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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 410, 414, 415, 421, 423, 425, 486, and 495

[CMS-1590-CN]

RIN 0938-AR11

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

AGENCY:

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

ACTION:

Correction of final rule with comment period.

SUMMARY:

This document corrects technical errors that appeared in the final rule with comment period published in the

Federal Register

on November 16, 2012, entitled “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013.”

DATES:

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

FOR FURTHER INFORMATION CONTACT:

Elliott Isaac, (410) 786-4735.

SUPPLEMENTARY INFORMATION:

I. Background

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

www.cms.gov//PhysicianFeeSched/

.

II. Summary of Errors

A. Summary of Errors in the Preamble

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

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

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

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

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

On page 68966, we inadvertently included language.

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

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

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

On page 69051,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

On pages 69347 through 69348, in Table 135: CY 2013 PFS Final Rule with

Comment Period Estimated Impact on Total Allowed Charges by Specialty by Selected Policy, due to technical errors in calculations of the impacts, there were errors in the estimates of the total impact and on the impact for the following specialties: 01—ALLERGY/IMMUNOLOGY, 02—ANESTHESIOLOGY, 13—GENERAL SURGERY, 18—INTERNAL MEDICINE, 19—INTERVENTIONAL PAIN MANAGEMENT, 21—MULTISPECIALTY CLINIC/OTHER PHY, 41—UROLOGY, 49—NURSE ANES/ANES ASST.

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

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

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

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

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

www.cms.gov//PhysicianFeeSched/

. Resulting changes to PE RVUs are reflected in the corrected Addenda B and C posted on the CMS Web site at

www.cms.gov//PhysicianFeeSched/

.

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

www.cms.gov//PhysicianFeeSched/

.

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

www.cms.gov//PhysicianFeeSched/

.

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

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

www.cms.gov//PhysicianFeeSched/

, includes these services and related information.

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

www.cms.gov//PhysicianFeeSched/

reflects this change.

Due to a technical error in the posting of Addendum C, the “NA” flags did not display for services when either the facility or nonfacility setting did not contain a value. The corrected Addendum C, which is posted on the CMS Web site at

www.cms.gov//PhysicianFeeSched/

, reflects the “NA” flags for services that are not valued in the indicated setting.

III. Waiver of Proposed Rulemaking

We ordinarily publish a notice of proposed rulemaking in the

Federal Register

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

Section 553(d) of the APA ordinarily requires a 30-day delay in the effective date of final rules after the date of their publication in the

Federal Register

. This 30-day delay in effective date can be waived, however, if an agency finds for good cause that the delay is impracticable, unnecessary, or contrary to the public interest, and the agency incorporates a statement of the findings and its reasons in the rule issued.

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

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

IV. Correction of Errors

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

A. Correction of Errors in the Preamble

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

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

Step

Source

Formula

99213

Office visit, est

nonfacility

33533

CABG, arterial, single

facility

71020

Chest x-ray

nonfacility

71020-TC

Chest x-ray

nonfacility

71020-26

Chest x-ray

nonfacility

93000

ECG, complete

nonfacility

93005

ECG, tracing

nonfacility

93010

ECG, report

nonfacility

(1) Labor cost (Lab)

Step 1

AMA

13.32

77.52

5.74

5.74

0.00

6.12

6.12

0.00

(2) Supply cost (Sup)

Step 1

AMA

2.98

0.00

3.39

3.39

0.00

1.19

1.19

0.00

(3) Equipment cost (Eqp)

Step 1

AMA

0.17

0.58

7.24

7.24

0.00

0.11

0.11

0.00

(4) Direct cost (Dir)

Step 1

=(1)+(2)+(3)

16.48

78.10

16.38

16.38

0.00

7.42

7.42

0.00

(5) Direct adjustment (Dir. Adj.)

Steps 2-4

See footnote*

0.5973

0.5973

0.5973

0.5973

0.5973

0.5973

0.5973

0.5973

(6) Adjusted Labor

Steps 2-4

=Labor * Dir Adj

=(1)*(5)

7.96

46.30

3.43

3.43

0.00

3.66

3.66

0.00

(7) Adjusted Supplies

Steps 2-4

=Eqp * Dir Adj

=(2)*(5)

1.78

0.00

2.03

2.03

0.00

0.71

0.71

0.00

(8) Adjusted Equipment

Steps 2-4

=Sup * Dir Adj

=(3)*(5)

0.10

0.35

4.33

4.33

0.00

0.06

0.06

0.00

(9) Adjusted Direct

Steps 2-4

=(6)+(7)+(8)

9.84

46.65

9.78

9.78

0.00

4.43

4.43

0.00

(10) Conversion Factor (CF)

Step 5

PFS

34.0376

34.0376

34.0376

34.0376

34.0376

34.0376

34.0376

34.0376

(11) Adj. labor cost converted

Step 5

=(Lab * Dir Adj)/CF

=(6)/(10)

0.23

1.36

0.10

0.10

0.00

0.11

0.11

0.00

(12) Adj. supply cost converted

Step 5

=(Sup * Dir Adj)/CF

=(7)/(10)

0.05

0.00

0.06

0.06

0.00

0.02

0.02

0.00

(13) Adj. equipment cost converted

Step 5

=(Eqp * Dir Adj)/CF

=(8)/(10)

0.00

0.01

0.13

0.13

0.00

0.00

0.00

0.00

(14) Adj. direct cost converted

Step 5

=(11)+(12)+(13)

0.29

1.37

0.29

0.29

0.00

0.13

0.13

0.00

(15) Work RVU

Setup File

PFS

0.97

33.75

0.22

0.00

0.22

0.17

0.00

0.17

(16) Dir_pct

Steps 6,7

Surveys

0.31

0.18

0.31

0.31

0.31

0.31

0.31

0.31

(17) Ind_pct

Steps 6,7

Surveys

0.69

0.82

0.69

0.69

0.69

0.69

0.69

0.69

(18) Ind. Alloc. Formula (1st part)

Step 8

See Step 8

((14)/(16)*(17)

((14)/(16)*(17)

((14)/(16)*(17)

((14)/(16)*(17)

((14)/(16)*(17)

((14)/(16)*(17)

((14)/(16)*(17)

((14)/(16)*(17)

(19) Ind. Alloc.(1st part)

Step 8

See 18

0.87

6.41

0.7

0.7

0

0.32

0.32

0

(20) Ind. Alloc. Formula (2nd part)

Step 8

See Step 8

(15)

(15)

(15+11)

(11)

(15)

(15+11)

(11)

(15)

(21) Ind. Alloc.(2nd part)

Step 8

See 20

0.97

33.75

0.32

0.10

0.22

0.28

0.11

0.17

(22) Indirect Allocator (1st + 2nd)

Step 8

=(19)+(21)

1.84

40.16

1.03

0.81

0.22

0.60

0.43

0.17

(23) Indirect Adjustment (Ind. Adj.)

Steps 9-11

See Footnote**

0.40

0.40

0.40

0.40

0.40

0.40

0.40

0.40

(24) Adjusted Indirect Allocator

Steps 9-11

=Ind Alloc * Ind Adj

0.75

16.25

0.42

0.33

0.09

0.24

0.17

0.07

(25) Ind. Practice Cost Index (IPCI)

Steps 12-16

1.08

0.79

0.92

0.92

0.92

0.92

0.92

0.92

(26) Adjusted Indirect

Step 17

= Adj.Ind Alloc * PCI

=(24)*(25)

0.81

12.76

0.38

0.30

0.08

0.22

0.16

0.06

(27) PE RVU

Step 18

=(Adj Dir + Adj Ind) * budn

=((14)+(26)) * budn

1.10

14.15

0.67

0.59

0.08

0.35

0.29

0.06

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

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

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

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

“6. Psychiatry Services

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

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

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

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

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

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

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

Other PT/OT Primary Functional Limitation

G8990

Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals.

G8991

Other physical or occupational therapy primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting.

G8992

Other physical or occupational therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting.

Other PT/OT Primary Functional Limitation

G8993

Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals.

G8994

Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting.

G8995

Other physical or occupational therapy subsequent functional limitation, discharge status, at discharge from therapy or to end reporting.

Swallowing

G8996

Swallowing functional limitation, current status at therapy episode outset and at reporting intervals.

G8997

Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting.

G8998

Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting.

Motor Speech

G8999

Motor speech functional limitation, current status at therapy episode outset and at reporting intervals.

G9186

Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.

Spoken Language Comprehension

G9159

Spoken language comprehension functional limitation, current status at therapy episode outset and at reporting intervals.

G9160

Spoken language comprehension functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.

G9161

Spoken language comprehension functional limitation, discharge status at discharge from therapy or to end reporting.

Spoken Language Expression

G9162

Spoken language expression functional limitation, current status at therapy episode outset and at reporting intervals.

G9163

Spoken language expression functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.

G9164

Spoken language expression functional limitation, discharge status at discharge from therapy or to end reporting.

Attention

G9165

Attention functional limitation, current status at therapy episode outset and at reporting intervals.

G9166

Attention functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.

G9167

Attention functional limitation, discharge status at discharge from therapy or to end reporting.

Memory

G9168

Memory functional limitation, current status at therapy episode outset and at reporting intervals.

G9169

Memory functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.

G9170

Memory functional limitation, discharge status at discharge from therapy or to end reporting.

Voice

G9171

Voice functional limitation, current status at therapy episode outset and at reporting intervals.

G9172

Voice functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.

G9173

Voice functional limitation, discharge status at discharge from therapy or to end reporting.

Other SLP Functional Limitation

G9174

Other speech language pathology functional limitation, current status at therapy episode outset and at reporting intervals.

G9175

Other speech language pathology functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge from or to end reporting.

G9176

Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting.

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

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

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

Comment:

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

Response:

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

www.cms.gov/PhysicianFeeSched/

.”.

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

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

11. On page 69051,

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

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

“CPT codes 37620, 75940, and 36010 were identified as potentially misvalued through the Codes Reported Together 75 percent or More screen. In response, the CPT Editorial Panel created CPT codes 37191 through 37193 and 37197 to bundle the services together. After clinical review of CPT code 37197 (Transcatheter retrieval, percutaneous, of intravascular foreign body (for example, fractured venous or arterial

catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed), along with the other related bundled services, we believe a work RVU of 6.29 accurately reflects the work involved in furnishing this service. We believe CPT code 37197 involves similar work as CPT code 36247 (Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family) and should be valued the same. Furthermore, we believe a work RVU of 6.29 appropriately reflects the relative difference in work between this service and related CPT codes 37191, 37192, and 37193. The AMA RUC recommended a work RVU of 6.72 for CPT code 37197, a direct crosswalk to CPT code 36475 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated). On an interim final basis for CY 2013, we are assigning a work RVU of 6.29 to CPT code 37197.”.

