Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2000

Federal RegisterApr 11, 2000

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 410, 411, 414, 415, and 485

[HCFA-1065-CN]

RIN 0938-AJ61

Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2000

AGENCY:

Health Care Financing Administration (HCFA), 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 2, 1999, entitled “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2000.”

EFFECTIVE DATE:

January 1, 2000.

FOR FURTHER INFORMATION CONTACT:

Diane Milstead, (410) 786-3355.

SUPPLEMENTARY INFORMATION:

Background

In FR Doc. 99-28367 of November 2, 1999, (64 FR 59380), there were a number of technical errors. The errors relate to the omission of language discussing payment for pulse oximetry, temperature gradient studies and venous pressure determinations and the removal of the x-ray requirement before chiropractic manipulation; acceptance of the RUC recommendations for work relative value units (RVUs); RUC recommendations for CPT codes 17276 and 95165; a comment on codes in the “zero work” pool; discussion of CPT code 61862 and the correct billing procedures; and regulations text definitions concerning the coverage of prostate screening. Additionally there are various revisions to Addenda B and C.

The provisions in this correction notice are effective as if they had been included in the document published in the

Federal Register

on November 2, 1999, that is, January 1, 2000.

Discussion of Addenda B and C

1. On page 39626 of the July 22, 1999 proposed rule, we discussed revising the work RVUs for certain pediatric surgical services to reflect more appropriate data. We inadvertently omitted these work RVU changes from Addendum B of the November 2, 1999 final rule. Entries on the pages listed below are corrected as follows: Page 59451 for CPT code 21740; page 59476 for CPT codes 38550 and 38555; page 59477 for CPT code 39503; page 59479 for CPT codes 42810 and 42815; page 59480 for CPT codes 43305, 43310, 43312, and 43831; page 59482 for CPT codes 45120 and 45121; page 59483 for CPT codes 46715, 46716, 46730, 46735,

46740, and 46751; page 59484 for CPT codes 47700 and 47701; page 59485 for CPT codes 49215, 49495, 49580, 49600, 49605, and 49606; page 59488 for CPT code 51940; and page 59495 for CPT code 60280. These corrections are reflected in correction number 8 to follow.

2. On page 59421 of the November 2, 1999 final rule, we assigned 5.85 work RVUs to CPT code 61885. We inadvertently omitted this value from Addenda B and C. Entries on the pages listed below are corrected as follows: Page 59497 and page 59582 for CPT code 61885. These corrections are reflected in correction number 9 to follow.

3. In Addendum B, we assigned incorrect status indicators for the following CPT codes: Page 59553 for CPT codes 94760 and 94761; and page 59578 for HCFA Common Procedure Coding System (HCPCS) codes Q0183, Q0184, Q0185, Q0186, Q1001, Q1002, Q1003, Q1004, and Q1005. These corrections are reflected in correction number 10 to follow.

4. On page 39630 of the July 22, 1999 proposed rule, we discussed accepting the RUC work RVU recommendations for five CPT codes that were carrier priced for 1999. The status of these codes would also change from Carrier Priced (C) to Active (A) in the final rule. We inadvertently omitted the work RVUs, status indicator, and correct global indicator changes from Addendum B of the final rule. Entries on the pages listed below are corrected as follows: Page 59473 for CPT code 35500; page 59475 for CPT code 36823; page 59476 for CPT code 38792; page 59495 for CPT 60650 (renumbered from CPT code 56321 for which we accepted the RUC recommendation); page 59476 for CPT code 38120 (renumbered from CPT code 56345 for which we accepted the RUC recommendation); and page 59481 for CPT code 44201 (renumbered from CPT code 56347 for which we accepted the RUC recommendation). In addition, we failed to reflect the practice expense values assigned to these codes. These corrections are reflected in correction 11 to follow.

5. In Addendum B, we inadvertently published incorrect global periods for CPT codes 33968, 47560, 62263, 96570 and 96571. Entries on pages listed below are corrected as follows: Pages 59472 and 59582 for CPT code 33968; page 59484 for CPT code 47560; pages 59497 and 59582 for CPT code 62263; and pages 59556 and 59583 for CPT codes 96570 and 96571. These corrections are reflected in correction number 12 to follow.

