentationoflow-densitylipoprotein(withinthelast12months)DiabptwnodocLDL12mG8387End-stagerenaldiseasepatientwithahematocritORhemoglobinnotdocumentedESRDptwHct/HgbnotdocumeG8388End-stagerenaldiseasepatientwithURRORKt/Vvaluenotdocumented,butotherwiseeligibleformeasureESRDptwURR/KtvnotdocelG8389MyelodysplasticSyndrome(MDS)patientswithnodocumentationofironstorespriortoreceivingerythropoietintherapyMDSptnodocFepriorEPOG8390Diabeticpatientswithnodocumentationofbloodpressuremeasurement(withinthelast12months)Diabeticw/odocumentBP12mG8391Patientswithpersistentasthma,nodocumentationofpreferredlongtermcontrolmedicationoracceptablealternativetreatmentprescribedPtwasthmanodocmedortxCodeswithreviseddescriptorsThelongand/orshortdescriptorsforthefollowingPQRIcodeshavebeenrevised.
CodeLongDescriptorChangeShortDescriptorChange2001FN/AWeightrecorded2010FVitalsigns(temperature,pulse,respiratoryrate,andbloodpressure)documentedandreviewedN/A2014FMentalstatusassessedN/A3028FOxygensaturationresultsdocumentedandreviewed(includesassessmentthroughpulseoximetryorarterialbloodgasmeasurement)N/A3044FN/AHGa1clevellt7.
0%3073FPre-surgical(cataract)axiallength,cornealpowermeasurementandmethodofintraocularlenspowercalculationdocumented(mustbeperformedwithinsixmonthspriortosurgery)3074FN/ASystbplt130mmhg3075FN/ASystbpge130–139mmhg3082FKt/V1levC0064TSpectroscopevalexpiredgasC0065TOcularphotoscreenbilatC0067T26Ctcolonography;dxC0067TTCCtcolonography;dxC0067TCtcolonography;dxC0068TInterp/reptheartsoundC0069TAnalysisonlyheartsoundC0070TInterponlyheartsoundC0071TU/sleiomyomataablate200C0075T26Perqstent/chestvertartC0075TTCPerqstent/chestvertartC0075TPerqstent/chestvertartC0076T26S&istent/chestvertartC0076TTCS&istent/chestvertartC0076TS&istent/chestvertartC0077TCerebthermperfusionprobeC0078TEndovascaortreprw/deviceC0079TEndovascviscextnsnreprC0080TEndovascaortreprrads&iC0081TEndovascviscextnsns&iC0084TTempprostateurethralstentC0085TBreathtestheartrejectC0086TLventriclefillpressureC0087TSpermevalhyaluronanC0088TRftonguebasevolreduxnC0089TActigraphytesting,3-dayC0090TCervicalartificdiscC0092TArtificdiscaddlC0093TCervicalartificdiskectomyC0095TArtificdiskectomyaddlC0096TRevcervicalartificdiscC0098TRevartificdiscaddlC0099TImplantcornealringC0100TProsthretinareceive&genC0101TExtracorpshockwvtx,hienrgC0102TExtracorpshockwvtx,anesthC0103THolotranscobalaminC0104TAtrestcardiogasrebreatheC0105TExerccardiogasrebreatheC0106TTouchquantsensorytestC0107TVibratequantsensorytestC0108TCoolquantsensorytestC0109THeatquantsensorytestC0110TNosquantsensorytestC0111TRbcmembranesfattyacidsC0123TScleralfistulizationC0124TConjunctivaldrugplacementC0126TChdriskimtstudyC0130TChroncaredruginvestigatnC0135TPerqcryoablaterenaltumorC0137TProstatesaturationsamplingC0140TExhaledbreathcondensatephC0144T26CTheartwodye;qualcalcC0144TTCCTheartwodye;qualcalcC0144TCTheartwodye;qualcalcC0145T26CTheartw/wodyefunctC0145TTCCTheartw/wodyefunctC0145TCTheartw/wodyefunctC0146T26CCTAw/wodyeC0146TTCCCTAw/wodyeC0146TCCTAw/wodyeC0147T26CCTAw/wo,quancalciumC0147TTCCCTAw/wo,quancalciumC0147TCCTAw/wo,quancalciumC0148T26CCTAw/wo,strxrC0148TTCCCTAw/wo,strxrC0148TCCTAw/wo,strxrC0149T26CCTAw/wo,strxrquancalcC0149TTCCCTAw/wo,strxrquancalcC0149TCCTAw/wo,strxrquancalcC0150T26CCTAw/wo,diseasestrxrC0150TTCCCTAw/wo,diseasestrxrC0150TCCTAw/wo,diseasestrxrC0151T26CTheartfunctadd-onC0151TTCCTheartfunctadd-onC0151TCTheartfunctadd-onC0153TTcathsensoraneurysmsacC0154TStudysensoraneurysmsacC0155TLapimplgastcurveelectrdC0156TLapremvgastcurveelectrdC0157TOpenimplgastcurveelectrdC0158TOpenremvgastcurveelectrdC0159T26CadbreastmriC0159TTCCadbreastmriC0159TCadbreastmriC0160TTcranialmagnstimtxplanC0161TTcranialmagnstimtxdelivC0162TAnalprogramgastneurostimC0163TLumbartifdiskectomyaddlC0164TRemovelumbartifdiscaddlC0165TReviselumbartifdiscaddlC0166TTcathvsdclosew/obypassC0167TTcathvsdclosewbypassC0168TRhinophototxlightappbilatC0169TPlacestereocathbrainC0170TAnorectalfistulaplugrprC0171TLumbarspineprocesdistractC0172TLumbarspineprocesaddlC0173TIopmonitiopressureC0174TCadcxrwithinterpC0175TCadcxrremoteC0176TAqucanaldilatw/oretentC0177TAqucanaldilatwretentC15431ApplyacellularxgraftaddC15847Excskinabdadd-onC15999RemovalofpressuresoreC17999SkintissueprocedureC19499BreastsurgeryprocedureC20999MusculoskeletalsurgeryC21088Prepareface/oralprosthesisC21089Prepareface/oralprosthesisC21299Cranio/maxillofacialsurgeryC21499HeadsurgeryprocedureC21742Repairstern/nussw/oscopeC21743Repairsternum/nussw/scopeC21899Neck/chestsurgeryprocedureC22899SpinesurgeryprocedureC22999AbdomensurgeryprocedureC23929ShouldersurgeryprocedureC24940RevisionofupperarmC24999Upperarm/elbowsurgeryC25999ForearmorwristsurgeryC26989Hand/fingersurgeryC27299Pelvis/hipjointsurgeryC27599LegsurgeryprocedureC27899Leg/anklesurgeryprocedureC28899Foot/toessurgeryprocedureC29799Casting/strappingprocedureC29999ArthroscopyofjointC30999NasalsurgeryprocedureC31299SinussurgeryprocedureC31599LarynxsurgeryprocedureC31899AirwayssurgicalprocedureC32855Preparedonorlung,singleC32856Preparedonorlung,doubleC32999ChestsurgeryprocedureC33933Preparedonorheart/lungC33944PreparedonorheartC33999CardiacsurgeryprocedureC36299VesselinjectionprocedureC37195Thrombolytictherapy,strokeC37501VascularendoscopyprocedureC37799VascularsurgeryprocedureC38129Laparoscopeproc,spleenC38589Laparoscopeproc,lymphaticC38999Blood/lymphsystemprocedureC39499ChestprocedureC39599DiaphragmsurgeryprocedureC40799LipsurgeryprocedureC40899MouthsurgeryprocedureC41599TongueandmouthsurgeryC41899DentalsurgeryprocedureC42299Palate/uvulasurgeryC42699SalivarysurgeryprocedureC42999ThroatsurgeryprocedureC43289Laparoscopeproc,esophC43496Freejejunumflap,microvascC43499EsophagussurgeryprocedureC43647Lapimplelectrode,antrumC43648Laprevise/remveltrdantrumC43659Laparoscopeproc,stomC43881Impl/redoelectrd,antrumC43882Revise/removeelectrdantrumC43999StomachsurgeryprocedureC44137RemoveintestinalallograftC44238Laparoscopeproc,intestineC44715PreparedonorintestineC44799UnlistedprocedureintestineC44899BowelsurgeryprocedureC44979Laparoscopeproc,appC45499Laparoscopeproc,rectumC45999RectumsurgeryprocedureC46999AnussurgeryprocedureC47143Prepdonorliver,wholeC47144Prepdonorliver,3-segmentC47145Prepdonorliver,lobesplitC47379Laparoscopeprocedure,liverC47399LiversurgeryprocedureC47579Laparoscopeproc,biliaryC47999BiletractsurgeryprocedureC48551PrepdonorpancreasC48999PancreassurgeryprocedureC49329Laparoproc,abdm/per/omentC49659Laparoproc,herniarepairC49906Freeomentalflap,microvascC49999AbdomensurgeryprocedureC50323PrepcadaverrenalallograftC50325PrepdonorrenalgraftC50549Laparoscopeproc,renalC50949Laparoscopeproc,ureterC51999Laparoscopeproc,blaC53899UrologysurgeryprocedureC54440RepairofpenisC54699Laparoscopeproc,testisC55559Laparoproc,spermaticcordC55899GenitalsurgeryprocedureC58578Laparoproc,uterusC58579HysteroscopeprocedureC58679Laparoproc,oviduct-ovaryC58974TransferofembryoC58999GenitalsurgeryprocedureC59897Fetalinvaspxw/usC59898Laparoproc,obcare/deliverC59899MaternitycareprocedureC60659Laparoproc,endocrineC60699EndocrinesurgeryprocedureC63043Laminotomy,addlcervicalC63044Laminotomy,addllumbarC64999NervoussystemsurgeryC66999EyesurgeryprocedureC67299EyesurgeryprocedureC67399EyemusclesurgeryprocedureC67599OrbitsurgeryprocedureC67999RevisionofeyelidC68399EyelidliningsurgeryC68899TearductsystemsurgeryC69399OuterearsurgeryprocedureC69799MiddleearsurgeryprocedureC69949InnerearsurgeryprocedureC69979TemporalbonesurgeryC70170TCX-rayexamoftearductC70170X-rayexamoftearductC70555TCFmribrainbyphys/psychC70555Fmribrainbyphys/psychC70557TCMribrainw/odyeC70557Mribrainw/odyeC70558TCMribrainw/dyeC70558Mribrainw/dyeC70559TCMribrainw/o&w/dyeC70559Mribrainw/o&w/dyeC71090TCX-ray&pacemakerinsertionC71090X-ray&pacemakerinsertionC72291TCPerqvertebroplasty,fluorC72291Perqvertebroplasty,fluorC72292TCPerqvertebroplasty,ctC72292Perqvertebroplasty,ctC73530TCX-rayexamofhipC73530X-rayexamofhipC74190TCX-rayexamofperitoneumC74190X-rayexamofperitoneumC74235TCRemoveesophagusobstructionC74235RemoveesophagusobstructionC74300TCX-raybileducts/pancreasC74300X-raybileducts/pancreasC74301TCX-raysatsurgeryadd-onC74301X-raysatsurgeryadd-onC74305TCX-raybileducts/pancreasC74305X-raybileducts/pancreasC74328TCX-raybileductendoscopyC74328X-raybileductendoscopyC74329TCX-rayforpancreasendoscopyC74329X-rayforpancreasendoscopyC74330TCX-raybile/pancendoscopyC74330X-raybile/pancendoscopyC74340TCX-rayguideforGItubeC74340X-rayguideforGItubeC74355TCX-rayguide,intestinaltubeC74355X-rayguide,intestinaltubeC74360TCX-rayguide,GIdilationC74360X-rayguide,GIdilationC74363TCX-ray,bileductdilationC74363X-ray,bileductdilationC74420TCContrstx-ray,urinarytractC74420Contrstx-ray,urinarytractC74425TCContrstx-ray,urinarytractC74425Contrstx-ray,urinarytractC74445TCX-rayexamofpenisC74445X-rayexamofpenisC74450TCX-ray,urethra/bladderC74450X-ray,urethra/bladderC74470TCX-rayexamofkidneylesionC74470X-rayexamofkidneylesionC74742TCX-ray,fallopiantubeC74742X-ray,fallopiantubeC74775TCX-rayexamofperineumC74775X-rayexamofperineumC75801TCLymphvesselx-ray,arm/legC75801Lymphvesselx-ray,arm/legC75803TCLymphvesselxray,arms/legsC75803Lymphvesselxray,arms/legsC75805TCLymphvesselx-ray,trunkC75805Lymphvesselx-ray,trunkC75807TCLymphvesselx-ray,trunkC75807Lymphvesselx-ray,trunkC75810TCVeinx-ray,spleen/liverC75810Veinx-ray,spleen/liverC75894TCX-rays,transcaththerapyC75894X-rays,transcaththerapyC75896TCX-rays,transcaththerapyC75896X-rays,transcaththerapyC75898TCFollow-upangiographyC75898Follow-upangiographyC75900TCIntravascularcathexchangeC75900IntravascularcathexchangeC75940TCX-rayplacement,veinfilterC75940X-rayplacement,veinfilterC75945TCIntravascularusC75945IntravascularusC75946TCIntravascularusadd-onC75946Intravascularusadd-onC75952TCEndovascrepairabdomaortaC75952EndovascrepairabdomaortaC75953TCAbdomaneurysmendovasrprC75953AbdomaneurysmendovasrprC75954TCIliacaneurysmendovasrprC75954IliacaneurysmendovasrprC75956TCXray,endovascthoraoreprC75956Xray,endovascthoraoreprC75957TCXray,endovascthoraoreprC75957Xray,endovascthoraoreprC75958TCXray,placeproxextthoraoC75958Xray,placeproxextthoraoC75959TCXray,placedistextthoraoC75959Xray,placedistextthoraoC75960TCTranscathivstentrs&iC75960Transcathivstentrs&iC75970TCVascularbiopsyC75970VascularbiopsyC75980TCContrastxrayexambileductC75980ContrastxrayexambileductC75982TCContrastxrayexambileductC75982ContrastxrayexambileductC75992TCAtherectomy,x-rayexamC75992Atherectomy,x-rayexamC75993TCAtherectomy,x-rayexamC75993Atherectomy,x-rayexamC75994TCAtherectomy,x-rayexamC75994Atherectomy,x-rayexamC75995TCAtherectomy,x-rayexamC75995Atherectomy,x-rayexamC75996TCAtherectomy,x-rayexamC75996Atherectomy,x-rayexamC76001TCFluoroscopeexam,extensiveC76001Fluoroscopeexam,extensiveC76125TCCine/videox-raysadd-onC76125Cine/videox-raysadd-onC76350Specialx-raycontraststudyC7649626FluoroscopicprocedureC76496TCFluoroscopicprocedureC76496FluoroscopicprocedureC7649726CtprocedureC76497TCCtprocedureC76497CtprocedureC7649826MriprocedureC76498TCMriprocedureC76498MriprocedureC7649926RadiographicprocedureC76499TCRadiographicprocedureC76499RadiographicprocedureC76932TCEchoguideforheartbiopsyC76932EchoguideforheartbiopsyC76940TCUsguide,tissueablationC76940Usguide,tissueablationC76941TCEchoguidefortransfusionC76941EchoguidefortransfusionC76945TCEchoguide,villussamplingC76945Echoguide,villussamplingC76975TCGIendoscopicultrasoundC76975GIendoscopicultrasoundC76998TCUsguide,intraopC76998Usguide,intraopC7699926EchoexaminationprocedureC76999TCEchoexaminationprocedureC76999EchoexaminationprocedureC77013TCCtguidefortissueablationC77013CtguidefortissueablationC77022TCMrifortissueablationC77022MrifortissueablationC7729926RadiationtherapyplanningC77299TCRadiationtherapyplanningC77299RadiationtherapyplanningC7739926ExternalradiationdosimetryC77399TCExternalradiationdosimetryC77399ExternalradiationdosimetryC7749926RadiationtherapymanagementC77499TCRadiationtherapyCmanagement77499RadiationtherapymanagementC77520Protontrmt,simplew/ocompC77522Protontrmt,simplew/compC77523Protontrmt,intermediateC77525Protontreatment,complexC7779926Radium/radioisotopetherapyC77799TCRadium/radioisotopetherapyC77799Radium/radioisotopetherapyC7809926EndocrinenuclearprocedureC78099TCEndocrinenuclearprocedureC78099EndocrinenuclearprocedureC7819926Blood/lymphnuclearexamC78199TCBlood/lymphnuclearexamC78199Blood/lymphnuclearexamC78282TCGIproteinlossexamC78282GIproteinlossexamC7829926GInuclearprocedureC78299TCGInuclearprocedureC78299GInuclearprocedureC7839926MusculoskeletalnuclearexamC78399TCMusculoskeletalnuclearexamC78399MusculoskeletalnuclearexamC78414TCNon-imagingheartfunctionC78414Non-imagingheartfunctionC78459TCHeartmuscleimaging(PET)C78459Heartmuscleimaging(PET)C78491TCHeartimage(pet),singleC78491Heartimage(pet),singleC78492TCHeartimage(pet),multipleC78492Heartimage(pet),multipleC7849926CardiovascularnuclearexamC78499TCCardiovascularnuclearexamC78499CardiovascularnuclearexamC7859926RespiratorynuclearexamC78599TCRespiratorynuclearexamC78599RespiratorynuclearexamC78608TCBrainimaging(PET)C78608Brainimaging(PET)C78609TCBrainimaging(PET)C78609Brainimaging(PET)C7869926NervoussystemnuclearexamC78699TCNervoussystemnuclearexamC78699NervoussystemnuclearCexam7879926GenitourinarynuclearexamC78799TCGenitourinarynuclearexamC78799GenitourinarynuclearexamC78811TCTumorimaging(pet),limitedC78811Tumorimaging(pet),limitedC78812TCTumorimage(pet)/skul-thighC78812Tumorimage(pet)/skul-thighC78813TCTumorimage(pet)fullbodyC78813Tumorimage(pet)fullbodyC78814TCTumorimagepet/ct,limitedC78814Tumorimagepet/ct,limitedC78815TCTumorimagepet/ctskul-thighC78815Tumorimagepet/ctskul-thighC78816TCTumorimagepet/ctfullbodyC78816Tumorimagepet/ctfullbodyC7899