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

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

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

13. On page 69072,

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

b. Second column,

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

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

c. Third column,

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

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

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

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

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

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

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

CPT

Code

CPT Code

description

CMS Code

CMS Code

description

NonFac/Fac

Labor activity

(if applicable)

RUC recommendation

or current value

(min or qty)

CMS refinement

(min or qty)

Comment

11300

Shave skin lesion 0.5 cm/<

ED004

camera, digital (6 mexapixel)

NF

29

14

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

29

14

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

29

14

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

29

14

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

29

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

29

24

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator(tubing, covering, etc.) with stand

NF

29

14

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11301

Shave skin lesion 0.6-1.0 cm

ED004

camera, digital (6 mexapixel)

NF

32

17

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

32

17

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

32

17

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

32

17

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

32

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

32

27

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

32

17

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11302

Shave skin lesion 1.1-2.0 cm

ED004

camera, digital (6 mexapixel)

NF

37

20

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

37

20

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

37

20

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

37

20

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

37

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

37

30

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

37

20

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11303

Shave skin lesion >2.0 cm

ED004

camera, digital (6 mexapixel)

NF

41

22

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

41

22

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

41

22

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

41

22

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

41

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

41

32

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

41

22

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11305

Shave skin lesion 0.5 cm/<

ED004

camera, digital (6 mexapixel)

NF

29

17

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

29

17

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

29

17

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

29

17

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

29

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

29

27

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

29

17

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11306

Shave skin lesion 0.6-1.0 cm

ED004

camera, digital (6 mexapixel)

NF

31

25

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

31

25

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

31

25

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

31

25

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

31

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

31

35

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

31

25

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Assist physician in performing procedure

10

18

Conforming to physician time.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11307

Shave skin lesion 1.1-2.0 cm

ED004

camera, digital (6 mexapixel)

NF

37

21

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

37

21

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

37

21

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

37

21

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

37

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

37

31

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

37

21

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11308

Shave skin lesion >2.0 cm

ED004

camera, digital (6 mexapixel)

NF

42

24

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

42

24

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

42

24

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

42

24

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

42

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

42

34

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

42

24

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11310

Shave skin lesion 0.5 cm/<

ED004

camera, digital (6 mexapixel)

NF

34

20

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

34

20

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

34

20

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

34

20

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

34

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

34

30

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

34

20

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11311

Shave skin lesion 0.6-1.0 cm

ED004

camera, digital (6 mexapixel)

NF

34

24

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

34

24

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

34

24

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

34

24

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

34

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

34

34

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

34

24

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Assist physician in performing procedure

11

17

Conforming to physician time.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11312

Shave skin lesion 1.1-2.0 cm

ED004

camera, digital (6 mexapixel)

NF

43

17

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

43

17

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

43

17

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

43

17

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

43

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

43

37

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

43

17

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11313

Shave skin lesion >2.0 cm

ED004

camera, digital (6 mexapixel)

NF

48

30

Refined equipment time to reflect typical use exclusive to patient.

EF014

light, surgical

NF

48

30

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

48

30

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

48

30

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

48

0

CMS clinical review; not described as typical in work vignette.

EQ137

instrument pack, basic ($500-$1499)

NF

48

40

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

48

30

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

1

10

Standardized time input.

SB003

cover, probe (cryosurgery)

NF

1

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB033

mask, surgical

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

11719

Trim nail(s) any number

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

3

1

CMS clinical review.

L037D

RN/LPN/MTA

NF

Provide pre-service education/obtain consent

2

1

CMS clinical review.

L037D

RN/LPN/MTA

NF

Prepare room, equipment, supplies

2

1

CMS clinical review.

L037D

RN/LPN/MTA

NF

Clean room/equipment by physician staff

3

1

CMS clinical review.

SJ028

hydrogen peroxide

NF

10

0

CMS clinical review.

SJ053

swab-pad, alcohol

NF

10

0

CMS clinical review.

13100

Cmplx rpr trunk 1.1-2.5 cm

EF014

light, surgical

NF

32

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

32

39

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

32

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

32

39

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

32

39

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

32

46

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

32

39

Refined equipment time to reflect typical use exclusive to patient.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13101

Cmplx rpr trunk 2.6-7.5 cm

EF014

light, surgical

NF

45

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

45

47

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

45

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

45

47

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

45

47

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

45

54

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

45

47

CMS clinical review.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB027

gown, staff, impervious

F

2

0

CMS clinical review.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SB034

mask, surgical, with face shield

F

2

1

CMS clinical review.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

10

0

Duplicative.

13102

Cmplx rpr trunk addl 5cm/<

EF015

mayo stand

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13120

Cmplx rpr s/a/l 1.1-2.5 cm

EF014

light, surgical

NF

86

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

86

41

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

86

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

86

41

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

86

41

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

86

48

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

86

41

Refined equipment time to reflect typical use exclusive to patient.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB027

gown, staff, impervious

F

2

0

CMS clinical review.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SB034

mask, surgical, with face shield

F

2

1

CMS clinical review.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13121

Cmplx rpr s/a/l 2.6-7.5 cm

EF014

light, surgical

NF

129

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

129

48

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

129

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

129

48

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

129

48

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

129

55

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

129

48

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

15

10

Standardized time input.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

10

0

Duplicative.

13122

Cmplx rpr s/a/l addl 5 cm/>

EF015

mayo stand

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

30

20

Refined equipment time to reflect typical use exclusive to patient.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13131

Cmplx rpr f/c/c/m/n/ax/g/h/f

EF014

light, surgical

NF

45

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

45

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

45

55

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13132

Cmplx rpr f/c/c/m/n/ax/g/h/f

EF014

light, surgical

NF

50

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

50

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

50

58

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

10

0

Duplicative.

13133

Cmplx rpr f/c/c/m/n/ax/g/h/f

EF015

mayo stand

NF

35

23

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

35

23

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

35

23

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

35

23

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

35

23

Refined equipment time to reflect typical use exclusive to patient.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13150

Cmplx rpr e/n/e/l 1.0 cm/<

EF014

light, surgical

NF

30

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

30

44

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

30

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

30

44

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

30

44

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

30

51

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

30

44

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Assist physician in performing procedure

20

26

Conforming to physician time.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13151

Cmplx rpr e/n/e/l 1.1-2.5 cm

EF014

light, surgical

NF

45

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

45

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

45

55

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

45

48

Refined equipment time to reflect typical use exclusive to patient.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

13152

Cmplx rpr e/n/e/l 2.6-7.5 cm

EF014

light, surgical

NF

50

27

Refined equipment time to reflect typical use exclusive to patient.

EF015

mayo stand

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

EF023

table, exam

NF

50

27

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

50

58

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

50

51

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

15

10

Standardized time input.

SB016

drape-cover, sterile, OR light handle

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

2

0

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

10

0

Duplicative.

13153

Cmplx rpr e/n/e/l addl 5cm/<

EF015

mayo stand

NF

45

30

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

45

30

Refined equipment time to reflect typical use exclusive to patient.

EQ114

electrosurgical generator, up to 120 watts

NF

45

30

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

45

30

Refined equipment time to reflect typical use exclusive to patient.

EQ351

Smoke Evacuator (tubing, covering, etc.) with stand

NF

45

30

Refined equipment time to reflect typical use exclusive to patient.

SC029

needle, 18-27g

NF

2

0

CMS clinical review.

Electrocautery Supply Pack

NF

1

0

Non-standard direct practice expense input.

SJ041

povidone soln (Betadine)

NF

5

0

Duplicative.

20600

Drain/inject joint/bursa

EF023

table, exam

NF

19

16

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

19

16

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

F

Discharge day management

6

0

CMS clinical review.

L037D

RN/LPN/MTA

F

Conduct phone calls/call in prescriptions

0

3

CMS clinical review.

SC029

needle, 18-27g

NF

4

2

CMS clinical review.

SC055

syringe 3ml

NF

2

1

CMS clinical review.

20605

Drain/inject joint/bursa

EF023

table, exam

NF

19

16

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

19

16

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

F

Discharge day management

6

0

CMS clinical review.

L037D

RN/LPN/MTA

F

Conduct phone calls/call in prescriptions

0

3

CMS clinical review.

SC029

needle, 18-27g

NF

4

2

CMS clinical review.

SC055

syringe 3ml

NF

2

1

CMS clinical review.

20610

Drain/inject joint/bursa

EF023

table, exam

NF

19

16

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

19

16

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

F

Discharge day management

6

0

CMS clinical review.

L037D

RN/LPN/MTA

F

Conduct phone calls/call in prescriptions

0

3

CMS clinical review.

SC029

needle, 18-27g

NF

4

2

CMS clinical review.

SC057

syringe 5-6ml

NF

2

1

CMS clinical review.

23472

Reconstruct shoulder joint

SA052

pack, post-op incision care (staple)

F

0

1

CMS clinical review.

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

23473

Revis reconst shoulder joint

SA052

pack, post-op incision care (staple)

F

0

1

CMS clinical review.

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

23474

Revis reconst shoulder joint

SA052

pack, post-op incision care (staple)

F

0

1

CMS clinical review.

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

24363

Replace elbow joint

SA052

pack, post-op incision care (staple)

F

0

1

CMS clinical review.

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

24370

Revise reconst elbow joint

SA052

pack, post-op incision care (staple)

F

0

1

CMS clinical review.

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

24371

Revise reconst elbow joint

SA052

pack, post-op incision care (staple)

F

0

1

CMS clinical review.

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

31231

Nasal endoscopy dx

ED032

printer, laser, paper

NF

43

35

Refined equipment time to reflect typical use exclusive to patient.

EF008

chair with headrest, exam, reclining

NF

43

35

Refined equipment time to reflect typical use exclusive to patient.

EQ138

instrument pack, medium ($1500 and up)

NF

0

47

Refined equipment time to reflect typical use exclusive to patient.

EQ167

light source, xenon

NF

43

35

Refined equipment time to reflect typical use exclusive to patient.

EQ170

light, fiberoptic headlight w-source

NF

43

35

Refined equipment time to reflect typical use exclusive to patient.

EQ234

suction and pressure cabinet, ENT (SMR)

NF

43

35

Refined equipment time to reflect typical use exclusive to patient.

ES013

endoscope, rigid, sinoscopy

NF

63

42

Refined equipment time to reflect typical use exclusive to patient.

ES013

endoscope, rigid, sinoscopy

NF

63

0

CMS clinical review.

ES031

video system, endoscopy (processor, digital capture, monitor, printer, cart)

NF

43

35

Refined equipment time to reflect typical use exclusive to patient.

ES036

Nasal Endoscopy Instrument Package

NF

63

0

Non-standard direct practice expense input.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

2

0

CMS clinical review.

L037D

RN/LPN/MTA

NF

Obtain vital signs

1

0

CMS clinical review.

L037D

RN/LPN/MTA

NF

Clean Surgical Instrument Package

10

15

Standardized time input.

L037D

RN/LPN/MTA

NF

Review/read X-ray, lab, and pathology reports

5

0

CMS clinical review.

SB027

gown, staff, impervious

NF

2

1

Duplicative.

SB034

mask, surgical, with face shield

NF

2

1

Duplicative.

31647

Bronchial valve init insert

L047C

RN/Respiratory Therapist

F

Complete pre-service diagnostic & referral forms

3

5

CMS clinical review.

L047C

RN/Respiratory Therapist

F

Coordinate pre-surgery services

5

3

CMS clinical review.