6. On page 39629 of the July 22, 1999 proposed rule, we proposed changing ventricular assist device insertions, CPT codes 33975 and 33976, to an XXX global and reducing the work RVUs accordingly. In the November 2, 1999 final rule, in Addendum B, we changed the global periods to XXX but inadvertently failed to reduce the work RVUs as stated in the proposed rule. Entries on the page listed below are corrected as follows: Page 59472 for CPT codes 33975 and 33976. In addition, we failed to show the adjustments to the CPEP data made to accommodate the changing global periods. These corrections are reflected in correction number 13 to follow.

7. In Addendum B, we inadvertently assigned incorrect practice expense and malpractice RVUs to HCPCS codes G0102, G0104, G0105, and incorrect malpractice relative value units for CPT codes 59000 through 59899. Entries on the pages listed below are corrected as follows: Page 59571 for HCPCS codes G0102, G0104, and G0105; pages 59494 and 59495 for CPT codes 59000 through 59899. These corrections are reflected in correction number 14 to follow.

8. On pages 59448 and 59582 of Addendum B, we assigned an incorrect procedure status and global period to CPT code 20979. Entries on pages listed below are corrected as follows: Pages 59448 and 59582 for CPT code 20979. These corrections are reflected in correction number 15 to follow.

9. In Addendum B, we inadvertently assigned incorrect practice expense RVUs for HCPCS codes G0106, G0106-26, G0106-TC, G0120, G0120-26, G0120-TC, G0170, G0171 and CPT code 45378-53. Entries on pages listed below are corrected as follows: Page 59571 for HCPCS codes G0106, G0106-26, G0106-TC, G0120, G0120-26 and G0120-TC; page 59572 and page 59583 for G0170 and G0171; and page 59482 for CPT 45378-53. These corrections are reflected in correction number 16 to follow.

10. We incorrectly denoted that CPT code 40814 was not applicable in a non-facility setting. On page 59477 of Addendum B, the applicable practice expense values are included for the nonfacility setting for CPT code 40814. These corrections are reflected in correction number 17 to follow.

11. In Addendum B, we assigned incorrect practice expense and/or malpractice RVUs for HCPCS codes G0163, G0163-26, G0163-TC, G0164, G0164-26, G0164-TC, G0165, G0165-26, and G0165-TC. Entries on the pages listed below are corrected as follows: Page 59571 for HCPCS codes G0163, G0163-26, and G0163-TC and page 59572 for G0164, G0164-26, G0164-TC, G0165, G0165-26 and G0165-TC. These corrections are reflected in correction number 18 to follow.

Correction of Errors

In FR Doc. 99-28367 of November 2, 1999, make the following corrections:

1. On page 59395, second column, after the sixth full paragraph, add the following:

CPT code 17276, Destruction, malignant lesion, any method scalp, neck, hands, feet, genitalia; lesion diameter over 4.0cm

The RUC forwarded a recommendation for supplies. We accepted the recommendation but deleted what appeared to be duplicated gauze supplies.”

2. On page 59398, first column, after the last paragraph insert the following:

“CPT Code 95165, professional services for the supervision and provision of antigens for allergen immunotherapy.

The nature of the RUC's recommendation regarding this code was significantly different than its recommendations regarding other codes. The RUC did not examine the direct expense inputs for code 95165 but commented on the definition of dose used for claims involving this code. Because the direct expense inputs have not been reviewed, we believe that it is not appropriate to revise the practice expense value at this time.”

3. On page 59406, in the last line of column two, insert the words “, in Table 7,” between the words “95956” and “should”.

4. On page 59413, column three, after line 7, add the following:

“Result of Evaluation of Comments:

We are adopting our proposal to bundle payment for these services beginning January 2000 with the exception of code 94762, which we will continue to pay separately when continuous overnight monitoring is medically necessary as a separate procedure.