926NucleardiagnosticexamC78999TCNucleardiagnosticexamC78999NucleardiagnosticexamC79300TCNuclrrx,interstitcolloidC79300Nuclrrx,interstitcolloidC79445TCNuclearrx,intra-arterialC79445Nuclearrx,intra-arterialC7999926NuclearmedicinetherapyC79999TCNuclearmedicinetherapyC79999NuclearmedicinetherapyC86485Skintest,candidaC8819926CytopathologyprocedureC88199TCCytopathologyprocedureC88199CytopathologyprocedureC88299CytogeneticstudyC8838026MicrodissectionC88380TCMicrodissectionC88380MicrodissectionC8838426Evalmolecularprobes,11-50C88384TCEvalmolecularprobes,11-50C88384Evalmolecularprobes,11-50C8839926SurgicalpathologyprocedureC88399TCSurgicalpathologyprocedureC88399SurgicalpathologyprocedureC89240PathologylabprocedureC90779Ther/prop/diaginj/infprocC90899Psychiatricservice/therapyC90999DialysisprocedureC91132TCElectrogastrographyC91132ElectrogastrographyC91133TCElectrogastrographyw/testC91133Electrogastrographyw/testC9129926GastroenterologyprocedureC91299TCGastroenterologyprocedureC91299GastroenterologyprocedureC9249926EyeserviceorprocedureC92499TCEyeserviceorprocedureC92499EyeserviceorprocedureC92700Entprocedure/serviceC92978TCIntravascus,heartadd-onC92978Intravascus,heartadd-onC92979TCIntravascus,heartadd-onC92979Intravascus,heartadd-onC92992RevisionofheartchamberC92993RevisionofheartchamberC93235ECGmonitor/report,24hrsC93236ECGmonitor/report,24hrsC93315TCEchotransesophagealC93315EchotransesophagealC93317TCEchotransesophagealC93317EchotransesophagealC93318TCEchotransesophagealintraopC93318EchotransesophagealintraopC93501TCRightheartcatheterizationC93501RightheartcatheterizationC93505TCBiopsyofheartliningC93505BiopsyofheartliningC93508TCCathplacement,angiographyC93508Cathplacement,angiographyC93510TCLeftheartcatheterizationC93510LeftheartcatheterizationC93511TCLeftheartcatheterizationC93511LeftheartcatheterizationC93514TCLeftheartcatheterizationC93514LeftheartcatheterizationC93524TCLeftheartcatheterizationC93524LeftheartcatheterizationC93526TCRt&LtheartcathetersC93526Rt&LtheartcathetersC93527TCRt&LtheartcathetersC93527Rt&LtheartcathetersC93528TCRt&LtheartcathetersC93528Rt&LtheartcathetersC93529TCRt,ltheartcatheterizationC93529Rt,ltheartcatheterizationC93530TCRtheartcath,congenitalC93530Rtheartcath,congenitalC93531TCR&lheartcath,congenitalC93531R&lheartcath,congenitalC93532TCR&lheartcath,congenitalC93532R&lheartcath,congenitalC93533TCR&lheartcath,congenitalC93533R&lheartcath,congenitalC93555TCImaging,cardiaccathC93555Imaging,cardiaccathC93556TCImaging,cardiaccathC93556Imaging,cardiaccathC93561TCCardiacoutputmeasurementC93561CardiacoutputmeasurementC93562TCCardiacoutputmeasurementC93562CardiacoutputmeasurementC93571TCHeartflowreservemeasureC93571HeartflowreservemeasureC93572TCHeartflowreservemeasureC93572HeartflowreservemeasureC93600TCBundleofHisrecordingC93600BundleofHisrecordingC93602TCIntra-atrialrecordingC93602Intra-atrialrecordingC93603TCRightventricularrecordingC93603RightventricularrecordingC93609TCMaptachycardia,add-onC93609Maptachycardia,add-onC93610TCIntra-atrialpacingC93610Intra-atrialpacingC93612TCIntraventricularpacingC93612IntraventricularpacingC93615TCEsophagealrecordingC93615EsophagealrecordingC93616TCEsophagealrecordingC93616EsophagealrecordingC93618TCHeartrhythmpacingC93618HeartrhythmpacingC93619TCElectrophysiologyevaluationC93619ElectrophysiologyevaluationC93620TCElectrophysiologyevaluationC93620ElectrophysiologyevaluationC93621TCElectrophysiologyevaluationC93621ElectrophysiologyevaluationC93622TCElectrophysiologyevaluationC93622ElectrophysiologyevaluationC93623TCStimulation,pacingheartC93623Stimulation,pacingheartC93624TCElectrophysiologicstudyC93624ElectrophysiologicstudyC93631TCHeartpacing,mappingC93631Heartpacing,mappingC93640TCEvaluationheartdeviceC93640EvaluationheartdeviceC93641TCElectrophysiologyevaluationC93641ElectrophysiologyevaluationC93662TCIntracardiacecg(ice)C93662Intracardiacecg(ice)C9374526Set-upcardiovert-defibrillC93745TCSet-upcardiovert-defibrillC93745Set-upcardiovert-defibrillC9379926CardiovascularprocedureC93799TCCardiovascularprocedureC93799CardiovascularprocedureC94642AerosolinhalationtreatmentC9477226Breathrecording,infantC94772TCBreathrecording,infantC94772Breathrecording,infantC94774Pedhomeapnearec,complC94775Pedhomeapnearec,hk-upC94776Pedhomeapnearec,downldC94777Pedhomeapnearec,reportC9479926Pulmonaryservice/procedureC94799TCPulmonaryservice/procedureC94799Pulmonaryservice/procedureC95199AllergyimmunologyservicesC95824TCEeg,cerebraldeathonlyC95824Eeg,cerebraldeathonlyC95951TCEEGmonitoring/videorecordC95951EEGmonitoring/videorecordC95965TCMeg,spontaneousC95965Meg,spontaneousC95966TCMeg,evoked,singleC95966Meg,evoked,singleC95967TCMeg,evoked,eachaddlC95967Meg,evoked,eachaddlC95999NeurologicalprocedureC96020TCFunctionalbrainmappingC96020FunctionalbrainmappingC96549Chemotherapy,unspecifiedC96999DermatologicalprocedureC97039PhysicaltherapytreatmentC97139PhysicalmedicineprocedureC97799PhysicalmedicineprocedureC99082UnusualphysiciantravelC99143Modcsbysamephys,<5yrsC99144Modcsbysamephys,5yrs+C99145Modcsbysamephysadd-onC99148Modcsdiffphys<5yrsC99149Modcsdiffphys5yrs+C99150Modcsdiffphysadd-onC99199Specialservice/proc/reportC99499Unlistede&mserviceCG0186Dstryeyelesn,fdrvssltechCG0339Robotlin-radsurgcom,firstCG0340Robtlin-radsurgfractx2-5CQ3001BrachytherapyRadioelementsCR0070Transportportablex-rayCR0075Transportportx-raymultiplC
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Thischangerequestamendsthosepaymentfilesandincludesnew/revisedcodesforthePhysicianQualityReportingInitiative.
B.
Policy:Section1848(c)(4)oftheSocialSecurityActauthorizestheSecretarytoestablishancillarypoliciesnecessarytoimplementrelativevaluesforphysicians'services.
II.
BUSINESSREQUIREMENTSTABLEUse"Shall"todenoteamandatoryrequirementNumberRequirementResponsibility(placean"X"ineachapplicablecolumn)A/DMFICADMRHShared-SystemMaintainersOTHERBMACEMACRRIERERCHIFISSMCSVMSCWF5614.
1EffectivefordatesofserviceonorafterJanuary1,2007,contractorsshallmanuallyupdatetheirsystemstoreflect11baseunitsforCPTcode00797.
XXX5614.
2ContractorsshallmanuallyupdatetheirHCPCSfiletoreflectacoverageindicatorof"C"fornewCategoryIIcodesincludedinthistransmittal.
XX5614.
3EffectivefordatesofserviceonorafterJuly1,2007,thefollowingCategoryIImodifierwillberecognizedinadditiontoCategoryIImodifiers1P,2Pand3P.
(NOTE:Thesearestatisticalmodifiers):8P–Performancemeasurereportingmodifier–actionnotperformed,reasonnototherwisespecified(NOTE:Modifier8Pisintendedtobeusedasa"reportingmodifier"toallowtheXXCMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page1NumberRequirementResponsibility(placean"X"ineachapplicablecolumn)A/DMFICADMRHShared-SystemMaintainersOTHERBMACEMACRRIERERCHIFISSMCSVMSCWFreportingofcircumstanceswhenanactiondescribedinameasure'snumeratorisnotperformedandthereasonisnototherwisespecified.