32554

Aspirate pleura w/o imaging

EF023

table, exam

NF

56

52

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

0

52

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Complete pre-service diagnostic & referral forms

5

0

CMS clinical review.

L037D

RN/LPN/MTA

NF

Coordinate pre-surgery services

3

1

CMS clinical review.

L037D

RN/LPN/MTA

NF

Monitor pt. following service/check tubes, monitors, drains

5

10

CMS clinical review.

SA048

pack, minimum multi-specialty visit

NF

0

1

CMS clinical review.

SA067

tray, shave prep

NF

0

1

CMS clinical review.

kit, thoracentesis

NF

1

0

CMS clincial review.

SA070

tray, thoracentesis

NF

0

1

CMS clincial review.

SA077

kit, pleural catheter insertion

NF

0

1

CMS clinical review.

SB001

cap, surgical

NF

0

2

CMS clinical review.

SB006

drape, non-sterile, sheet 40in x 60in

NF

1

0

CMS clinical review.

SB024

gloves, sterile

NF

1

2

CMS clinical review.

SB034

mask, surgical, with face shield

NF

0

2

CMS clinical review.

SB039

shoe covers, surgical

NF

0

2

CMS clinical review.

SB044

underpad 2ft x 3ft (Chux)

NF

0

1

CMS clinical review.

SG056

gauze, sterile 4in x 4in (10 pack uou)

NF

1

0

CMS clinical review.

32555

Aspirate pleura w/imaging

ED024

film processor, dry, laser

NF

58

7

Refined equipment time to reflect typical use exclusive to patient.

EF019

stretcher chair

NF

15

10

CMS clinical review.

EL015

room, ultrasound, general

NF

33

30

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

58

7

Refined equipment time to reflect typical use exclusive to patient.

L041B

Radiologic Technologist

NF

Complete pre-service diagnostic & referral forms

5

0

CMS clinical review.

L041B

Radiologic Technologist

NF

Coordinate pre-surgery services

3

1

CMS clinical review.

L041B

Radiologic Technologist

NF

Monitor pt. following service/check tubes, monitors, drains

15

10

CMS clinical review.

L041B

Radiologic Technologist

NF

Process images, complete data sheet, present images and data to the interpreting physician

5

2

CMS clinical review.

kit, thoracentesis

NF

1

0

CMS clinical review.

SA070

tray, thoracentesis

NF

0

1

CMS clinical review.

SA077

kit, pleural catheter insertion

NF

0

1

CMS clinical review.

SB001

cap, surgical

NF

0

3

CMS clinical review.

SB027

gown, staff, impervious

NF

0

1

CMS clinical review.

SB039

shoe covers, surgical

NF

0

3

CMS clinical review.

SB044

underpad 2ft x 3ft (Chux)

NF

0

1

CMS clinical review.

SG078

tape, surgical occlusive 1in (Blenderm)

NF

0

15

CMS clinical review.

SM012

disinfectant spray (Transeptic)

NF

10

0

CMS clinical review.

SM021

sanitizing cloth-wipe (patient)

NF

2

0

CMS clinical review.

32556

Insert cath pleura w/o image

EQ168

light, exam

NF

0

76

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Complete pre-service diagnostic & referral forms

5

0

CMS clinical review.

L037D

RN/LPN/MTA

NF

Coordinate pre-surgery services

3

1

CMS clinical review.

SA044

pack, moderate sedation

NF

0

1

CMS clinical review.

SA048

pack, minimum multi-specialty visit

NF

0

1

CMS clinical review.

SA067

tray, shave prep

NF

0

1

CMS clinical review.

SB001

cap, surgical

NF

0

2

CMS clinical review.

SB006

drape, non-sterile, sheet 40in x 60in

NF

1

0

CMS clinical review.

SB034

mask, surgical, with face shield

NF

0

2

CMS clinical review.

SB039

shoe covers, surgical

NF

0

2

CMS clinical review.

SB044

underpad 2ft x 3ft (Chux)

NF

0

1

CMS clinical review.

SC010

closed flush system, angiography

NF

0

1

CMS clinical review.

SG056

gauze, sterile 4in x 4in (10 pack uou)

NF

1

0

CMS clinical review.

SH065

sodium chloride 0.9% flush syringe

NF

0

1

CMS clinical review.

SH069

sodium chloride 0.9% irrigation (500-1000ml uou)

NF

0

1

CMS clinical review.

SL157

cup, sterile, 8 oz

NF

0

1

CMS clinical review.

32557

Insert cath pleura w/image

ED024

film processor, dry, laser

NF

58

7

CMS clinical review.

EF019

stretcher chair

NF

15

10

CMS clinical review.

EL007

room, CT

NF

43

40

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

60

40

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

58

7

CMS clinical review.

L046A

CT Technologist

NF

Complete pre-service diagnostic & referral forms

5

0

CMS clinical review.

L046A

CT Technologist

NF

Coordinate pre-surgery services

3

1

CMS clinical review.

L046A

CT Technologist

NF

Check dressings & wound/home care instructions/coordinate office visits/prescriptions

3

5

CMS clinical review.

L046A

CT Technologist

NF

Assist physician in performing procedure

28

30

Conforming to physician time.

SA071

kit, AccuStick II Introducer System with RO Marker

NF

1

0

CMS clinical review.

SA077

kit, pleural catheter insertion

NF

0

1

CMS clinical review.

SB001

cap, surgical

NF

2

3

CMS clinical review.

SB011

drape, sterile, fenestrated 16in x 29in

NF

1

0

CMS clinical review.

SB014

drape, sterile, three-quarter sheet

NF

1

0

CMS clinical review.

SB019

drape-towel, sterile 18in x 26in

NF

4

0

CMS clinical review.

SB024

gloves, sterile

NF

2

1

CMS clinical review.

SB027

gown, staff, impervious

NF

0

1

CMS clinical review.

SB039

shoe covers, surgical

NF

2

3

CMS clinical review.

SC049

stop cock, 3-way

NF

1

0

CMS clinical review.

SC056

syringe 50-60ml

NF

2

0

CMS clinical review.

SC058

syringe w-needle, OSHA compliant (SafetyGlide)

NF

1

0

CMS clinical review.

SD043

dilator, vessel, angiographic

NF

1

0

CMS clinical review.

SD088

guidewire

NF

1

0

CMS clinical review.

SD146

catheter percutaneous fastener (Percu-Stay)

NF

1

0

CMS clinical review.

SD161

drainage catheter, all purpose

NF

1

0

CMS clinical review.

SD163

drainage pouch, nephrostomy-biliary

NF

1

0

CMS clinical review.

SF007

blade, surgical (Bard-Parker)

NF

1

0

CMS clinical review.

SG009

applicator, sponge-tipped

NF

4

0

CMS clinical review.

SG078

tape, surgical occlusive 1in (Blenderm)

NF

0

25

CMS clinical review.

SH047

lidocaine 1%-2% inj (Xylocaine)

NF

10

0

CMS clinical review.

SJ041

povidone soln (Betadine)

NF

60

0

CMS clinical review.

SL036

cup, biopsy-specimen sterile 4oz

NF

1

0

CMS clinical review.

SL156

cup, sterile, 12-16 oz

NF

1

0

CMS clinical review.

33361

Replace aortic valve perq

L037D

RN/LPN/MTA

F

Coordinate pre-surgery services

40

10

Standardized time input.

L037D

RN/LPN/MTA

F

Schedule space and equipment in facility

8

5

Standardized time input.

L037D

RN/LPN/MTA

F

Provide pre-service education/obtain consent

20

7

Standardized time input.

L037D

RN/LPN/MTA

F

Follow-up phone calls & prescriptions

7

3

Standardized time input.

33362

Replace aortic valve open

L037D

RN/LPN/MTA

F

Coordinate pre-surgery services

40

10

Standardized time input.

L037D

RN/LPN/MTA

F

Schedule space and equipment in facility

8

5

Standardized time input.

L037D

RN/LPN/MTA

F

Provide pre-service education/obtain consent

20

7

Standardized time input.

L037D

RN/LPN/MTA

F

Follow-up phone calls & prescriptions

7

3

Standardized time input.

33363

Replace aortic valve open

L037D

RN/LPN/MTA

F

Coordinate pre-surgery services

40

10

Standardized time input.

L037D

RN/LPN/MTA

F

Schedule space and equipment in facility

8

5

Standardized time input.

L037D

RN/LPN/MTA

F

Provide pre-service education/obtain consent

20

7

Standardized time input.

L037D

RN/LPN/MTA

F

Follow-up phone calls & prescriptions

7

3

Standardized time input.

33364

Replace aortic valve open

L037D

RN/LPN/MTA

F

Coordinate pre-surgery services

40

10

Standardized time input.

L037D

RN/LPN/MTA

F

Schedule space and equipment in facility

8

5

Standardized time input.

L037D

RN/LPN/MTA

F

Provide pre-service education/obtain consent

20

7

Standardized time input.

L037D

RN/LPN/MTA

F

Follow-up phone calls & prescriptions

7

3

Standardized time input.

33365

Replace aortic valve open

L037D

RN/LPN/MTA

F

Coordinate pre-surgery services

40

10

Standardized time input.

L037D

RN/LPN/MTA

F

Schedule space and equipment in facility

8

5

Standardized time input.

L037D

RN/LPN/MTA

F

Provide pre-service education/obtain consent

20

7

Standardized time input.

L037D

RN/LPN/MTA

F

Follow-up phone calls & prescriptions

7

3

Standardized time input.

33366

#N/A

L037D

RN/LPN/MTA

F

Coordinate pre-surgery services

40

10

Standardized time input.

L037D

RN/LPN/MTA

F

Schedule space and equipment in facility

8

5

Standardized time input.

L037D

RN/LPN/MTA

F

Provide pre-service education/obtain consent

20

7

Standardized time input.

L037D

RN/LPN/MTA

F

Follow-up phone calls & prescriptions

7

3

Standardized time input.

33405

Replacement of aortic valve

L051A

RN

F

Other Clinical Activity—specify: for reference code 33406 and codes 33405 and 33430: Additional coordination between multiple specialties for complex procedures (tests, meds, scheduling, etc) prior to patient arrival at site of service.

15

0

CMS clinical review.

L051A

RN

F

Other Clinical Activity—specify: for reference code 33406 and codes 33405 and 33430: Additional coordination between multiple specialties for complex procedures (tests, meds, scheduling, etc) prior to patient arrival at site of service.

15

0

CMS clinical review.

35475

Repair arterial blockage

EL011

room, angiography

NF

51

52

Refined equipment time to reflect typical use exclusive to patient.

EQ011

ECG, 3-channel (with SpO2, NIBP, temp, resp)

NF

212

285

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EQ032

IV infusion pump

NF

212

285

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EQ168

light, exam

NF

120

52

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

F

Complete pre-service diagnostic & referral forms

5

3

CMS clinical review.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare room, equipment, supplies

4

2

Standardized time input.

SB019

drape-towel, sterile 18in x 26in

NF

4

2

CMS clinical review.