M. Removal of Requirement for X-ray Before Chiropractic Manipulation

We are conforming our regulations to section 4513(a) of the BBA that deleted the requirement that a spinal subluxation be demonstrated by an x-ray for a chiropractor to receive payment under Medicare Part B for manual manipulation of the spine to correct a subluxation.

Comment

: We received one comment requesting we revise § 410.22 (Limitations on services of a chiropractor) to recognize chiropractors as physicians for purposes of ordering and furnishing diagnostic tests and other services and supplies related to manual manipulation for treatment of subluxation of the spine.

Response

: We believe that extending the scope of services of the chiropractor to include other services, such as ordering and furnishing diagnostic tests, is inconsistent with section 1861(r) of the Act. Thus, we cannot implement this comment.

Comment

: Two commenters expressed concern that the x-ray requirement has been removed without being replaced by clear”

5. On page 59418, in the third column, line 6 from the top, replace “69” with “85”, and line 9, replace “31” with “15”.

§ 410.39

[Corrected]

6. On page 59440, in the second column, § 410.39 is corrected by adding paragraphs (a)(4) and (a)(5) as follows:

§ 410.39

Prostate cancer screening tests: Conditions for and limitations on coverage.

(a) * * *

(4) A physician for purposes of this provision means a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act) who is fully knowledgeable about the beneficiary, and who would be responsible for explaining the results of the screening examination or test.

(5) A physician assistant, nurse practitioner, clinical nurse specialist, or certified nurse midwife for purposes of this provision means a physician assistant, nurse practitioner, clinical nurse specialist, or certified nurse midwife (as defined in sections 1861(aa) and 1861(gg) of the Act) who is fully knowledgeable about the beneficiary, and who would be responsible for explaining the results of the screening examination or test.

7. On page 59440, in the second and third columns, in § 410.39, paragraphs (b) and (d), add the phrase “as defined in paragraphs (a)(4) or (a)(5) of this section,” after the word “midwife.”

Addendum B [Corrected]

8. In the table of Addendum B, the following CPT codes are corrected to read as follows:

CPT

/HCPCS

MOD

Status

Description

Physician Work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 transitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully Implemented non facility total