)5614.
3.
1CarriersshallmanuallyupdatetheirsystemstoreflectthisnewCategoryIImodifier(8P).
XX5614.
4CarriersshalleithermanuallyupdatethePerformancePaymentIndicatorforthecodeslistedinAttachment3orloadtheseparatefileandmanuallyre-loadanycarrierpricedfeestheymayhaveestablished.
XX5614.
5Contractorsshall,inaccordancewithPub100-4,Chapter23,Section30.
1,giveproviders30daysnoticebeforeimplementingthechangesidentifiedinAttachment1.
Unlessotherwisestatedinthistransmittal,changeswillberetroactivetoJanuary1,2007.
XXX5614.
6Contractorsneednotsearchtheirfilestoeitherretractpaymentforclaimsalreadypaidortoretroactivelypayclaims.
However,contractorsshalladjustclaimsbroughttotheirattention.
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7Contractorsshallretrievetherevisedpaymentfiles,asidentifiedinAttachment2,fromtheCMSMainframeTelecommunicationsSystem.
FileswillbeavailableforretrievalonMay24,2007.
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8CMSwillsendCWFtwofilestofacilitateduplicatebillingedits:1)PurchasedDiagnosticand2)DuplicateRadiologyEditing.
CWFshallinstallthesefilesintotheirsystems.
CWFwillbenotifiedviaemailwhenthesefileshavebeensenttothem.
X5614.
9Notificationofsuccessfulreceiptshallbesentviae-mailtoprice_file_receipt@cms.
hhs.
govstatingthenameofthefilereceivedandtheentityforwhichitwasreceived(e.
g.
,carrier/fiscalintermediarynameandnumber).
XXXIII.
PROVIDEREDUCATIONTABLENumberRequirementResponsibility(placean"X"ineachapplicablecolumn)CMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page2A/BDMEFICARDMERHHShared-SystemMaintainersOTHERFMVCRRIICMWMMICSSSFACACERS5614.
10Aprovidereducationarticlerelatedtothisinstructionwillbeavailableathttp://www.
cms.
hhs.
gov/MLNMattersArticles/shortlyaftertheCRisreleased.
Youwillreceivenotificationofthearticlereleaseviatheestablished"MLNMatters"listserv.
Contractorsshallpostthisarticle,oradirectlinktothisarticle,ontheirWebsiteandincludeinformationaboutitinalistservmessagewithinoneweekoftheavailabilityoftheprovidereducationarticle.
Inaddition,theprovidereducationarticleshallbeincludedinyournextregularlyscheduledbulletin.
ContractorsarefreetosupplementMLNMattersarticleswithlocalizedinformationthatwouldbenefittheirprovidercommunityinbillingandadministeringtheMedicareprogramcorrectly.
XXXIV.
SUPPORTINGINFORMATIONA.
Foranyrecommendationsandsupportinginformationassociatedwithlistedrequirements,usetheboxbelow:Use"Should"todenotearecommendation.
X-RefRecommendationsorothersupportinginformation:RequirementNumberB.
Forallotherrecommendationsandsupportinginformation,usethisspace:V.
CONTACTSPre-ImplementationContact(s):GayshaBrooks,Gaysha.
Brooks@cms.
hhs.
gov,(410)786-9649Post-ImplementationContact(s):AppropriateRegionalOfficeVI.
FUNDINGA.
CMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page3NoadditionalfundingwillbeprovidedbyCMS;contractoractivitiesaretobecarriedoutwithintheirFY2007operatingbudgets.
B.
Thecontractorisherebyadvisedthatthisconstitutestechnicaldirectionasdefinedinyourcontract.
CMSdoesnotconstruethisasachangetotheStatementofWork(SOW).
ThecontractorisnotobligatedtoincurcostsinexcessoftheamountsallottedinyourcontractunlessanduntilspecificallyauthorizedbytheContractingOfficer.
Ifthecontractorconsidersanythingprovided,asdescribedabove,tobeoutsidethecurrentscopeofwork,thecontractorshallwithholdperformanceonthepart(s)inquestionandimmediatelynotifytheContractingOfficer,inwritingorbye-mail,andrequestformaldirectionsregardingcontinuedperformancerequirements.
CMS/CMM/MCMG/DCOMChangeRequestForm:Lastupdated22January2007Page4Attachment1ChangesincludedintheJulyUpdatetothe2007MedicarePhysicianFeeScheduleDatabaseareasfollows:ThefollowingcodesareincludedinFileA(changesretroactivetoJanuary1,2007):CPT/HCPCSACTION00797BaseUnits=110115TProcedureStatus=N0116TProcedureStatus=N0117TProcedureStatus=N19301ShortDescriptor=Partialmastectomy33208WorkRVUs=8.
7275635-TCDiagnosticIndicator=0277422TransitionalNon-FacilityPERVU=2.
61FullyImplementedNon-FacilityPERVU=5.
31(InformationalOnly)TransitionalFacilityPERVU=2.
61FullyImplementedFacilityPERVU=5.
31(InformationalOnly)77423TransitionalNon-FacilityPERVU=3.
57FullyImplementedNon-FacilityPERVU=7.
51(InformationalOnly)TransitionalFacilityPERVU=3.
57FullyImplementedFacilityPERVU=7.
51(InformationalOnly)G9041TransitionalNon-FacilityPERVU=0.
29FullyImplementedNon-FacilityPERVU=0.
29(InformationalOnly)TransitionalFacilityPERVU=0.
29FullyImplementedFacilityPERVU=0.
29(InformationalOnly)G9042TransitionalNon-FacilityPERVU=0.
29FullyImplementedNon-FacilityPERVU=0.
29(InformationalOnly)TransitionalFacilityPERVU=0.
29FullyImplementedFacilityPERVU=0.
29(InformationalOnly)G9043TransitionalNon-FacilityPERVU=0.
29FullyImplementedNon-FacilityPERVU=0.
29(InformationalOnly)TransitionalFacilityPERVU=0.
29FullyImplementedFacilityPERVU=0.
29(InformationalOnly)G9044TransitionalNon-FacilityPERVU=0.
23FullyImplementedNon-FacilityPERVU=0.
23(InformationalOnly)TransitionalFacilityPERVU=0.
23FullyImplementedFacilityPERVU=0.
23(InformationalOnly)ThefollowingcodesareincludedinFileB(changeseffectivefordatesofserviceonorafterJuly1,2007):0024TProcedureStatus=IEffectivefordatesofserviceonorafterJuly1,20070133TProcedureStatus=IEffectivefordatesofserviceonorafterJuly1,2007EffectivefordatesofserviceonorafterJuly1,2007,thefollowingCategoryIImodifierwillberecognizedinadditiontoCategoryIImodifiers1P,2Pand3P.
(NOTE:Thesearestatisticalmodifiers):8P–Performancemeasurereportingmodifier–actionnotperformed,reasonnototherwisespecified(NOTE:Modifier8Pisintendedtobeusedasa"reportingmodifier"toallowthereportingofcircumstanceswhenanactiondescribedinameasure'snumeratorisnotperformedandthereasonisnototherwisespecified.
)EffectivefordatesofserviceonorafterJuly1,2007,thefollowingG-codeswillnolongerbeusedforthePQRIprogram.
ThestatusindicatorfortheseG-codeswillbechangedto"I"ontheMPFSDB.
G8158G8160G8161G8163G8191G8192G8194G8195G8197G8198G8199G8201G8202G8203G8205G8206G8207G8208G8210G8211G8212G8213G8215G8216G8218G8222G8224G8225G8227G8228G8229G8230G8232G8235G8236G8237G8239G8241G8242G8245G8247G8249G8250G8252G8253G8255G8256G8258G8259G8261G8262G8264G8265G8267G8269G8270G8272G8273G8275G8277G8278G8280G8281G8283G8284G8286G8287G8288G8290G8291G8292G8294G8295G8297G8300G8301G8309G8311G8312G8313G8315G8316G8317G8319G8320G8321G8323G8324G8325G8327G8328G8329G8331G8332G8333G8335G8336G8337G8339G8340G8342G8343G8344G8346G8347G8348G8349G8350G8351G8352G8353G8355G8356G8358G8359G8361G8363G8364G8366G8368NewCategoryIIcodesforthePhysicianQualityReportingInitiative(PQRI)EffectivefordatesofserviceonorafterJuly1,2007,thefollowingCategoryIIcodeswillbeaddedtotheMPFSDBwithastatusindicatorof"M".
Thepaymentindicatorsareidenticalforallservices.
Thus,thepaymentindicatorswillonlybelistedforthefirstservice(CategoryIIcode0509F).
CPTcode:LongDescriptor:ShortDescriptor:ProcedureStatus:WRVU:Non-FacilityPERVU:FacilityPERVU:MalpracticeRVU:PC/TC:SiteofService:GlobalSurgery:MultipleProcedureIndicator:BilateralSurgeryIndicator:AssistantatSurgeryIndicator:Co-SurgeryIndicator:TeamSurgeryIndicator:0509FUrinaryincontinenceplanofcaredocumented(GER)Urineinconplandoc'dM0.