35476

Repair venous blockage

Ef027

table, instrument, mobile

NF

302

277

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EL011

room, angiography

NF

43

44

Refined equipment time to reflect typical use exclusive to patient.

EQ011

ECG, 3-channel (with SpO2, NIBP, temp, resp)

NF

137

277

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EQ032

IV infusion pump

NF

137

277

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EQ168

light, exam

NF

120

44

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

F

Schedule space and equipment in facility

3

5

CMS clinical review.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare room, equipment, supplies

4

2

Standardized time input.

SB019

drape-towel, sterile 18in x 26in

NF

4

2

CMS clinical review.

36221

Place cath thoracic aorta

EF018

stretcher

NF

272

0

CMS Code correction.

EF027

table, instrument, mobile

NF

0

272

CMS Code correction.

EL011

room, angiography

NF

49

45

Refined equipment time to reflect typical use exclusive to patient.

EQ088

contrast media warmer

NF

49

45

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

49

45

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

5

3

Standardized time input.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

L041A

Angio Technician

NF

Image Post Processing

5

0

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare room, equipment, supplies

2

7

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare and position patient/monitor patient/set up IV

2

7

CMS clinical review.

SD249

Sterile Radio-opaque ruler (le Maitre, documentation available)

NF

1

0

CMS clinical review.

36222

Place cath carotid/inom art

EF018

stretcher

NF

282

0

CMS Code correction.

EF027

table, instrument, mobile

NF

0

282

CMS Code correction.

EL011

room, angiography

NF

59

55

Refined equipment time to reflect typical use exclusive to patient.

EQ088

contrast media warmer

NF

59

55

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

59

55

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

5

3

Standardized time input.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

SD147

catheter, (Glide)

NF

1

0

CMS clinical review.

SD249

Sterile Radio-opaque ruler (le Maitre, documentation available)

NF

1

0

CMS clinical review.

36223

Place cath carotid/inom art

EF018

stretcher

NF

287

0

CMS Code correction.

EF027

table, instrument, mobile

NF

0

287

CMS Code correction.

EL011

room, angiography

NF

64

60

Refined equipment time to reflect typical use exclusive to patient.

EQ088

contrast media warmer

NF

64

60

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

64

60

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

5

3

Standardized time input.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

SD249

Sterile Radio-opaque ruler (le Maitre, documentation available)

NF

1

0

CMS clinical review.

36224

Place cath carotd art

EF018

stretcher

NF

292

0

CMS Code correction.

EF027

table, instrument, mobile

NF

0

292

CMS Code correction.

EL011

room, angiography

NF

69

65

Refined equipment time to reflect typical use exclusive to patient.

EQ088

contrast media warmer

NF

69

65

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

69

65

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

5

3

Standardized time input.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

36225

Place cath subclavian art

EF018

stretcher

NF

287

0

CMS Code correction.

EF027

table, instrument, mobile

NF

0

287

CMS Code correction.

EL011

room, angiography

NF

64

60

Refined equipment time to reflect typical use exclusive to patient.

EQ088

contrast media warmer

NF

64

60

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

64

60

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

5

3

Standardized time input.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

36226

Place cath vertebral art

EF018

stretcher

NF

292

0

CMS Code correction.

EF027

table, instrument, mobile

NF

0

292

CMS Code correction.

EL011

room, angiography

NF

69

65

Refined equipment time to reflect typical use exclusive to patient.

EQ088

contrast media warmer

NF

69

65

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

69

65

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

5

3

Standardized time input.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

36228

Place cath intracranial art

L041B

Radiologic Technologist

NF

Prepare room, equipment, supplies

1

0

CMS clinical review.

L041B

Radiologic Technologist

NF

Assisting with flouroscopy/image acquisition (75%)

23

22

CMS clinical review.

SC057

syringe 5-6ml

NF

4

0

CMS clinical review.

37197

Remove intrvas foreign body

EF027

table, instrument, mobile

NF

305

302

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EL011

room, angiography

NF

77

72

Refined equipment time to reflect typical use exclusive to patient.

EQ011

ECG, 3-channel (with SpO2, NIBP, temp, resp)

NF

305

302

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EQ032

IV infusion pump

NF

305

302

Moderate Sedation equipment—Time includes administering anesthesia, procedure time, and monitoring patient.

EQ088

contrast media warmer

NF

77

0

CMS clinical review.

EQ250

ultrasound unit, portable

NF

77

0

CMS clinical review.

ER029

film alternator (motorized film viewbox)

NF

77

72

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Greet patient, provide gowning, assure appropriate medical records are available

5

3

Standardized time input.

L037D

RN/LPN/MTA

NF

Obtain vital signs

5

3

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare room, equipment, supplies (including imaging equipment)

7

5

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare and position patient/monitor patient/set up IV

5

2

Standardized time input.

SB005

cover-condom, transducer or ultrasound probe

NF

1

0

CMS clinical review.

SB048

sheath-cover, sterile, 96in x 6in (transducer)

NF

1

0

CMS clinical review.

SD147

catheter, (Glide)

NF

1

0

CMS clinical review.

SD252

guidewire, Amplatz wire 260 cm

NF

1

0

CMS clinical review.

SH065

sodium chloride 0.9% flush syringe

NF

2

0

CMS clinical review.

47600

Removal of gallbladder

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

SA054

pack, post-op incision care (suture)

F

0

1

CMS clinical review.

47605

Removal of gallbladder

SA053

pack, post-op incision care (suture & staple)

F

1

0

CMS clinical review.

SA054

pack, post-op incision care (suture)

F

0

1

CMS clinical review.

50590

Fragmenting of kidney stone

EL014

room, radiographic-fluoroscopic

NF

86

0

Consistent with the AMA RUC's CY2011 recommendation.

EQ175

lithotriptor, with C-arm (ESWL)

NF

86

67

Refined equipment time to reflect typical use exclusive to patient.

52214

Cystoscopy and treatment

EF027

table, instrument, mobile

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

EQ153

laser (gs, uro, obg, ge) (Indigo Optima)

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

EQ167

light source, xenon

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

ES006

endoscope forceps, biopsy

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

ES007

endoscope forceps, grasping

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

ES018

fiberscope, flexible, cystoscopy

NF

100

92

Refined equipment time to reflect typical use exclusive to patient.

ES031

video system, endoscopy (processor, digital capture, monitor, printer, cart)

NF

100

65

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Review Chart

3

0

CMS clinical review.

SB019

drape-towel, sterile 18in x 26in

NF

1

0

Duplicative.

SB024

gloves, sterile

NF

0

1

CMS clinical review.

SD270

Penis clamp

NF

1

0

Not a disposable according to submitted invoice.

SH047

lidocaine 1%-2% inj (Xylocaine)

NF

50

0

Duplicative.

52224

Cystoscopy and treatment

EF027

table, instrument, mobile

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

EQ153

laser (gs, uro, obg, ge) (Indigo Optima)

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

EQ167

light source, xenon

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

ES006

endoscope forceps, biopsy

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

ES007

endoscope forceps, grasping

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

ES018

fiberscope, flexible, cystoscopy

NF

105

94

Refined equipment time to reflect typical use exclusive to patient.

ES031

video system, endoscopy (processor, digital capture, monitor, printer, cart)

NF

105

67

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Review Chart

3

0

CMS clinical review.

L037D

RN/LPN/MTA

NF

Prepare biopsy Specimen

5

2

CMS clinical review.

SB019

drape-towel, sterile 18in x 26in

NF

1

0

Duplicative.

SB024

gloves, sterile

NF

3

1

CMS clinical review.

SD270

Penis clamp

NF

1

0

Not a disposable according to submitted invoice.

SH047

lidocaine 1%-2% inj (Xylocaine)

NF

50

0

Duplicative.

SL036

cup, biopsy-specimen sterile 4oz

NF

6

3

CMS clinical review.

52287

Cystoscopy chemodenervation

EF027

table, instrument, mobile

NF

78

49

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

78

49

Refined equipment time to reflect typical use exclusive to patient.

EQ170

light, fiberoptic headlight w-source

NF

78

49

Refined equipment time to reflect typical use exclusive to patient.

ES018

fiberscope, flexible, cystoscopy

NF

78

76

Refined equipment time to reflect typical use exclusive to patient.

ES031

video system, endoscopy (processor, digital capture, monitor, printer, cart)

NF

78

49

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Assist physician in performing procedure

20

21

Conforming to physician time.

SH048

lidocaine 2% jelly, topical (Xylocaine)

NF

10

0

Duplicative.

53850

Prostatic microwave thermotx

EF020

stretcher, endoscopy

NF

99

85

Refined equipment time to reflect typical use exclusive to patient.

EF027

table, instrument, mobile

NF

99

85

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

169

152

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

F

169

152

Refined equipment time to reflect typical use exclusive to patient.

EQ037

TUMT system control unit

NF

99

85

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

169

152

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

F

169

152

Refined equipment time to reflect typical use exclusive to patient.

EQ250

ultrasound unit, portable

NF

99

85

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Prepare room, equipment, supplies

2

4

CMS clinical review.

L037D

RN/LPN/MTA

NF

Setup ultrasound probe

5

0

CMS clinical review.

L037D

RN/LPN/MTA

NF

Setup TUMT machine

5

0

CMS clinical review.

L037D

RN/LPN/MTA

NF

Clean TUMT machine

3

0

CMS clinical review.

SB022

gloves, non-sterile

NF

3

2

CMS clinical review.

SB024

gloves, sterile

NF

3

2

CMS clinical review.

SH047

lidocaine 1%-2% inj (Xylocaine)

NF

3

30

CMS clinical review.

64612

Destroy nerve face muscle

EL006

lane, screening (oph)

F

39

27

Refined equipment time to reflect typical use exclusive to patient.

EL006

lane, screening (oph)

NF

48

45

Refined equipment time to reflect typical use exclusive to patient.

SC031

needle, 30g

F

0

1

CMS clinical review.

64615

Chemodenerv musc migraine

EF023

table, exam

NF

24

18

Refined equipment time to reflect typical use exclusive to patient.

65800

Drainage of eye

EL006

Lane, Screening

NF

21

22

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

21

22

Refined equipment time to reflect typical use exclusive to patient.

67810

Biopsy eyelid & lid margin

EF014

light, surgical

NF

20

22

Refined equipment time to reflect typical use exclusive to patient.

EF031

table, power

NF

20

22

Refined equipment time to reflect typical use exclusive to patient.

EQ110

electrocautery-hyfrecator, up to 45 watts

NF

1

22

Refined equipment time to reflect typical use exclusive to patient.

EQ137

instrument pack, basic ($500-$1499)

NF

1

30

Refined equipment time to reflect typical use exclusive to patient.

SB011

drape, sterile, fenestrated 16in x 29in

NF

0

1

CMS clinical review.

SB019

drape-towel, sterile 18in x 26in

NF

4

1

CMS clinical review.

SC029

needle, 18-27g

NF

1

0

Standardized time input.

72040

X-ray exam neck spine 3/<vws

ED025

film processor, wet

NF

20

4

Refined equipment time to reflect typical use exclusive to patient.