Year 2000 transitional nonfacility total

Fully implemented facility total

Year 2000 transitional facility total

Global

21740

Reconstruction of sternum

16.80

15.80

12.78

1.95

34.55

31.53

090

38550

Removal, neck/armpit lesion

6.92

5.24

4.38

0.50

12.66

11.80

090

38555

Removal, neck/armpit lesion

14.14

11.47

9.68

1.53

27.14

25.35

090

39503

Repair of diaphragm hernia

37.54

14.98

21.16

3.26

55.78

61.96

090

42810

Excision of neck cyst

3.25

4.77

4.09

3.83

3.62

0.27

8.29

7.61

7.35

7.14

090

42815

Excision of neck cyst

7.07

6.06

7.35

0.55

13.68

14.97

090

43305

Repair esophagus and fistula

17.39

12.60

13.74

1.32

31.31

32.45

090

43310

Repair of esophagus

27.47

17.64

18.04

3.07

48.18

48.58

090

43312

Repair esophagus and fistula

30.50

23.15

19.02

3.46

57.11

52.98

090

43831

Place gastrostomy tube

7.84

4.15

4.90

0.74

12.73

13.48

090

45120

Removal of rectum

25.00

11.45

14.62

2.31

38.76

41.93

090

45121

Removal of rectum and colon

27.51

12.98

12.35

2.65

43.14

42.51

090

46715

Repair of anovaginal fistula

7.46

4.31

4.06

0.86

12.63

12.38

090

46716

Repair of anovaginal fistula

12.85

6.50

6.54

1.21

20.56

20.60

090

46730

Construction of absent anus

22.39

11.74

11.70

1.91

36.04

36.00

090

46735

Construction of absent anus

27.02

12.15

13.15

2.59

41.76

42.76

090

46740

Construction of absent anus

24.19

10.40

11.47

2.31

36.90

37.97

090

46751

Repair of anal sphincter

8.77

5.53

4.98

0.86

15.16

14.61

090

47700

Exploration of bile ducts

15.62

8.23

8.26

1.37

25.22

25.25

090

47701

Bile duct revision

29.55

13.21

11.06

2.87

45.63

43.48

090

49215

Excise sacral spine tumor

23.20

10.50

9.86

2.18

35.88

35.24

090

49495

Repair inguinal hernia, init

5.84

3.67

4.54

0.56

10.07

10.94

090

49580

Repair umbilical hernia

3.34

2.74

3.47

0.34

6.42

7.15

090

49600

Repair umbilical lesion

10.96

5.66

5.69

0.95

17.57

17.60

090

49605

Repair umbilical lesion

24.94

11.31

10.31

2.20

38.45

37.45

090

49606

Repair umbilical lesion

21.31

8.89

8.96

1.91

32.11

32.18

090

51940

Correction of bladder defect

28.43

13.38

16.98

1.90

43.71

47.31

090

60280

Remove thyroid duct lesion

5.87

4.86

6.06

0.48

11.21

12.41

090

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

9. In the table of Addenda's B and C, the following CPT code is corrected to read as follows:

CPT

/HCPCS

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 transitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional non-facility total

Fully implemented facility total

Year 2000 transitional facility total

Global

61885

Implant neurostim one array

5.85

4.86

6.06

0.48

11.21

12.41

090

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

10. In the table of Addendum B, the following HCPCS codes are corrected to read as follows:

CPT

/HCPCS

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 transitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional non-facility total

Fully implemented facility total

Year 2000 transitional facility total

Global

Q0183

Nonmetabolic active tissue

0.00

XXX

Q0184

Metabolically active tissue

0.00

XXX

Q0185

Metabolic active D/E tissue

0.00

XXX

Q0186

Paramedic intercept, rural

0.00

XXX

Q1001

Ntiol category 1

0.00

XXX

Q1002

Ntiol category 2

0.00

XXX

Q1003

Ntiol category 3

0.00

XXX

Q1004

Ntiol category 4

0.00

XXX

Q1005

Ntiol category 5

0.00

XXX

94760

Measure blood oxygen level

0.00

0.08

0.18

0.08

0.18

0.02

0.10

0.20

0.10

0.20

XXX

94761

Measure blood oxygen level

0.00

0.15

0.42

0.15

0.42

0.05

0.20

0.47

0.20

0.47

XXX

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

11. In the table of Addendum B, the following CPT codes are corrected to read as follows:

CPT

/HCPCS

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 trasitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional facility total

Fully implemented facility total

Year 2000 transitional facility total

Global

35500

Harvest vein for bypass

6.45

2.43

0.73

9.61

ZZZ

36823

Insert cannula(s)

21.00

11.54

0.67

33.21

090

38120

Laparoscopic splenectomy

17.00

7.83

1.04

25.87

090

38792

Identify sentinel node

0.52

0.20

0.01

0.73

000

44201

Laparoscopic jejunostomy

9.78

3.61

1.35

14.74

090

60650

Laparoscopy adrenalectomy

20.00

9.10

1.35

30.45

090

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

12. In the table of Addenda's B and/or C, the following CPT codes are corrected to read as follows:

CPT

/HCPC

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 trasitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional facility total

Fully implemented facility total

Year 2000 transitional facility total

Global

33968

Remove aortic assist device

0.64

0.25

0.27

1.16

000

47560

Laparoscopy w/ cholangio

4.89

N/A

1.95

2.48

0.46

N/A

7.30

7.83

000

62263

Lysis epidural adhesions

6.02

4.61

2.18

0.88

11.51

9.08

010

96570

Photodynamic tx, 30 min

1.10

0.71

0.43

0.28

2.09

1.81

ZZZ

96571

Photodynamc tx, addl 15 min

0.55

0.31

0.21

0.28

1.14

1.04

ZZZ

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

13. In table of Addendum B, the following CPT codes are corrected to read as follows:

CPT

/HCPC

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 trasitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional facility total