000.
000.
000.
0099XXX99999PhysicianSupervisionDiagnosticIndicator:9TypeofService:1DiagnosticFamilyImagingIndicator:99EffectiveforservicesperformedonorafterJuly1,2007CodeLongDescriptorShortDescriptor1060FDocumentationofpermanentORpersistentORparoxysmalatrialfibrillationDocperm/cont/paroxatr.
fib1061FDocumentationofabsenceofpermanentANDpersistentANDparoxysmalatrialfibrillationDoclackperm+cont+paroxfib1065FIschemicstrokesymptomonsetoflessthan3hourspriortoarrivalIschmstrokesymplt3hrsb/41066FIschemicstrokesymptomonsetgreaterthanorequalto3hourspriortoarrivalIschmstrokesympge3hrsb/41070FAlarmsymptoms(involuntaryweightloss,dysphagia,orgastrointestinalbleeding)assessed;nonepresentAlarmsympassessed-absent1071FAlarmsymptoms(involuntaryweightloss,dysphagia,orgastrointestinalbleeding)assessed;oneormorepresentAlarmsympassessed-1+prsnt1080FSurrogatedecisionmakeroradvancecareplandocumentedinthemedicalrecordDecismkr/advncdplandoc'd1090FPresenceorabsenceofurinaryincontinenceassessedPres/absnurineinconassess1091FUrinaryincontinencecharacterized(egfrequency,volume,timing,typeofsymptoms,howbothersome)Urineinconcharacterized1100FPatientscreenedforfuturefallrisk;documentationoftwoormorefallsinthepastyearoranyfallwithinjuryinthepastyear(GER)Ptfallsassess-doc'dge2+/yr1101FPatientscreenedforfuturefallrisk;documentationofnofallsinthepastyearoronlyonefallwithoutinjuryinthepastyearPtfallsassess-doc'dle1/yr1110FPatientdischargedfromaninpatientfacility(eghospital,skillednursingfacility,orrehabilitationfacility)withinthelast60daysPtlftinptfacw/in60days1111FDischargemedicationsreconciledwiththecurrentmedicationlistinoutpatientmedicalrecordDschrgmed/currentmedmerge3100FCarotidimagingstudyreportincludesdirectorindirectreferencetomeasurementsofdistalinternalcarotiddiameterasthedenominatorforstenosismeasurementImagetestrefcarotdiam3110FPresenceorabsenceofhemorrhageandmasslesionandacuteinfarctiondocumentedinfinalCTorMRIreportPres/absnhmrhg/lesiondoc'd3111FCTorMRIofthebrainperformedwithin24hoursofarrivaltothehospitalCT/MRIbraindonew/in24hrs3112FCTorMRIofthebrainperformedgreaterthan24hoursafterarrivaltothehospitalCT/MRIbraindoneGT24hrs3120F12-LeadECGPerformed12-LeadECGperformed3130FUppergastrointestinalendoscopyperformedUpperGIendoscopyperformed3132FDocumentationofreferralforuppergastrointestinalDocref.
upperGIendoscopyendoscopy3140FUppergastrointestinalendoscopyreportindicatessuspicionofBarrett'sesophagusUpperGIendoshowsbarrtt's3141FUppergastrointestinalendoscopyreportindicatesnosuspicionofBarrett'sesophagusUpperGIendonotbarrtt's3142FBariumswallowtestorderedBariumswallowtestordered3150FForcepsesophagealbiopsyperformedForcepsesophbiopsydone3155FCytogenetictestingperformedonbonemarrowattimeofdiagnosisorpriortoinitiatingtreatmentCytogentestmarrowb/4tx3160FDocumentationofironstorespriortoinitiatingerythropoietintherapyDocfe+storesb/4epothx3170FFlowcytometrystudiesperformedattimeofdiagnosisorpriortoinitiatingtreatmentFlowcytodoneb/4tx3200FBariumswallowtestnotorderedBariumswallowtestnotreq3210FGroupAStrepTestPerformedGrpAstreptestperformed4041FDocumentationoforderforcefazolinORcefuroximeforantimicrobialprophylaxisDocordercefazolin/cefurox.
4042FDocumentationthatprophylacticantibioticswereneithergivenwithin4hourspriortosurgicalincisionnorgivenintraoperativelyDocantibionotgiven4043FDocumentationthatanorderwasgiventodiscontinueprophylacticantibioticswithin48hoursofsurgicalendtime,cardiacproceduresDocordergivenstopantibio4044FDocumentationthatanorderwasgivenforvenousthromboembolism(VTE)prophylaxistobegivenwithin24hrspriortoincisiontimeor24hoursaftersurgeryendtimeDocordergivenVTEprophylx4046FDocumentationthatprophylacticantibioticsweregivenwithin4hourspriortosurgicalincisionorgivenintraoperativelyDocantibiogivenb/4surg4047FDocumentationoforderforprophylacticantibioticstobegivenwithinonehour(iffluoroquinoloneorvancomycin,twohours)priortosurgicalincision(orstartofprocedurewhennoincisionisrequired)Docantibiogivenb/4surg4048FDocumentationthatprophylacticantibioticwasgivenwithinonehour(iffluoroquinoloneorvancomycin,twohours)priortosurgicalincision(orstartofprocedurewhennoincisionisrequired)Docantibiogivenb/4surg4049FDocumentationthatorderwasgiventodiscontinueprophylacticantibioticswithin24hoursofsurgicalendtime,non-cardiacprocedureDocordergivenstopantibio4070FDeepVeinThrombosis(DVT)prophylaxisreceivedbyendofhospitalday2DVTprophylxrecv'dday24073FOralantiplatelettherapyprescribedatdischargeOralantiplatthxrxdischrg4075FAnticoagulanttherapyprescribedatdischargeAnticoagthxrxatdischrg4077FDocumentationthattissueplasminogenactivator(t-PA)administrationwasconsideredDoct-paadminconsidered4079FDocumentationthatrehabilitationserviceswereconsideredDocrehabsvcsconsidered4084FAspirinreceivedwithin24hoursbeforeemergencydepartmentarrivalorduringemergencydepartmentstayAspirinrecv'dw/in24hrs4090FPatientreceivingerythropoietintherapyPtrcvngepothxpy4095FPatientnotreceivingerythropoietintherapyPtnotrcvngepothxpy4100FBisphosphonatetherapy,intravenous,orderedorreceivedBiphosthxpyveinord/rec'vd4110FInternalmammaryarterygraftperformedforprimary,isolatedcoronaryarterybypassgraftprocedureInt.
mamartusedforcabg4115FBetablockeradministeredwithin24hourspriortosurgicalincisionBetablckradminw/in24hrs4120FAntibioticprescribedordispensedAntibiotrx'd/given4124FAntibioticneitherprescribednordispensedAntibiotnotrx'd/given6010FDysphagiascreeningconductedpriortoorderfororreceiptofanyfoods,fluidsormedicationbymouthDysphagtestdoneb/4eating6015FPatientreceivingoreligibletoreceivefoods,fluidsormedicationbymouthPtrecvng/OKforeating/swal6020FNPO(nothingbymouth)orderedNPO(nothing-mouth)orderedNewG-CodesforPQRIEffectivefordatesofserviceonorafterJuly1,2007,thefollowingG-codes(G8370throughG8389)willbeaddedtotheMPFSDBwithastatusindicatorof"M".
Thepaymentindicatorsareidenticalforallservicesinthiscoderange.
Thus,thepaymentindicatorswillonlybelistedforthefirstservice(HCPCScodeG8370)inthisrange.
HCPCSCode:G8370LongDescriptor:AsthmapatientswithnumericfrequencyofsymptomsorpatientcompletionofanShortDescriptor:ProcedureStatus:WRVU:Non-FacilityPERVU:FacilityPERVU:MalpracticeRVU:PC/TC:SiteofService:GlobalSurgery:MultipleProcedureIndicator:BilateralSurgeryIndicator:asthmaassessmenttool/survey/questionnairenotdocumentedAMIptrecdaspirinatarrivM0.
000.
000.
000.