EL012

room, basic radiology

NF

20

13

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

20

4

Refined equipment time to reflect typical use exclusive to patient.

Film jacket or jacket insert

NF

1

0

Non-standard direct practice expense input.

72050

X-ray exam neck spine 4/5vws

ED025

film processor, wet

NF

28

6

Refined equipment time to reflect typical use exclusive to patient.

EL012

room, basic radiology

NF

28

19

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

28

6

Refined equipment time to reflect typical use exclusive to patient.

Film jacket or jacket insert

NF

1

0

Non-standard direct practice expense input.

72052

X-ray exam neck spine 6/>vws

ED025

film processor, wet

NF

36

8

Refined equipment time to reflect typical use exclusive to patient.

EL012

room, basic radiology

NF

36

25

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

36

8

Refined equipment time to reflect typical use exclusive to patient.

Film jacket or jacket insert

NF

1

0

Non-standard direct practice expense input.

72191

Ct angiograph pelv w/o&w/dye

EL007

room, CT

NF

101

40

Refined equipment time to reflect typical use exclusive to patient.

L041B

Radiologic Technologist

NF

Retrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information

0

5

CMS clinical review.

L041B

Radiologic Technologist

NF

Greet patient, provide gowning, assure appropriate medical records are available

0

3

CMS clinical review.

L041B

Radiologic Technologist

NF

Education/instruction/counseling/obtain consent

0

2

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare room, equipment, supplies

0

2

Standardized time input.

L041B

Radiologic Technologist

NF

Prepare and position patient/monitor patient/set up IV

0

7

CMS clinical review.

L041B

Radiologic Technologist

NF

Aquire images

0

28

CMS clinical review.

L041B

Radiologic Technologist

NF

Clean room/equipment by physician staff

0

3

CMS clinical review.

L046A

CT Technologist

NF

Retrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information

5

0

CMS clinical review.

L046A

CT Technologist

NF

Greet patient, provide gowning, assure appropriate medical records are available

3

0

CMS clinical review.

L046A

CT Technologist

NF

Education/instruction/counseling/obtain consent

2

0

CMS clinical review.

L046A

CT Technologist

NF

Prepare room, equipment, supplies

5

0

CMS clinical review.

L046A

CT Technologist

NF

Prepare and position patient/monitor patient/set up IV

7

0

CMS clinical review.

L046A

CT Technologist

NF

Aquire images

28

0

CMS clinical review.

L046A

CT Technologist

NF

Clean room/equipment by physician staff

3

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

1

0.1

CMS clinical review.

72192

Ct pelvis w/o dye

ED024

film processor, dry, laser

NF

5

0

CMS clinical review.

ED032

printer, laser, paper

NF

0

5

CMS clinical review.

EL007

room, CT

NF

45

22

CMS clinical review.

L046A

CT Technologist

NF

Pre-Service Period

6

4

CMS clinical review.

SK013

computer media, dvd

NF

1

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK091

x-ray envelope

NF

1

0

CMS clinical review.

SK098

film, x-ray, laser print

NF

4

8

CMS clinical review.

72193

Ct pelvis w/dye

ED024

film processor, dry, laser

NF

5

0

CMS clinical review.

ED032

printer, laser, paper

NF

0

5

CMS clinical review.

EL007

room, CT

NF

40

32

CMS clinical review.

L046A

CT Technologist

NF

Pre-Service Period

7

4

CMS clinical review.

L046A

CT Technologist

NF

Service Period

40

43

CMS clinical review.

SB006

drape, non-sterile, sheet 40in x 60in

NF

1

0

CMS clinical review.

SB014

drape, sterile, three-quarter sheet

NF

0

1

CMS clinical review.

SC001

angiocatheter 14g-24g

NF

1

0

CMS clinical review.

SC002

angiocatheter set

NF

0

1

CMS clinical review.

SC025

needle, 14-20g, biopsy

NF

0

1

CMS clinical review.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

SC059

syringe, 25ml (MRI power injector)

NF

0

1

CMS clinical review.

SG068

plaster bandage (4in x 5yd uou)

NF

1

0

CMS clinical review.

SG075

tape, elastic, 1in (Elastoplast, Elasticon) (5yd uou)

NF

0

6

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

6

0

CMS clinical review.

SH065

sodium chloride 0.9% flush syringe

NF

0

15

CMS clinical review.

SK013

computer media, dvd

NF

1

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK091

x-ray envelope

NF

1

0

CMS clinical review.

72194

Ct pelvis w/o & w/dye

ED024

film processor, dry, laser

NF

10

7

CMS clinical review.

EL007

room, CT

NF

54

39

CMS clinical review.

ER029

film alternator (motorized film viewbox)

NF

10

7

CMS clinical review.

L046A

CT Technologist

NF

Pre-Service Period

7

4

CMS clinical review.

L046A

CT Technologist

NF

Service Period

54

52

CMS clinical review.

SC025

needle, 14-20g, biopsy

NF

0

1

CMS clinical review.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

SK013

computer media, dvd

NF

1

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK091

x-ray envelope

NF

1

0

CMS clinical review.

SK098

film, x-ray, laser print

NF

0

8

CMS clinical review.

73221

Mri joint upr extrem w/o dye

ED024

film processor, dry, laser

NF

63

33

Refined equipment time to reflect typical use exclusive to patient.

EL008

room, MR

NF

63

33

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

63

33

Refined equipment time to reflect typical use exclusive to patient.

L047A

MRI Technologist

NF

Prepare room, equipment, supplies

5

3

CMS clinical review.

L047A

MRI Technologist

NF

Prepare and position patient/monitor patient/set up IV

3

2

Standardized time input.

L047A

MRI Technologist

NF

Escort patient from exam room due to magnetic sensitivity

2

0

Non-standard direct practice expense input.

Insert folder

NF

1

0

Non-standard direct practice expense input.

73721

Mri jnt of lwr extre w/o dye

ED024

film processor, dry, laser

NF

63

33

Refined equipment time to reflect typical use exclusive to patient.

EL008

room, MR

NF

63

33

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

63

33

Refined equipment time to reflect typical use exclusive to patient.

L047A

MRI Technologist

NF

Prepare room, equipment, supplies

5

3

CMS clinical review.

L047A

MRI Technologist

NF

Prepare and position patient/monitor patient/set up IV

3

2

Standardized time input.

L047A

MRI Technologist

NF

Escort patient from exam room due to magnetic sensitivity

2

0

Non-standard direct practice expense input.

Insert folder

NF

1

0

Non-standard direct practice expense input.

74150

Ct abdomen w/o dye

ED024

film processor, dry, laser

NF

5

0

CMS clinical review.

ED032

printer, laser, paper

NF

0

5

CMS clinical review.

EL007

room, CT

NF

32

22

CMS clinical review.

L046A

CT Technologist

NF

Pre-Service Period

6

4

CMS clinical review.

SK013

computer media, dvd

NF

1

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK091

x-ray envelope

NF

1

0

CMS clinical review.

SK098

film, x-ray, laser print

NF

4

8

CMS clinical review.

74160

Ct abdomen w/dye

ED024

film processor, dry, laser

NF

7

0

CMS clinical review.

ED032

printer, laser, paper

NF

0

5

CMS clinical review.

EL007

room, CT

NF

47

32

CMS clinical review.

ER029

film alternator (motorized film viewbox)

NF

7

5

CMS clinical review.

L046A

CT Technologist

NF

Pre-Service Period

7

4

CMS clinical review.

L046A

CT Technologist

NF

Service Period

47

43

CMS clinical review.

SB006

drape, non-sterile, sheet 40in x 60in

NF

1

0

CMS clinical review.

SB014

drape, sterile, three-quarter sheet

NF

0

1

CMS clinical review.

SC001

angiocatheter 14g-24g

NF

1

0

CMS clinical review.

SC002

angiocatheter set

NF

0

1

CMS clinical review.

SC025

needle, 14-20g, biopsy

NF

0

1

CMS clinical review.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

SC059

syringe, 25ml (MRI power injector)

NF

0

1

CMS clinical review.

SG075

tape, elastic, 1in (Elastoplast, Elasticon) (5yd uou)

NF

0

6

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

6

0

CMS clinical review.

SH065

sodium chloride 0.9% flush syringe

NF

0

15

CMS clinical review.

SH068

sodium chloride 0.9% inj bacteriostatic (30ml uou)

NF

1

0

CMS clinical review.

SK013

computer media, dvd

NF

1

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK091

x-ray envelope

NF

1

0

CMS clinical review.

SK098

film, x-ray, laser print

NF

6

4

CMS clinical review.

74170

Ct abdomen w/o & w/dye

ED024

film processor, dry, laser

NF

15

7

Refined equipment time to reflect typical use exclusive to patient.

EL007

room, CT

NF

65

39

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

15

7

Refined equipment time to reflect typical use exclusive to patient.

L046A

CT Technologist

NF

Retrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information and confirm contrast protocol with interpreting MD

7

4

CMS clinical review.

L046A

CT Technologist

NF

Assist physician in performing procedure

32

27

CMS clinical review.

L046A

CT Technologist

NF

Image Post Processing

15

7

CMS clinical review.

SB006

drape, non-sterile, sheet 40in x 60in

NF

1

0

CMS clinical review.

SB014

drape, sterile, three-quarter sheet

NF

0

1

CMS clinical review.

SC001

angiocatheter 14g-24g

NF

1

0

CMS clinical review.

SC002

angiocatheter set

NF

0

1

CMS clinical review.

SC025

needle, 14-20g, biopsy

NF

0

1

CMS clinical review.

SC029

needle, 18-27g

NF

1

0

CMS clinical review.

SC059

syringe, 25ml (MRI power injector)

NF

0

1

CMS clinical review.

SG050

gauze, non-sterile 2in x 2in

NF

0

1

CMS clinical review.

SG075

tape, elastic, 1in (Elastoplast, Elasticon) (5yd uou)

NF

0

6

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

6

0

CMS clinical review.

SH016

barium suspension (Polibar)

NF

900

0

CMS clinical review.

SH065

sodium chloride 0.9% flush syringe

NF

0

15

CMS clinical review.

SH068

sodium chloride 0.9% inj bacteriostatic (30ml uou)

NF

1

0

CMS clinical review.

SK013

computer media, dvd

NF

1

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK091

x-ray envelope

NF

1

0

CMS clinical review.

SK098

film, x-ray, laser print

NF

14

8

CMS clinical review.

74175

Ct angio abdom w/o & w/dye

EL007

room, CT

NF

101

40

Refined equipment time to reflect typical use exclusive to patient.

L041B

Radiologic Technologist

NF

Retrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information

0

5

CMS clinical review.

L041B

Radiologic Technologist

NF

Greet patient, provide gowning, assure appropriate medical records are available

0

3

CMS clinical review.

L041B

Radiologic Technologist

NF

Education/instruction/counseling/obtain consent

0

2

CMS clinical review.

L041B

Radiologic Technologist

NF

Prepare room, equipment, supplies

0

2

Standardized time input.

L041B

Radiologic Technologist

NF

Prepare and position patient/monitor patient/set up IV

0

7

CMS clinical review.