Fully implemented facility total

Year 2000 transitional facility total

Global

33975

Implant ventricular device

21.00

16.80

16.10

2.86

40.66

39.96

XXX

33976

Implant ventricular device

23.00

18.65

19.82

3.91

45.56

46.73

XXX

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

14. In table of Addendum B, the following CPT codes are corrected to read as follows:

CPT

/HCPC

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 trasitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional facility total

Fully implemented facility total

Year 2000 transitional facility total

Global

G0102

Prostate ca screening; dre

0.17

0.51

0.37

0.06

0.09

0.01

0.69

0.55

0.24

0.27

XXX

G0104

CA screen; flexi sigmoidscope

0.96

1.35

1.34

0.33

0.46

0.07

2.38

2.37

1.36

1.49

000

G0105

Colorectal scrn; hi risk ind

3.70

5.99

5.24

1.29

2.86

0.26

9.95

9.20

5.25

6.82

000

59000

Amniocentesis

1.30

1.54

1.30

0.49

0.77

0.19

3.03

2.79

1.98

2.26

000

59012

Fetal cord punture, prenatal

3.45

1.38

2.11

0.51

5.34

6.07

000

59015

Chorion biopsy

2.20

1.27

1.29

0.85

1.08

0.32

3.79

3.81

3.37

3.60

000

59020

Fetal contract stress test

0.66

0.78

1.06

0.78

1.06

0.21

1.65

1.93

1.65

1.93

000

59020

Fetal contract stress test

0.66

0.26

0.53

0.26

0.53

0.13

1.05

1.32

1.05

1.32

000

59020

Fetal contract stress test

0.00

0.52

0.53

0.52

0.53

0.08

0.60

0.61

0.60

0.61

000

59025

Fetal non-stress test

0.53

0.43

0.55

0.43

0.55

0.10

1.06

1.18

1.06

1.18

000

59025

Fetal non-stress test

0.53

0.20

0.31

0.20

0.31

0.08

0.81

0.92

0.81

0.92

000

59025

Fetal non-stress test

0.00

0.23

0.24

0.23

0.24

0.02

0.25

0.26

0.25

0.26

000

59030

Fetal scalp blood sample

1.99

0.77

1.24

0.30

3.06

3.53

000

59050

Fetal monitor w/ report

0.89

0.34

0.61

0.12

1.35

1.62

XXX

59051

Fetal monitor/interpret only

0.74

0.28

0.58

0.10

1.12

XXX

59100

Remove uterus lesion

12.35

6.05

5.27

1.80

20.20

19.42

090

59120

Treat ectopic pregnancy

11.49

5.73

7.13

1.67

18.89

20.29

090

59121

Treat ectopic pregnancy

11.67

5.84

1.70

19.21

090

59130

Treat ectopic pregnancy

14.22

6.89

6.68

2.07

23.18

22.97

090

59135

Treat ectopic pregnancy

13.88

6.76

8.73

2.01

22.65

24.62

090

59136

Treat ectopic pregnancy

13.18

6.49

6.62

1.92

21.59

21.72

090

59140

Treat ectopic pregnancy

5.46

3.40

4.23

0.79

9.65

10.48

090

59150

Treat ectopic pregnancy

6.89

3.95

4.44

1.00

11.84

12.33

090

59151

Treat ectopic pregnancy

7.86

4.01

6.68

1.15

13.02

15.69

090

59160

D & C after delivery

2.71

3.30

3.24

2.07

2.63

0.39

6.40

6.34

5.17

5.73

010

59200

Insert cervical dilator

0.79

1.19

0.89

0.29

0.3

0.11

2.09

1.79

1.19

1.20

000

59300

Episiotomy or vaginal repair

2.41

1.56

1.32

0.92

0.73

0.34

4.31

4.07

3.67

3.48

000

59320

Revision of cervix

2.48

1.30

1.62

0.36

4.14

4.46

000

59325

Revision of cervix

4.07

1.92

2.53