0099XXX99AssistantatSurgeryIndicator:9Co-SurgeryIndicator:9TeamSurgeryIndicator:9PhysicianSupervisionDiagnosticIndicator:9TypeofService:1DiagnosticFamilyImagingIndicator:99CodeLongDescriptorShortDescriptorG8371ChemotherapydocumentedasnotreceivedorprescribedforStageIIIcoloncancerpatientsChemothernotrecstg3colonG8372ChemotherapydocumentedasreceivedorprescribedforStageIIIcoloncancerpatientsChemotherrecstg3coloncaG8373ChemotherapyplandocumentedpriortochemotherapyadministrationChemoplandocumpriorchemoG8374ChemotherapyplannotdocumentedpriortochemotherapyadministrationChemoplannotdocpriorcheG8375Chroniclymphocyticleukemia(CLL)patientwithnodocumentationofbaselineflowcytometryperformedCLLptw/odocflowcytometrG8376CliniciandocumentationthatbreastcancerpatientwasnoteligiblefortamoxifenoraromatoseinhibitortherapymeasureBrstcaptineligtamoxifenG8377CliniciandocumentationthatcoloncancerpatientisnoteligibleforchemotherapymeasureMDdoccoloncaptineligchG8378CliniciandocumentationthatpatientwasnotaneligiblecandidateforradiationtherapymeasureMDdocptineligradtherapyG8379Documentationofradiationtherapyrecommendedwithin12monthsoffirstofficevisitRadiattxrecomdoc12moovG8380ForpatientswithERorPRpositive,StageIC-IIIbreastcancer,cliniciandidnotdocumentthatthepatientreceivedorwasprescribedtamoxifenoraromataseinhibitorPtwstgIC-3Brstcaw/otamG8381ForpatientswithERorPRpositive,StageIC-IIIbreastcancer,cliniciandocumentedorprescribedPtwstgIC-3BrstcarectamthatthepatientisreceivingtamoxifenoraromataseinhibitorG8382MultipleMyelomapatientswithnodocumentationofprescribedorreceivedintravenousbisphosphonatetherapyMMptw/odocIVbisphophonG8383Nodocumentationofradiationtherapyrecommendedwithin12monthsoffirstofficevisitRadiationrecnotdoc12mooG8384BaselinecytogenetictestingnotperformedinpatientswithMyelodysplasticSyndrome(MDS)orAcuteLeukemiasMDSptw/obasecytogentestG8385DiabeticpatientswithnodocumentationofHemoglobinA1clevel(withinthelast12months)DiabptwnodocHgbA1c12mG8386Diabeticpatientswithnodocumentationoflow-densitylipoprotein(withinthelast12months)DiabptwnodocLDL12mG8387End-stagerenaldiseasepatientwithahematocritORhemoglobinnotdocumentedESRDptwHct/HgbnotdocumeG8388End-stagerenaldiseasepatientwithURRORKt/Vvaluenotdocumented,butotherwiseeligibleformeasureESRDptwURR/KtvnotdocelG8389MyelodysplasticSyndrome(MDS)patientswithnodocumentationofironstorespriortoreceivingerythropoietintherapyMDSptnodocFepriorEPOG8390Diabeticpatientswithnodocumentationofbloodpressuremeasurement(withinthelast12months)Diabeticw/odocumentBP12mG8391Patientswithpersistentasthma,nodocumentationofpreferredlongtermcontrolmedicationoracceptablealternativetreatmentprescribedPtwasthmanodocmedortxCodeswithreviseddescriptorsThelongand/orshortdescriptorsforthefollowingPQRIcodeshavebeenrevised.
CodeLongDescriptorChangeShortDescriptorChange2001FN/AWeightrecorded2010FVitalsigns(temperature,pulse,respiratoryrate,andbloodpressure)documentedandreviewedN/A2014FMentalstatusassessedN/A3028FOxygensaturationresultsdocumentedandreviewed(includesassessmentthroughpulseoximetryorarterialbloodgasmeasurement)N/A3044FN/AHGa1clevellt7.
0%3073FPre-surgical(cataract)axiallength,cornealpowermeasurementandmethodofintraocularlenspowercalculationdocumented(mustbeperformedwithinsixmonthspriortosurgery)3074FN/ASystbplt130mmhg3075FN/ASystbpge130–139mmhg3082FKt/V1levC0064TSpectroscopevalexpiredgasC0065TOcularphotoscreenbilatC0067T26Ctcolonography;dxC0067TTCCtcolonography;dxC0067TCtcolonography;dxC0068TInterp/reptheartsoundC0069TAnalysisonlyheartsoundC0070TInterponlyheartsoundC0071TU/sleiomyomataablate200C0075T26Perqstent/chestvertartC0075TTCPerqstent/chestvertartC0075TPerqstent/chestvertartC0076T26S&istent/chestvertartC0076TTCS&istent/chestvertartC0076TS&istent/chestvertartC0077TCerebthermperfusionprobeC0078TEndovascaortreprw/deviceC0079TEndovascviscextnsnreprC0080TEndovascaortreprrads&iC0081TEndovascviscextnsns&iC0084TTempprostateurethralstentC0085TBreathtestheartrejectC0086TLventriclefillpressureC0087TSpermevalhyaluronanC0088TRftonguebasevolreduxnC0089TActigraphytesting,3-dayC0090TCervicalartificdiscC0092TArtificdiscaddlC0093TCervicalartificdiskectomyC0095TArtificdiskectomyaddlC0096TRevcervicalartificdiscC0098TRevartificdiscaddlC0099TImplantcornealringC0100TProsthretinareceive&genC0101TExtracorpshockwvtx,hienrgC0102TExtracorpshockwvtx,anesthC0103THolotranscobalaminC0104TAtrestcardiogasrebreatheC0105TExerccardiogasrebreatheC0106TTouchquantsensorytestC0107TVibratequantsensorytestC0108TCoolquantsensorytestC0109THeatquantsensorytestC0110TNosquantsensorytestC0111TRbcmembranesfattyacidsC0123TScleralfistulizationC0124TConjunctivaldrugplacementC0126TChdriskimtstudyC0130TChroncaredruginvestigatnC0135TPerqcryoablaterenaltumorC0137TProstatesaturationsamplingC0140TExhaledbreathcondensatephC0144T26CTheartwodye;qualcalcC0144TTCCTheartwodye;qualcalcC0144TCTheartwodye;qualcalcC0145T26CTheartw/wodyefunctC0145TTCCTheartw/wodyefunctC0145TCTheartw/wodyefunctC0146T26CCTAw/wodyeC0146TTCCCTAw/wodyeC0146TCCTAw/wodyeC0147T26CCTAw/wo,quancalciumC0147TTCCCTAw/wo,quancalciumC0147TCCTAw/wo,quancalciumC0148T26CCTAw/wo,strxrC0148TTCCCTAw/wo,strxrC0148TCCTAw/wo,strxrC0149T26CCTAw/wo,strxrquancalcC0149TTCCCTAw/wo,strxrquancalcC0149TCCTAw/wo,strxrquancalcC0150T26CCTAw/wo,diseasestrxrC0150TTCCCTAw/wo,diseasestrxrC0150TCCTAw/wo,diseasestrxrC0151T26CTheartfunctadd-onC0151TTCCTheartfunctadd-onC0151TCTheartfunctadd-onC0153TTcathsensoraneurysmsacC0154TStudysensoraneurysmsacC0155TLapimplgastcurveelectrdC0156TLapremvgastcurveelectrdC0157TOpenimplgastcurveelectrdC0158TOpenremvgastcurveelectrdC0159T26CadbreastmriC0159TTCCadbreastmriC0159TCadbreastmriC0160TTcranialmagnstimtxplanC0161TTcranialmagnstimtxdelivC0162TAnalprogramgastneurostimC0163TLumbartifdiskectomyaddlC0164TRemovelumbartifdiscaddlC0165TReviselumbartifdiscaddlC0166TTcathvsdclosew/obypassC0167TTcathvsdclosewbypassC0168TRhinophototxlightappbilatC0169TPlacestereocathbrainC0170TAnorectalfistulaplugrprC0171TLumbarspineprocesdistractC0172TLumbarspineprocesaddlC0173TIopmonitiopressureC0174TCadcxrwithinterpC0175TCadcxrremoteC0176TAqucanaldilatw/oretentC0177TAqucanaldilatwretentC15431ApplyacellularxgraftaddC15847Excskinabdadd-onC15999RemovalofpressuresoreC17999SkintissueprocedureC19499BreastsurgeryprocedureC20999MusculoskeletalsurgeryC21088Prepareface/oralprosthesisC21089Prepareface/oralprosthesisC21299Cranio/maxillofacialsurgeryC21499HeadsurgeryprocedureC21742Repairstern/nussw/oscopeC21743Repairsternum/nussw/scopeC21899Neck/chestsurgeryprocedureC22899SpinesurgeryprocedureC22999AbdomensurgeryprocedureC23929ShouldersurgeryprocedureC24940RevisionofupperarmC24999Upperarm/elbowsurgeryC25999ForearmorwristsurgeryC26989Hand/fingersurgeryC27299Pelvis/hipjointsurgeryC27599LegsurgeryprocedureC27899Leg/anklesurgeryprocedureC28899Foot/toessurgeryprocedureC29799Casting/strappingprocedureC29999ArthroscopyofjointC30999NasalsurgeryprocedureC31299SinussurgeryprocedureC31599LarynxsurgeryprocedureC31899AirwayssurgicalprocedureC32855Preparedonorlung,singleC32856Preparedonorlung,doubleC32999ChestsurgeryprocedureC33933Preparedonorheart/lungC33944PreparedonorheartC33999CardiacsurgeryprocedureC36299VesselinjectionprocedureC37195Thrombolytictherapy,strokeC37501VascularendoscopyprocedureC37799VascularsurgeryprocedureC38129Laparoscopeproc,spleenC38589Laparoscopeproc,lymphaticC38999Blood/lymphsystemprocedureC39499ChestprocedureC39599DiaphragmsurgeryprocedureC40799LipsurgeryprocedureC40899MouthsurgeryprocedureC41599TongueandmouthsurgeryC41899DentalsurgeryprocedureC42299Palate/uvulasurgeryC42699SalivarysurgeryprocedureC42999ThroatsurgeryprocedureC43289Laparoscopeproc,esophC43496Freejejunumflap,microvascC43499EsophagussurgeryprocedureC43647Lapimplelectrode,antrumC43648Laprevise/remveltrdantrumC43659Laparoscopeproc,stomC43881Impl/redoelectrd,antrumC43882Revise/removeelectrdantrumC43999StomachsurgeryprocedureC44137RemoveintestinalallograftC44238Laparoscopeproc,intestineC44715PreparedonorintestineC44799UnlistedprocedureintestineC44899BowelsurgeryprocedureC44979Laparoscopeproc,appC45499Laparoscopeproc,rectumC45999RectumsurgeryprocedureC46999AnussurgeryprocedureC47143Prepdonorliver,wholeC47144Prepdonorliver,3-segmentC47145Prepdonorliver,lobesplitC47379Laparoscopeprocedure,liverC47399LiversurgeryprocedureC47579Laparoscopeproc,biliaryC47999BiletractsurgeryprocedureC48551PrepdonorpancreasC48999PancreassurgeryprocedureC49329Laparoproc,abdm/per/omentC49659Laparoproc,herniarepairC49906Freeomentalflap,microvascC49999AbdomensurgeryprocedureC50323PrepcadaverrenalallograftC50325PrepdonorrenalgraftC50549Laparoscopeproc,renalC50949Laparoscopeproc,ureterC51999Laparoscopeproc,blaC53899UrologysurgeryprocedureC54440RepairofpenisC54699Laparoscopeproc,testisC55559Laparoproc,spermaticcordC55899GenitalsurgeryprocedureC58578Laparoproc,uterusC58579HysteroscopeprocedureC58679Laparoproc,oviduct-ovaryC58974TransferofembryoC58999GenitalsurgeryprocedureC59897Fetalinvaspxw/usC59898Laparoproc,obcare/deliverC59899MaternitycareprocedureC60659Laparoproc,endocrineC60699EndocrinesurgeryprocedureC63043Laminotomy,addlcervicalC63044Laminotomy,addllumbarC64999NervoussystemsurgeryC66999EyesurgeryprocedureC67299EyesurgeryprocedureC67399EyemusclesurgeryprocedureC67599OrbitsurgeryprocedureC67999RevisionofeyelidC68399EyelidliningsurgeryC68899TearductsystemsurgeryC69399OuterearsurgeryprocedureC69799MiddleearsurgeryprocedureC69949InnerearsurgeryprocedureC69979TemporalbonesurgeryC70170TCX-rayexamoftearductC70170X-rayexamoftearductC70555TCFmribrainbyphys/psychC70555Fmribrainbyphys/psychC70557TCMribrainw/odyeC70557Mribrainw/odyeC70558TCMribrainw/dyeC70558Mribrainw/dyeC70559TCMribrainw/o&w/dyeC70559Mribrainw/o&w/dyeC71090TCX-ray&pacemakerinsertionC71090X-ray&pacemakerinsertionC72291TCPerqvertebroplasty,fluorC72291Perqvertebroplasty,fluorC72292TCPerqvertebroplasty,ctC72292Perqvertebroplasty,ctC73530TCX-rayexamofhipC73530X-rayexamofhipC74190TCX-rayexamofperitoneumC74190X-rayexamofperitoneumC74235TCRemoveesophagusobstructionC74235RemoveesophagusobstructionC74300TCX-raybileducts/pancreasC74300X-raybileducts/pancreasC74301TCX-raysatsurgeryadd-onC74301X-raysatsurgeryadd-onC74305TCX-raybileducts/pancreasC74305X-raybileducts/pancreasC74328TCX-raybileductendoscopyC74328X-raybileductendoscopyC74329TCX-rayforpancreasendoscopyC74329X-rayforpancreasendoscopyC74330TCX-raybile/pancendoscopyC74330X-raybile/pancendoscopyC74340TCX-rayguideforGItubeC74340X-rayguideforGItubeC74355TCX-rayguide,intestinaltubeC74355X-rayguide,intestinaltubeC74360TCX-rayguide,GIdilationC74360X-rayguide,GIdilationC74363TCX-ray,bileductdilationC74363X-ray,bileductdilationC74420TCContrstx-ray,urinarytractC74420Contrstx-ray,urinarytractC74425TCContrstx-ray,urinarytractC74425Contrstx-ray,urinarytractC74445TCX-rayexamofpenisC74445X-rayexamofpenisC74450TCX-ray,urethra/bladderC74450X-ray,urethra/bladderC74470TCX-rayexamofkidneylesionC74470X-rayexamofkidneylesionC74742TCX-ray,fallopiantubeC74742X-ray,fallopiantubeC74775TCX-rayexamofperineumC74775X-rayexamofperineumC75801TCLymphvesselx-ray,arm/legC75801Lymphvesselx-ray,arm/legC75803TCLymphvesselxray,arms/legsC75803Lymphvesselxray,arms/legsC75805TCLymphvesselx-ray,trunkC75805Lymphvesselx-ray,trunkC75807TCLymphvesselx-ray,trunkC75807Lymphvesselx-ray,trunkC75810TCVeinx-ray,spleen/liverC75810Veinx-ray,spleen/liverC75894TCX-rays,transcaththerapyC75894X-rays,transcaththerapyC75896TCX-rays,transcaththerapyC75896X-rays,transcaththerapyC75898TCFollow-upangiographyC75898Follow-upangiographyC75900TCIntravascularcathexchangeC75900IntravascularcathexchangeC75940TCX-rayplacement,veinfilterC75940X-rayplacement,veinfilterC75945TCIntravascularusC75945IntravascularusC75946TCIntravascularusadd-onC75946Intravascularusadd-onC75952TCEndovascrepairabdomaortaC75952EndovascrepairabdomaortaC75953TCAbdomaneurysmendovasrprC75953AbdomaneurysmendovasrprC75954TCIliacaneurysmendovasrprC75954IliacaneurysmendovasrprC75956TCXray,endovascthoraoreprC75956Xray,endovascthoraoreprC75957TCXray,endovascthoraoreprC75957Xray,endovascthoraoreprC75958TCXray,placeproxextthoraoC75958Xray,placeproxextthoraoC75959TCXray,placedistextthoraoC75959Xray,placedistextthoraoC75960TCTranscathivstentrs&iC75960Transcathivstentrs&iC75970TCVascularbiopsyC75970VascularbiopsyC75980TCContrastxrayexambileductC75980ContrastxrayexambileductC75982TCContrastxrayexambileductC75982ContrastxrayexambileductC75992TCAtherectomy,x-rayexamC75992Atherectomy,x-rayexamC75993TCAtherectomy,x-rayexamC75993Atherectomy,x-rayexamC75994TCAtherectomy,x-rayexamC75994Atherectomy,x-rayexamC75995TCAtherectomy,x-rayexamC75995Atherectomy,x-rayexamC75996TCAtherectomy,x-rayexamC75996Atherectomy,x-rayexamC76001TCFluoroscopeexam,extensiveC76001Fluoroscopeexam,extensiveC76125TCCine/videox-raysadd-onC76125Cine/videox-raysadd-onC76350Specialx-raycontraststudyC7649626FluoroscopicprocedureC76496TCFluoroscopicprocedureC76496FluoroscopicprocedureC7649726CtprocedureC76497TCCtprocedureC76497CtprocedureC7649826MriprocedureC76498TCMriprocedureC76498MriprocedureC7649926RadiographicprocedureC76499TCRadiographicprocedureC76499RadiographicprocedureC76932TCEchoguideforheartbiopsyC76932EchoguideforheartbiopsyC76940TCUsguide,tissueablationC76940Usguide,tissueablationC76941TCEchoguidefortransfusionC76941EchoguidefortransfusionC76945TCEchoguide,villussamplingC76945Echoguide,villussamplingC76975TCGIendoscopicultrasoundC76975GIendoscopicultrasoundC76998TCUsguide,intraopC76998Usguide,intraopC7699926EchoexaminationprocedureC76999TCEchoexaminationprocedureC76999EchoexaminationprocedureC77013TCCtguidefortissueablationC77013CtguidefortissueablationC77022TCMrifortissueablationC77022MrifortissueablationC7729926RadiationtherapyplanningC77299TCRadiationtherapyplanningC77299RadiationtherapyplanningC7739926ExternalradiationdosimetryC77399TCExternalradiationdosimetryC77399ExternalradiationdosimetryC7749926RadiationtherapymanagementC77499TCRadiationtherapyCmanagement77499RadiationtherapymanagementC77520Protontrmt,simplew/ocompC77522Protontrmt,simplew/compC77523Protontrmt,intermediateC77525Protontreatment,complexC7779926Radium/radioisotopetherapyC77799TCRadium/radioisotopetherapyC77799Radium/radioisotopetherapyC7809926EndocrinenuclearprocedureC78099TCEndocrinenuclearprocedureC78099EndocrinenuclearprocedureC7819926Blood/lymphnuclearexamC78199TCBlood/lymphnuclearexamC78199Blood/lymphnuclearexamC78282TCGIproteinlossexamC78282GIproteinlossexamC7829926GInuclearprocedureC78299TCGInuclearprocedureC78299GInuclearprocedureC7839926MusculoskeletalnuclearexamC78399TCMusculoskeletalnuclearexamC78399MusculoskeletalnuclearexamC78414TCNon-imagingheartfunctionC78414Non-imagingheartfunctionC78459TCHeartmuscleimaging(PET)C78459Heartmuscleimaging(PET)C78491TCHeartimage(pet),singleC78491Heartimage(pet),singleC78492TCHeartimage(pet),multipleC78492Heartimage(pet),multipleC7849926CardiovascularnuclearexamC78499TCCardiovascularnuclearexamC78499CardiovascularnuclearexamC7859926RespiratorynuclearexamC78599TCRespiratorynuclearexamC78599RespiratorynuclearexamC78608TCBrainimaging(PET)C78608Brainimaging(PET)C78609TCBrainimaging(PET)C78609Brainimaging(PET)C7869926NervoussystemnuclearexamC78699TCNervoussystemnuclearexamC78699NervoussystemnuclearCexam7879926GenitourinarynuclearexamC78799TCGenitourinarynuclearexamC78799GenitourinarynuclearexamC78811TCTumorimaging(pet),limitedC78811Tumorimaging(pet),limitedC78812TCTumorimage(pet)/skul-thighC78812Tumorimage(pet)/skul-thighC78813TCTumorimage(pet)fullbodyC78813Tumorimage(pet)fullbodyC78814TCTumorimagepet/ct,limitedC78814Tumorimagepet/ct,limitedC78815TCTumorimagepet/ctskul-thighC78815Tumorimagepet/ctskul-thighC78816TCTumorimagepet/ctfullbodyC78816Tumorimagepet/ctfullbodyC7899926NucleardiagnosticexamC78999TCNucleardiagnosticexamC78999NucleardiagnosticexamC79300TCNuclrrx,interstitcolloidC79300Nuclrrx,interstitcolloidC79445TCNuclearrx,intra-arterialC79445Nuclearrx,intra-arterialC7999926NuclearmedicinetherapyC79999TCNuclearmedicinetherapyC79999NuclearmedicinetherapyC86485Skintest,candidaC8819926CytopathologyprocedureC88199TCCytopathologyprocedureC88199CytopathologyprocedureC88299CytogeneticstudyC8838026MicrodissectionC88380TCMicrodissectionC88380MicrodissectionC8838426Evalmolecularprobes,11-50C88384TCEvalmolecularprobes,11-50C88384Evalmolecularprobes,11-50C8839926SurgicalpathologyprocedureC88399TCSurgicalpathologyprocedureC88399SurgicalpathologyprocedureC89240PathologylabprocedureC90779Ther/prop/diaginj/infprocC90899Psychiatricservice/therapyC90999DialysisprocedureC91132TCElectrogastrographyC91132ElectrogastrographyC91133TCElectrogastrographyw/testC91133Electrogastrographyw/testC9129926GastroenterologyprocedureC91299TCGastroenterologyprocedureC91299GastroenterologyprocedureC9249926EyeserviceorprocedureC92499TCEyeserviceorprocedureC92499EyeserviceorprocedureC92700Entprocedure/serviceC92978TCIntravascus,heartadd-onC92978Intravascus,heartadd-onC92979TCIntravascus,heartadd-onC92979Intravascus,heartadd-onC92992RevisionofheartchamberC92993RevisionofheartchamberC93235ECGmonitor/report,24hrsC93236ECGmonitor/report,24hrsC93315TCEchotransesophagealC93315EchotransesophagealC93317TCEchotransesophagealC93317EchotransesophagealC93318TCEchotransesophagealintraopC93318EchotransesophagealintraopC93501TCRightheartcatheterizationC93501RightheartcatheterizationC93505TCBiopsyofheartliningC93505BiopsyofheartliningC93508TCCathplacement,angiographyC93508Cathplacement,angiographyC93510TCLeftheartcatheterizationC93510LeftheartcatheterizationC93511TCLeftheartcatheterizationC93511LeftheartcatheterizationC93514TCLeftheartcatheterizationC93514LeftheartcatheterizationC93524TCLeftheartcatheterizationC93524LeftheartcatheterizationC93526TCRt&LtheartcathetersC93526Rt&LtheartcathetersC93527TCRt&LtheartcathetersC93527Rt&LtheartcathetersC93528TCRt&LtheartcathetersC93528Rt&LtheartcathetersC93529TCRt,ltheartcatheterizationC93529Rt,ltheartcatheterizationC93530TCRtheartcath,congenitalC93530Rtheartcath,congenitalC93531TCR&lheartcath,congenitalC93531R&lheartcath,congenitalC93532TCR&lheartcath,congenitalC93532R&lheartcath,congenitalC93533TCR&lheartcath,congenitalC93533R&lheartcath,congenitalC93555TCImaging,cardiaccathC93555Imaging,cardiaccathC93556TCImaging,cardiaccathC93556Imaging,cardiaccathC93561TCCardiacoutputmeasurementC93561CardiacoutputmeasurementC93562TCCardiacoutputmeasurementC93562CardiacoutputmeasurementC93571TCHeartflowreservemeasureC93571HeartflowreservemeasureC93572TCHeartflowreservemeasureC93572HeartflowreservemeasureC93600TCBundleofHisrecordingC93600BundleofHisrecordingC93602TCIntra-atrialrecordingC93602Intra-atrialrecordingC93603TCRightventricularrecordingC93603RightventricularrecordingC93609TCMaptachycardia,add-onC93609Maptachycardia,add-onC93610TCIntra-atrialpacingC93610Intra-atrialpacingC93612TCIntraventricularpacingC93612IntraventricularpacingC93615TCEsophagealrecordingC93615EsophagealrecordingC93616TCEsophagealrecordingC93616EsophagealrecordingC93618TCHeartrhythmpacingC93618HeartrhythmpacingC93619TCElectrophysiologyevaluationC93619ElectrophysiologyevaluationC93620TCElectrophysiologyevaluationC93620ElectrophysiologyevaluationC93621TCElectrophysiologyevaluationC93621ElectrophysiologyevaluationC93622TCElectrophysiologyevaluationC93622ElectrophysiologyevaluationC93623TCStimulation,pacingheartC93623Stimulation,pacingheartC93624TCElectrophysiologicstudyC93624ElectrophysiologicstudyC93631TCHeartpacing,mappingC93631Heartpacing,mappingC93640TCEvaluationheartdeviceC93640EvaluationheartdeviceC93641TCElectrophysiologyevaluationC93641ElectrophysiologyevaluationC93662TCIntracardiacecg(ice)C93662Intracardiacecg(ice)C9374526Set-upcardiovert-defibrillC93745TCSet-upcardiovert-defibrillC93745Set-upcardiovert-defibrillC9379926CardiovascularprocedureC93799TCCardiovascularprocedureC93799CardiovascularprocedureC94642AerosolinhalationtreatmentC9477226Breathrecording,infantC94772TCBreathrecording,infantC94772Breathrecording,infantC94774Pedhomeapnearec,complC94775Pedhomeapnearec,hk-upC94776Pedhomeapnearec,downldC94777Pedhomeapnearec,reportC9479926Pulmonaryservice/procedureC94799TCPulmonaryservice/procedureC94799Pulmonaryservice/procedureC95199AllergyimmunologyservicesC95824TCEeg,cerebraldeathonlyC95824Eeg,cerebraldeathonlyC95951TCEEGmonitoring/videorecordC95951EEGmonitoring/videorecordC95965TCMeg,spontaneousC95965Meg,spontaneousC95966TCMeg,evoked,singleC95966Meg,evoked,singleC95967TCMeg,evoked,eachaddlC95967Meg,evoked,eachaddlC95999NeurologicalprocedureC96020TCFunctionalbrainmappingC96020FunctionalbrainmappingC96549Chemotherapy,unspecifiedC96999DermatologicalprocedureC97039PhysicaltherapytreatmentC97139PhysicalmedicineprocedureC97799PhysicalmedicineprocedureC99082UnusualphysiciantravelC99143Modcsbysamephys,<5yrsC99144Modcsbysamephys,5yrs+C99145Modcsbysamephysadd-onC99148Modcsdiffphys<5yrsC99149Modcsdiffphys5yrs+C99150Modcsdiffphysadd-onC99199Specialservice/proc/reportC99499Unlistede&mserviceCG0186Dstryeyelesn,fdrvssltechCG0339Robotlin-radsurgcom,firstCG0340Robtlin-radsurgfractx2-5CQ3001BrachytherapyRadioelementsCR0070Transportportablex-rayCR0075Transportportx-raymultiplC
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