L041B

Radiologic Technologist

NF

Aquire images

0

28

CMS clinical review.

L041B

Radiologic Technologist

NF

Clean room/equipment by physician staff

0

3

CMS clinical review.

L046A

CT Technologist

NF

Retrieve prior appropriate imaging exams and hang for MD review, verify orders, review the chart to incorporate relevant clinical information

5

0

CMS clinical review.

L046A

CT Technologist

NF

Greet patient, provide gowning, assure appropriate medical records are available

3

0

CMS clinical review.

L046A

CT Technologist

NF

Education/instruction/counseling/obtain consent

2

0

CMS clinical review.

L046A

CT Technologist

NF

Prepare room, equipment, supplies

5

0

CMS clinical review.

L046A

CT Technologist

NF

Prepare and position patient/monitor patient/set up IV

7

0

CMS clinical review.

L046A

CT Technologist

NF

Aquire images

28

0

CMS clinical review.

L046A

CT Technologist

NF

Clean room/equipment by physician staff

3

0

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

1

0.1

CMS clinical review.

74176

Ct abd & pelvis

ED032

printer, laser, paper

NF

8

7

CMS clinical review.

ER029

film alternator (motorized film viewbox)

NF

27

7

CMS clinical review.

L046A

CT Technologist

NF

Service Period

40

39

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

74177

Ct abd & pelv w/contrast

ED032

printer, laser, paper

NF

10

7

CMS clinical review.

EL007

room, CT

NF

42

39

CMS clinical review.

ER029

film alternator (motorized film viewbox)

NF

42

7

CMS clinical review.

L046A

CT Technologist

NF

Pre-Service Period

7

6

CMS clinical review.

L046A

CT Technologist

NF

Service Period

58

52

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK098

film, x-ray, laser print

NF

10

8

CMS clinical review.

74178

Ct abd & pelv 1/> regns

ED032

printer, laser, paper

NF

20

10

CMS clinical review.

EL007

room, CT

NF

57

48

CMS clinical review.

ER029

film alternator (motorized film viewbox)

NF

57

10

CMS clinical review.

L046A

CT Technologist

NF

Pre-Service Period

7

6

CMS clinical review.

L046A

CT Technologist

NF

Service Period

83

64

CMS clinical review.

SK016

computer media, optical disk 2.6gb

NF

0

0.1

CMS clinical review.

SK076

slide sleeve (photo slides)

NF

0

1

CMS clinical review.

SK098

film, x-ray, laser print

NF

23

16

CMS clinical review.

76830

Transvaginal us non-ob

ED024

film processor, dry, laser

NF

5

0

CMS clinical review.

ED032

printer, laser, paper

NF

1

0

CMS clinical review.

EF027

table, instrument, mobile

NF

0

36

Refined equipment time to reflect typical use exclusive to patient.

EF034

table, ultrasound

NF

0

36

Refined equipment time to reflect typical use exclusive to patient.

EL015

room, ultrasound, general

NF

37

0

CMS clinical review.

EQ250

ultrasound unit, portable

NF

0

36

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

10

0

CMS clinical review.

ER086

ultrasound probe

NF

0

37

Refined equipment time to reflect typical use exclusive to patient.

L051B

RN/Diagnostic Medical Sonographer

NF

Clean room/equipment by physician staff

3

2

CMS clinical review.

SB026

gown, patient

NF

0

1

CMS clinical review.

SJ033

lubricating jelly (Surgilube)

NF

1

0

CMS clinical review.

76872

Us transrectal

EF027

table, instrument, mobile

NF

68

34

Refined equipment time to reflect typical use exclusive to patient.

EF034

table, ultrasound

NF

68

34

Refined equipment time to reflect typical use exclusive to patient.

EQ250

ultrasound unit, portable

NF

68

34

Refined equipment time to reflect typical use exclusive to patient.

ER086

ultrasound probe

NF

68

35

Refined equipment time to reflect typical use exclusive to patient.

L051B

RN/Diagnostic Medical Sonographer

NF

Retrieve prior images for comparison:

0

3

CMS clinical review.

L051B

RN/Diagnostic Medical Sonographer

NF

Review Chart

3

0

CMS clinical review.

L051B

RN/Diagnostic Medical Sonographer

NF

Obtain vital signs

3

0

CMS clinical review.

L051B

RN/Diagnostic Medical Sonographer

NF

Prepare room, equipment, supplies

2

3

CMS clinical review.

L051B

RN/Diagnostic Medical Sonographer

NF

Prepare ultrasound probe

5

0

CMS clinical review.

L051B

RN/Diagnostic Medical Sonographer

NF

Obtain vital signs

3

0

CMS clinical review.

L051B

RN/Diagnostic Medical Sonographer

NF

Clean room/equipment by physician staff

3

2

CMS clinical review.

SB012

drape, sterile, for Mayo stand

NF

1

0

CMS clinical review.

SC019

iv tubing (extension)

NF

1

0

CMS clinical review.

SH048

lidocaine 2% jelly, topical (Xylocaine)

NF

10

0

CMS clinical review.

SJ001

alcohol isopropyl 70%

NF

5

0

CMS clinical review.

SJ032

lubricating jelly (K-Y) (5gm uou)

NF

2

0

CMS clinical review.

SM018

glutaraldehyde 3.4% (Cidex, Maxicide, Wavicide)

NF

32

0

CMS clinical review.

SM019

glutaraldehyde test strips (Cidex, Metrex)

NF

1

0

CMS clinical review.

SM022

sanitizing cloth-wipe (surface, instruments, equipment)

NF

2

0

CMS clinical review.

77003

Fluoroguide for spine inject

ED025

film processor, wet

NF

3

2

Refined equipment time to reflect typical use exclusive to patient.

EL014

room, radiographic-fluoroscopic

NF

9

18

Refined equipment time to reflect typical use exclusive to patient.

ER029

film alternator (motorized film viewbox)

NF

3

2

Refined equipment time to reflect typical use exclusive to patient.

L041B

Radiologic Technologist

NF

Clean room/equipment by physician staff

2

1

CMS clinical review.

L041B

Radiologic Technologist

NF

Process films, hang films and review study with interpreting MD prior to patient discharge

3

2

CMS clinical review.

77080

Dxa bone density axial

ER078

phantom, spine, DXA calibration check

NF

1

2

Refined equipment time to reflect typical use exclusive to patient.

77301

Radiotherapy dose plan imrt

ED011

computer system, record and verify

NF

20

0

CMS clinical review.

ED033

treatment planning system, IMRT (Corvus w-Peregrine 3D Monte Carlo)

NF

376

330

CMS clinical review.

ER005

IMRT CT-based simulator

NF

58

47

CMS clinical review.

ER014

chamber, Farmer-type

NF

45

47

Refined equipment time to reflect typical use exclusive to patient.

ER028

electrometer, PC-based, dual channel

NF

45

47

Refined equipment time to reflect typical use exclusive to patient.

ER050

phantom, solid water calibration check

NF

45

47

Refined equipment time to reflect typical use exclusive to patient.

ER089

IMRT accelerator

NF

45

47

CMS clinical review.

L037D

RN/LPN/MTA

NF

Obtain vital signs

3

0

CMS clinical review.

78012

Thyroid uptake measurement

EF010

chair, thyroid imaging

NF

40

30

Refined equipment time to reflect typical use exclusive to patient.

ER063

thyroid uptake system

NF

40

30

Refined equipment time to reflect typical use exclusive to patient.

78013

Thyroid imaging w/blood flow

ER032

gamma camera system, single-dual head

NF

48

38

Refined equipment time to reflect typical use exclusive to patient.

78014

Thyroid imaging w/blood flow

EF010

chair, thyroid imaging

NF

65

55

Refined equipment time to reflect typical use exclusive to patient.

ER032

gamma camera system, single-dual head

NF

65

50

Refined equipment time to reflect typical use exclusive to patient.

ER063

thyroid uptake system

NF

65

55

Refined equipment time to reflect typical use exclusive to patient.

78070

Parathyroid planar imaging

ER032

gamma camera system, single-dual head

NF

73

68

Refined equipment time to reflect typical use exclusive to patient.

78071

Parathyrd planar w/wo subtrj

ER032

gamma camera system, single-dual head

NF

86

81

Refined equipment time to reflect typical use exclusive to patient.

86153

Cell enumeration phys interp

EP106

CELLSEARCH system

NF

16

0

Laboratory physician interpretation code.

EP107

Laboratory Information System

NF

4

0

Laboratory physician interpretation code.

L045A

Cytotechnologist

NF

Collate images and review with Pathologist

5

0

Laboratory physician interpretation code.

88120

Cytp urne 3-5 probes ea spec

EP088

ThermoBrite

NF

107

321

CMS clinical review.

EP092

Olympus BX41 Fluorescent Microscope (without filters or camera )

NF

1.33

73.00

CMS clinical review.

88121

Cytp urine 3-5 probes cmptr

EP088

ThermoBrite

NF

26.75

160.50

CMS clinical review.

EP090

IkoniLan Software

NF

2.97

29.70

CMS clinical review.

EP091

IkoniScope

NF

2.97

29.70

CMS clinical review.

88300

Surgical path gross

courier transportation cost

NF

2.02

0

Indirect Practice Expense.

Copath System with maintenance contract

NF

3

0

Indirect Practice Expense.

Copath software

NF

3

0

Indirect Practice Expense.

88302

Tissue exam by pathologist

specimen, solvent, and formalin disposal cost

NF

0.18

0

Indirect Practice Expense.

courier transportation cost

NF

2.02

0

Indirect Practice Expense.

equipment maintenance cost

NF

0.61

0

Included in equipment cost per minute calculation.

Copath System with maintenance contract

NF

3

0

Indirect Practice Expense.

Copath software

NF

3

0

Indirect Practice Expense.

88304

Tissue exam by pathologist

specimen, solvent, and formalin disposal cost

NF

0.35

0

Indirect Practice Expense.

courier transportation cost

NF

2.02

0

Indirect Practice Expense.

equipment maintenance cost

NF

0.61

0

Included in equipment cost per minute calculation.

Copath System with maintenance contract

NF

5

0

Indirect Practice Expense.

Copath software

NF

5

0

Indirect Practice Expense.

88305

Tissue exam by pathologist

specimen, solvent, and formalin disposal cost

NF

0.35

0

Indirect Practice Expense.

courier transportation cost

NF

2.02

0

Indirect Practice Expense.

equipment maintenance cost

NF

0.61

0

Included in equipment cost per minute calculation.

Copath System with maintenance contract

NF

4

0

Indirect Practice Expense.

Copath software

NF

4

0

Indirect Practice Expense.

88307

Tissue exam by pathologist

specimen, solvent, and formalin disposal cost

NF

1.85

0

Indirect Practice Expense.

courier transportation cost

NF

2.02

0

Indirect Practice Expense.

equipment maintenance cost

NF

0.61

0

Included in equipment cost per minute calculation.

Copath System with maintenance contract

NF

10

0

Indirect Practice Expense.

Copath software

NF

10

0

Indirect Practice Expense.