0.59

6.58

7.19

000

59350

Repair of uterus

4.95

1.84

2.84

0.73

7.52

8.52

000

59400

Obstetrical care

23.06

13.44

14.86

3.35

39.85

41.27

MMM

59409

Obstetrical care

13.50

5.08

7.69

1.97

20.55

23.16

MMM

59410

Obstetrical care

14.78

6.01

8.6

2.15

22.94

25.53

MMM

59412

Antepartum manipulation

1.71

1.16

1.24

0.65

0.99

0.25

3.12

3.20

2.61

2.95

MMM

59414

Deliver placenta

1.61

1.13

1.19

0.24

2.98

3.04

MMM

59425

Antepartum care only

4.81

4.62

3.88

4.62

3.1

0.71

10.14

9.40

10.14

8.62

MMM

59426

Antepartum care only

8.28

7.85

6.61

7.81

5.25

1.20

17.33

16.09

17.29

14.73

MMM

59430

Care after delivery

2.13

1.14

0.78

1.14

0.68

0.32

3.59

3.23

3.59

3.13

MMM

59510

Cesarean delivery

26.22

15.40

16.87

3.82

45.44

46.91

MMM

59514

Cesarean delivery only

15.97

6.01

8.97

2.32

24.30

27.26

MMM

59515

Cesarean delivery

17.37

7.56

10.2

2.53

27.46

30.10

MMM

59525

Remover uterus after cesarean

8.54

3.19

3.66

1.24

12.97

13.44

ZZZ

59610

Vbac delivery

24.62

9.36

12.82

3.58

37.56

41.02

MMM

59612

Vbac delivery only

15.06

5.77

8.03

2.20

23.03

25.29

MMM

59614

Vbac care after delivery

16.34

6.29

8.74

2.38

25.01

27.46

MMM

59618

Attempted Vbac delivery

27.78

10.51

14.43

4.05

42.34

46.26

MMM

59620

Attempted Vbac delivery only

17.53

6.67

9.30

2.55

26.75

29.38

MMM

59622

Attempted Vbac after care

18.93

7.27

10.05

2.76

28.96

31.74

MMM

59812

Treatment of miscarriage

3.25

4.21

4.07

2.23

3.06

0.48

7.94

7.80

5.96

6.79

090

59820

Care of miscarriage

4.01

4.40

4.24

2.52

3.3

0.59

9.00

8.84

7.12

7.90

090

59821

Treatment of miscarriage

4.47

4.87

3.91

2.71

2.83

0.66

10.00

9.04

7.84

7.96

090

59830

Treat uterus infection

6.11

3.64

4.28

0.89

10.64

11.28

090

59840

Abortion

3.01

4.64

4.07

2.14

2.82

0.44

8.09

7.52

5.59

6.27

010

59841

Abortion

5.24

6.01

5.04

3.35

3.71

0.75

12.00

11.03

9.34

9.70

010

59850

Abortion

5.91

2.52

3.43

0.86

9.29

10.20

090

59851

Abortion

5.93

2.87

3.76

0.86

9.66

10.55

090

59852

Abortion

8.24

4.34

5.16

1.19

13.77

14.59

090

59855

Abortion

6.12

3.17

3.83

0.89

10.18

10.84

090

59856

Abortion

7.48

3.55

4.55

1.09

12.12

13.12

090

59857

Abortion

9.29

4.28

5.52

1.36

14.93

16.17

090

59866

Abortion (mpr)

4.00

1.55

2.33

0.58

6.13

6.91

000

59870

Evacuate mole of uterus

4.28

2.85

3.01

0.62

7.75

7.91

090

59871

Remove cerclage suture

2.13

1.89

1.91

0.81

1.37

0.32

4.34

4.36

3.26

3.82

000

59898

Laparo proc, ob care/delivery

0.00

YYY

59899

Maternity care procedure

0.00

YYY

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

15. In table of Addenda B and C, the following CPT code is corrected to read as follows:

CPT

/HCPCS

MOD

Status

Description

Physician work RVUs

Fully implemented facility PE RVUs

Year 2000 transitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional nonfacility total