88309

Tissue exam by pathologist

specimen, solvent, and formalin disposal cost

NF

1.85

0

Indirect Practice Expense.

courier transportation cost

NF

2.02

0

Indirect Practice Expense.

equipment maintenance cost

NF

0.61

0

Included in equipment cost per minute calculation.

Copath System with maintenance contract

NF

12

0

Indirect Practice Expense.

Copath software

NF

12

0

Indirect Practice Expense.

90791

Psych diagnostic evaluation

NF

2012 Fully Implemented PE RVUs maintained.

90832

Psytx pt&/family 30 minutes

NF

2012 Fully Implemented PE RVUs maintained.

90834

Psytx pt&/family 45 minutes

NF

2012 Fully Implemented PE RVUs maintained.

90836

Psytx pt&/fam w/e&m 45 min

NF

2012 Fully Implemented PE RVUs maintained.

91112

Gi wireless capsule measure

Activation Fixture

NF

5

0

CMS clinical review.

Docking Station

NF

40

0

CMS clinical review.

MotiliGI software

NF

40

0

CMS clinical review.

EQ352

Data receiver

NF

7,220

2,880

CMS clinical review.

SA048

pack, minimum multi-specialty visit

NF

1

0

CMS clinical review.

SmartBar

NF

1

0

CMS clinical review.

92081

Visual field examination(s)

SA050

pack, ophthalmology visit (no dilation)

NF

1

0

CMS clinical review.

EL006

lane, screening (oph)

NF

12

17

Refined equipment time to reflect typical use exclusive to patient.

EQ029

Humphrey field analyzer

NF

12

17

Refined equipment time to reflect typical use exclusive to patient.

EQ165

lens set, trial, full diameter, w-frame

NF

12

17

CMS clinical review.

92082

Visual field examination(s)

SA050

pack, ophthalmology visit (no dilation)

NF

1

0

CMS clinical review.

EL006

lane, screening (oph)

NF

22

27

Refined equipment time to reflect typical use exclusive to patient.

EQ029

Humphrey field analyzer

NF

22

27

Refined equipment time to reflect typical use exclusive to patient.

EQ165

lens set, trial, full diameter, w-frame

NF

22

27

CMS clinical review.

92083

Visual field examination(s)

SA050

pack, ophthalmology visit (no dilation)

NF

1

0

CMS clinical review.

EL006

lane, screening (oph)

NF

32

37

Refined equipment time to reflect typical use exclusive to patient.

EQ029

Humphrey field analyzer

NF

32

37

Refined equipment time to reflect typical use exclusive to patient.

EQ165

lens set, trial, full diameter, w-frame

NF

32

37

CMS clinical review.

92235

Eye exam with photos

ED008

camera, retinal (TRC 50IX, w-ICG, filters, motor drives)

NF

60

35

Refined equipment time to reflect typical use exclusive to patient.

EF030

table, motorized (for instruments-equipment)

NF

60

35

Refined equipment time to reflect typical use exclusive to patient.

EL005

lane, exam (oph)

NF

60

35

Refined equipment time to reflect typical use exclusive to patient.

L038A

COMT/COT/RN/CST

NF

Monitor pt. following service/check tubes, monitors, drains

5

2

CMS clinical review.

L039A

Certified Retinal Angio

NF

Assist physician in performing procedure

40

20

CMS clinical review.

93015

Cardiovascular stress test

EF023

table, exam

NF

58

46

Refined equipment time to reflect typical use exclusive to patient.

EQ078

cardiac monitor w-treadmill (12-lead PC-based ECG)

NF

58

46

Refined equipment time to reflect typical use exclusive to patient.

L051A

RN

NF

Assist physician in performing procedure

20

14

CMS clinical review.

93017

Cardiovascular stress test

EF023

table, exam

NF

58

46

Refined equipment time to reflect typical use exclusive to patient.

EQ078

cardiac monitor w-treadmill (12-lead PC-based ECG)

NF

58

46

Refined equipment time to reflect typical use exclusive to patient.

L051A

RN

NF

Assist physician in performing procedure

20

14

CMS clinical review.

L051A

RN

NF

Complete diagnostic forms, lab & X-ray requisitions

0

4

CMS clinical review.

93925

Lower extremity study

ED011

computer system, record and verify

NF

10

0

CMS clinical review.

ED021

computer, desktop, w-monitor

NF

95

7

Refined equipment time to reflect typical use exclusive to patient.

ED025

film processor, wet

NF

10

7

Refined equipment time to reflect typical use exclusive to patient.

ED034

video SVHS VCR (medical grade)

NF

95

0

CMS clinical review.

EL016

room, ultrasound, vascular

NF

95

76

Refined equipment time to reflect typical use exclusive to patient.

ER067

x-ray view box, 4 panel

NF

10

7

Refined equipment time to reflect typical use exclusive to patient.

L054A

Vascular Technologist

NF

Provide pre-service education/obtain consent

3

2

CMS clinical review.

L054A

Vascular Technologist

NF

Prepare room, equipment, supplies

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Prepare and position patient

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Other Clinical Activity: Collate preliminary data, arrange images, archive

10

7

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: Record patient history

1

0

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: QA documentation

4

0

CMS clinical review.

SK086

video tape, VHS

NF

1

0

CMS clinical review.

93926

Lower extremity study

ED011

computer system, record and verify

NF

10

0

CMS clinical review.

ED021

computer, desktop, w-monitor

NF

59

4

Refined equipment time to reflect typical use exclusive to patient.

ED025

film processor, wet

NF

10

4

Refined equipment time to reflect typical use exclusive to patient.

ED034

video SVHS VCR (medical grade)

NF

59

0

CMS clinical review.

EL016

room, ultrasound, vascular

NF

59

42

Refined equipment time to reflect typical use exclusive to patient.

ER067

x-ray view box, 4 panel

NF

10

4

Refined equipment time to reflect typical use exclusive to patient.

L054A

Vascular Technologist

NF

Provide pre-service education/obtain consent

3

2

CMS clinical review.

L054A

Vascular Technologist

NF

Prepare room, equipment, supplies

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Prepare and position patient

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Other Clinical Activity: Collate preliminary data, arrange images, archive

8

4

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: Record patient history

1

0

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: QA documentation

4

0

CMS clinical review.

SK086

video tape, VHS

NF

1

0

CMS clinical review.

93970

Extremity study

ED011

computer system, record and verify

NF

10

0

CMS clinical review.

ED021

computer, desktop, w-monitor

NF

71

7

Refined equipment time to reflect typical use exclusive to patient.

ED025

film processor, wet

NF

10

7

Refined equipment time to reflect typical use exclusive to patient.

ED034

video SVHS VCR (medical grade)

NF

71

0

CMS clinical review.

EL016

room, ultrasound, vascular

NF

71

52

Refined equipment time to reflect typical use exclusive to patient.

ER067

x-ray view box, 4 panel

NF

10

7

Refined equipment time to reflect typical use exclusive to patient.

L054A

Vascular Technologist

NF

Provide pre-service education/obtain consent

3

2

CMS clinical review.

L054A

Vascular Technologist

NF

Prepare room, equipment, supplies

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Prepare and position patient

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Other Clinical Activity: Collate preliminary data, arrange images, archive

10

7

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: Record patient history

1

0

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: QA documentation

4

0

CMS clinical review.

SK086

video tape, VHS

NF

1

0

CMS clinical review.

93971

Extremity study

ED011

computer system, record and verify

NF

10

0

CMS clinical review.

ED021

computer, desktop, w-monitor

NF

45

4

Refined equipment time to reflect typical use exclusive to patient.

ED025

film processor, wet

NF

10

4

Refined equipment time to reflect typical use exclusive to patient.

ED034

video SVHS VCR (medical grade)

NF

45

0

CMS clinical review.

EL016

room, ultrasound, vascular

NF

45

30

CMS clinical review.

ER067

x-ray view box, 4 panel

NF

10

4

Refined equipment time to reflect typical use exclusive to patient.

L054A

Vascular Technologist

NF

Provide pre-service education/obtain consent

3

2

CMS clinical review.

L054A

Vascular Technologist

NF

Prepare room, equipment, supplies

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Prepare and position patient

3

2

Standardized time input.

L054A

Vascular Technologist

NF

Other Clinical Activity: Collate preliminary data, arrange images, archive

6

4

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: Record patient history

1

0

CMS clinical review.

L054A

Vascular Technologist

NF

Other Clinical Activity: QA documentation

4

0

CMS clinical review.

SB006

drape, non-sterile, sheet 40in x 60in

NF

2

1

CMS clinical review.

SK086

video tape, VHS

NF

1

0

CMS clinical review.

95076

Ingest challenge ini 120 min

EF023

table, exam

NF

141

133

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

141

133

Refined equipment time to reflect typical use exclusive to patient.

L037D

RN/LPN/MTA

NF

Prepare testing doses

15

7

CMS clinical review.

95115

Immunotherapy one injection

EF040

refrigerator, vaccine, commercial grade, w-alarm lock

NF

15

0

CMS clinical review.

95117

Immunotherapy injections

EF041

x-ray machine, portable

NF

17

0

CMS clinical review.

95782

Polysom <6 yrs 4/> paramtrs

EF003

bedroom furniture (hospital bed, table, reclining chair)

NF

660

602

Refined equipment time to reflect typical use exclusive to patient.

Crib

NF

660

0

CMS clinical review.

EQ134

impedance meter, 32-channel

NF

660

602

Refined equipment time to reflect typical use exclusive to patient.

EQ272

sleep diagnostic system, attended (w-acquisition station, review master, computer)

NF

660

662

Refined equipment time to reflect typical use exclusive to patient.

Capnograph

NF

660

0

Duplicative.

ER088

Infrared illuminator

NF

660

602

Refined equipment time to reflect typical use exclusive to patient.

L047B

REEGT

NF

Provide pre-service education/obtain consent

5

3

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Set up and calibrate all monitoring and recording equipment (initial), including capnograph (for child)

6

5

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Measure and mark head and face. Apply and secure electrodes to head and face. Check impedances. Reapply electrodes as needed. (1.5 min per electrode for child, 1 min per electrode for adult)

30

20

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning and snoring

0

15

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning, snoring and capnography

20

0

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Daytime tech reviews and edits recording, marks artifacts, scores sleep stages, performs evaluation of physiological changes

100

97

CMS clinical review.

95783

Polysom <6 yrs cpap/bilvl

EF003

bedroom furniture (hospital bed, table, reclining chair)

NF

660

647

Refined equipment time to reflect typical use exclusive to patient.

Crib

NF

660

0

CMS clinical review.

EQ134

impedance meter, 32-channel

NF

660

647

Refined equipment time to reflect typical use exclusive to patient.

EQ272

sleep diagnostic system, attended (w-acquisition station, review master, computer)

NF

660

707

Refined equipment time to reflect typical use exclusive to patient.

Capnograph

NF

660

0

Duplicative.

ER088

Infrared illuminator

NF

660

647

Refined equipment time to reflect typical use exclusive to patient.

L047B

REEGT

NF

Provide pre-service education/obtain consent

5

3

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Set up and calibrate all monitoring and recording equipment (initial), including capnograph (for child)

6

5

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Measure and mark head and face. Apply and secure electrodes to head and face. Check impedances. Reapply electrodes as needed. (1.5 min per electrode for child, 1 min per electrode for adult)

30

20

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning and snoring

0

15

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Apply recording devices for cardio-respiratory, leg movements, body positioning, snoring and capnography

20

0

CMS clinical review.

L047B

REEGT

NF

Other Clinical Activity—specify: Daytime tech reviews and edits recording, marks artifacts, scores sleep stages, performs evaluation of physiological changes

100

97

CMS clinical review.

95861

Muscle test 2 limbs

EF023

table, exam

NF

44

41

Refined equipment time to reflect typical use exclusive to patient.

EQ024

EMG-NCV-EP system, 8 channel

NF

44

41

Refined equipment time to reflect typical use exclusive to patient.

L037A

Electrodiagnostic Technologist

NF

Assist physician in performing procedure

19

29

Conforming to physician time.

95863

Muscle test 3 limbs

EF023

table, exam

NF

58

52

Refined equipment time to reflect typical use exclusive to patient.

EQ024

EMG-NCV-EP system, 8 channel

NF

58

52

Refined equipment time to reflect typical use exclusive to patient.

95864

Muscle test 4 limbs

EF023

table, exam

NF

71

62

Refined equipment time to reflect typical use exclusive to patient.

EQ024

EMG-NCV-EP system, 8 channel

NF

71

62

Refined equipment time to reflect typical use exclusive to patient.

95868

Muscle test cran nerve bilat

EF023

table, exam

NF

35

32

Refined equipment time to reflect typical use exclusive to patient.

EQ024

EMG-NCV-EP system, 8 channel

NF

35

32

Refined equipment time to reflect typical use exclusive to patient.

95907

Motor&/sens 1-2 nrv cndj tst

SG051

gauze, non-sterile 4in x 4in

NF

0

4

CMS clinical review.

SG055

gauze, sterile 4in x 4in

NF

4

0

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

12

0

CMS clinical review.

SJ022

electrode skin prep gel (NuPrep)

NF

100

0

CMS clinical review.

95908

Motor&/sens 3-4 nrv cndj tst

SG051

gauze, non-sterile 4in x 4in

NF

0

8

CMS clinical review.

SG055

gauze, sterile 4in x 4in

NF

8

0

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

24

0

CMS clinical review.

SJ022

electrode skin prep gel (NuPrep)

NF

100

0

CMS clinical review.

95909

Motor&/sens 5-6 nrv cndj tst

SG051

gauze, non-sterile 4in x 4in

NF

0

12

CMS clinical review.

SG055

gauze, sterile 4in x 4in

NF

12

0

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

36

0

CMS clinical review.

SJ022

electrode skin prep gel (NuPrep)

NF

100

0

CMS clinical review.

95910

Motor&sens 7-8 nrv cndj test

L037A

Electrodiagnostic Technologist

NF

50

40

Conforming to physician time.

SG051

gauze, non-sterile 4in x 4in

NF

0

16

CMS clinical review.

SG055

gauze, sterile 4in x 4in

NF

16

0

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

48

0

CMS clinical review.

SJ022

electrode skin prep gel (NuPrep)

NF

100

0

CMS clinical review.

95911

Motor&sen 9-10 nrv cndj test

L037A

Electrodiagnostic Technologist

NF

64

50

Conforming to physician time.

SG051

gauze, non-sterile 4in x 4in

NF

0

20

CMS clinical review.

SG055

gauze, sterile 4in x 4in

NF

20

0

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

60

0

CMS clinical review.

SJ022

electrode skin prep gel (NuPrep)

NF

100

0

CMS clinical review.

95912

Motor&sen 11-12 nrv cnd test

L037A

Electrodiagnostic Technologist

NF

77

60

Conforming to physician time.

SG051

gauze, non-sterile 4in x 4in

NF

0

24

CMS clinical review.

SG055

gauze, sterile 4in x 4in

NF

24

0

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

72

0

CMS clinical review.

SJ022

electrode skin prep gel (NuPrep)

NF

100

0

CMS clinical review.

95913

Motor&sens 13/> nrv cnd test

L037A

Electrodiagnostic Technologist

NF

87

70

Conforming to physician time.

SG051

gauze, non-sterile 4in x 4in

NF

0

26

CMS clinical review.

SG055

gauze, sterile 4in x 4in

NF

26

0

CMS clinical review.

SG079

tape, surgical paper 1in (Micropore)

NF

78

0

CMS clinical review.

SJ022

electrode skin prep gel (NuPrep)

NF

100

0

CMS clinical review.

95921

Autonomic nrv parasym inervj

EF032

table, tilt (w-trendelenberg)

NF

64

55

Refined equipment time to reflect typical use exclusive to patient.

EQ051

arterial tonometry acquisition system (WR Testworks)

NF

64

55

Refined equipment time to reflect typical use exclusive to patient.

EQ052

arterial tonometry monitor (Colin Pilot)

NF

64

55

Refined equipment time to reflect typical use exclusive to patient.

L037A

Electrodiagnostic Technologist

NF

Greet patient, provide gowning, assure appropriate medical records are available

3

0

CMS clinical review.

L037A

Electrodiagnostic Technologist

NF

Obtain vital signs

3

0

CMS clinical review.

L037A

Electrodiagnostic Technologist

NF

Monitor pt. following service/check tubes, monitors, drains

5

2

CMS clinical review.

95922

Autonomic nrv adrenrg inervj

EF032

table, tilt (w-trendelenberg)

NF

79

70

Refined equipment time to reflect typical use exclusive to patient.

EQ051

arterial tonometry acquisition system (WR Testworks)

NF

79

70

Refined equipment time to reflect typical use exclusive to patient.

EQ052

arterial tonometry monitor (Colin Pilot)

NF

79

70

Refined equipment time to reflect typical use exclusive to patient.

L037A

Electrodiagnostic Technologist

NF

Greet patient, provide gowning, assure appropriate medical records are available

3

0

CMS clinical review.

L037A

Electrodiagnostic Technologist

NF

Obtain vital signs

3

0

CMS clinical review.

L037A

Electrodiagnostic Technologist

NF

Monitor pt. following service/check tubes, monitors, drains

5

2

CMS clinical review.

95923

Autonomic nrv syst funj test

EQ035

QSART acquisition system (Q-Sweat)

NF

74

61

Refined equipment time to reflect typical use exclusive to patient.

EQ124

stimulator, constant current, w-stimulating and grounding electrodes (Grass Telefactor)

NF

74

61

Refined equipment time to reflect typical use exclusive to patient.

EQ171

light, infra-red, ceiling mount

NF

74

61

Refined equipment time to reflect typical use exclusive to patient.

L037A

Electrodiagnostic Technologist

NF

Assist physician in performing procedure

55

45

CMS clinical review.

L037A

Electrodiagnostic Technologist

NF

Monitor pt. following service/check tubes, monitors, drains

5

2

CMS clinical review.

SJ020

electrode conductive gel

NF

5

0

CMS clinical review.

95924

Ans parasymp & symp w/tilt

EF032

table, tilt (w-trendelenberg)

NF

79

76

Refined equipment time to reflect typical use exclusive to patient.

EQ051

arterial tonometry acquisition system (WR Testworks)

NF

79

76

Refined equipment time to reflect typical use exclusive to patient.

EQ052

arterial tonometry monitor (Colin Pilot)

NF

79

76

Refined equipment time to reflect typical use exclusive to patient.

L037A

Electrodiagnostic Technologist

NF

Monitor pt. following service/check tubes, monitors, drains

5

2

CMS clinical review.

96920

Laser tx skin < 250 sq cm

EF031

table, power

NF

20

26

Refined equipment time to reflect typical use exclusive to patient.

EQ161

laser, excimer

NF

20

26

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

17

26

Refined equipment time to reflect typical use exclusive to patient.

Annual Laser Service Package

NF

1

0

Included in equipment cost per minute calculation.

L037D

RN/LPN/MTA

NF

Monitor pt. following service/check tubes, monitors, drains

3

1

CMS clinical review.

L037D

RN/LPN/MTA

NF

Clean room/equipment by physician staff

3

2

CMS clinical review.

SF028

laser tip (single use)

NF

1

0

CMS clinical review.

SJ029

ice pack, instant

NF

4

1

CMS Code correction.

96921

Laser tx skin 250-500 sq cm

EF031

table, power

NF

23

29

Refined equipment time to reflect typical use exclusive to patient.

EQ161

laser, excimer

NF

23

29

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

23

29

Refined equipment time to reflect typical use exclusive to patient.

Annual Laser Service Package

NF

1

0

Included in equipment cost per minute calculation.

L037D

RN/LPN/MTA

NF

Monitor pt. following service/check tubes, monitors, drains

3

1

CMS clinical review.

L037D

RN/LPN/MTA

NF

Clean room/equipment by physician staff

3

2

CMS clinical review.

SF028

laser tip (single use)

NF

1

0

CMS clinical review.

SJ029

ice pack, instant

NF

4

2

CMS Code correction.

96922

Laser tx skin >500 sq cm

EF031

table, power

NF

33

39

Refined equipment time to reflect typical use exclusive to patient.

EQ161

laser, excimer

NF

33

39

Refined equipment time to reflect typical use exclusive to patient.

EQ168

light, exam

NF

30

39

Refined equipment time to reflect typical use exclusive to patient.

Annual Laser Service Package

NF

1

0

Included in equipment cost per minute calculation.

L037D

RN/LPN/MTA

NF

Monitor pt. following service/check tubes, monitors, drains

3

1

CMS clinical review.

L037D

RN/LPN/MTA

NF

Clean room/equipment by physician staff

3

2

CMS clinical review.

SF028

laser tip (single use)

NF

1

0

CMS clinical review.

97150

Group therapeutic procedures

EQ248

ultrasonic biometry, pachymeter

NF

10

5

Refined equipment time to reflect typical use exclusive to patient.

EQ269

blood pressure monitor, ambulatory, w-battery charger

NF

1

0

CMS clinical review.

SA007

kit, cooking activity ingredients (mac-cheese)

NF

1

0

CMS clinical review.

99495

Trans care mgmt 14 day disch

L042A

RN/LPN

F

Communication (with patient, family members, guardian or caretaker, surrogate decision makers, and/or other professionals) regarding aspects of care, etc.

0

45

CMS clinical review.

99496

Trans care mgmt 7 day disch

L042A

RN/LPN

NF

Communication (with patient, family members, guardian or caretaker, surrogate decision makers, and/or other professionals) regarding aspects of care, etc.

60

70

CMS clinical review.

L042A

RN/LPN

F

Communication (with patient, family members, guardian or caretaker, surrogate decision makers, and/or other professionals) regarding aspects of care, etc.

0

70

CMS clinical review.

17. On page 69138,

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

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

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

CY 2013 Conversion Factor

$25.0008

is corrected to read as follows:

CY 2013 Conversion Factor

$25.0070

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

CY 2013 Anesthesia Factor

$15.93

is corrected to read as follows:

CY 2013 Anesthesia Factor

$16.1236

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

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

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

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