Fully implemented facility total

Year 2000 transitional facility total

Global

20979

U.S. bone stimulation

0.17

0.25

0.07

0.01

0.43

0.25

XXX

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

16. In the table of Addendum B, the following CPT codes are corrected to read as follows:

CPT

HCPCS

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 transitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 Transitional nonfacility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 Transitional nonfacility total

Fully implemented facility total

Year 2000 Transitional facility total

Global

G0106

Colon CA screen; barium enema

0.99

2.51

2.66

2.51

2.66

0.15

3.65

3.80

3.65

3.80

XXX

G0106

Colon CA screen; barium enema

0.99

0.27

0.38

0.27

0.38

0.04

1.30

1.41

1.30

1.41

XXX

G0106

Colon CA screen; barium enema

0.00

2.24

2.28

2.24

2.28

0.11

2.35

2.39

2.35

2.39

XXX

G0120

Colon ca scrn barium enema

0.99

2.51

2.66

2.51

2.66

0.15

3.65

3.80

3.65

3.80

XXX

G0120

Colon ca scrn barium enema

0.99

0.27

0.38

0.27

0.38

0.04

1.30

1.41

1.30

1.41

XXX

G0120

Colon ca scrn barium enema

0.00

2.24

2.28

2.24

2.28

0.11

2.35

2.39

2.35

2.39

XXX

G0170

Skin biograft

1.50

3.14

1.10

0.39

5.03

2.99

G0171

Skin biograft add-on

0.38

0.30

0.15

0.39

1.07

0.92

ZZZ

45378

Diagnostic colonoscopy

0.96

1.35

1.34

0.33

0.46

0.07

2.38

2.37

1.36

1.49

000

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

17. In the table of Addendum B, the following CPT code is corrected to read as follows:

CPT

HCPCS

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 transitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 Transitional nonfacility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 Transitional nonfacility total

Fully implemented facility total

Year 2000 Transitional facility total

Global

40814

Excise/repair mouth lesion

3.42

3.64

3.58

3.64

2.70

0.25

7.31

7.25

7.31

6.37

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

18. In the table of Addendum B, the following HCPCS codes are corrected to read as follows:

CPT

/HCPCS

MOD

Status

Description

Physician work RVUs

Fully implemented nonfacility PE RVUs

Year 2000 transitional nonfacility PE RVUs

Fully implemented facility PE RVUs

Year 2000 transitional facility PE RVUs

Malpractice RVUs

Fully implemented nonfacility total

Year 2000 transitional nonfacility total

Fully implemented facility total

Year 2000 transitional facility total

Global

G0163

PET for rec of colorectal ca

1.50

56.21

2.06

59.77

XXX

G0163

PET for rec of colorectal ca

1.50

0.58

0.05

2.13

XXX

G0163

PET for rec of colorectal ca

0.00

55.63

2.01

57.64

XXX

G0164

PET for lymphoma staging

1.87

56.35

2.06

60.28

XXX

G0164

PET for lymphoma staging

1.87

0.72

0.05

2.64

XXX

G0164

PET for lymphoma staging

0.00

55.63

2.01

57.64

XXX

G0165

PET, rec of melanoma/met ca

1.50

56.21

2.06

59.77

XXX

G0165

PET, rec of melanoma/met ca

1.50

0.58

0.05

2.13

XXX

G0165

PET, rec of melanoma/met ca

0.00

55.63

2.01

57.64

XXX

+ Indicates RVUs are not used for Medicare payment.

PE RVUs = Practice Expense Relative Value Units.

(Section 1848 of the Social Security Act (42 U.S.C. 1395w-4)) (Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

Dated: March 23, 2000.

Brian P. Burns,

Deputy Assistant Secretary for Information Resources Management.

[FR Doc. 00-8717 Filed 4-10-00; 8:45 am]

BILLING CODE 4120-01-P

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.