# 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 > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/fr%3A2013-19378 ## Record - **Collection:** Federal Register - **Document type:** Rule - **Published:** August 12, 2013 - **Citation:** 78 FR 48996 ## Text 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/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/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/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. 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/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 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 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 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 #189 and #190 are deleted. 22. On page 69267, after Table 95: Individual Quality Measures for the Physician Quality Reporting System Proposed to be Available for Reporting via Claims, Registry, EHR, or GRPO Web Interface Beginning in 2013 or 2014*, the following note is added: *Measures that can be reported using the GPRO web interface. †These measures can only be reported by participants using the GPRO. They are not available for reporting for individual Eligible Professionals using this reporting method. ¥ Titles and descriptions in this table are aligned with 2013 Physician Quality Reporting System Claims and Qualified Registry measure titles and descriptions, and may differ from existing measures in other programs. Please reference the National Quality Forum (NQF) and Physician Quality Reporting System numbers for clarification. ⋄Measures to be deleted in 2014. ‡Measures to be added in 2013. ○Measures to be added in 2014. 23. On page 69269, in Table 96: PQRS Quality Measures Available for Reporting for Group Practices Using the GPRO Web Interface for 2013 and Beyond, in the Measure and Title description for NQF/PQRS 0097/46 the phrase that reads “ seen within 60 days following discharge ” is corrected to read “ seen within 30 days following discharge. ” 24. On page 69277, in Table 108: HIV/AIDS Measures Group, the following measures: HIV/AIDS Measures Group: PQRS Measure #206 (“HIV/AIDS: Screening for High Risk Sexual Behaviors”) and #207 (“HIV/AIDS: Screening for Injection Drug Use”) are deleted. 25. On page 69300, a. Third column, line 22-23, the phrase “a deadline of February 28, 2013 to request an informal review” is corrected to read “a deadline of 90 days following the receipt of the feedback reports to request an informal review.” b. Lines 27-28, the phrase “a deadline of February 28, 2014 to request an informal review” is corrected to read “a deadline of 90 days following the receipt of the feedback reports to request an informal review.” 26. On pages 69344 through 69345, we are correcting Table 134: CY 2013 PFS Final Rule with Comment Period Estimated Impact on Total Allowed Charges by Specialty* and the first footnote (*) that reads: *Table 83 shows only the final payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law.” to read as follows: Table 134—CY 2013 Final Rule With Comment Period Estimated Impact on Total Allowed Charges by Specialty * [Estimated impact for RVU changes *] Specialty Allowed charges (mil) Impact of work and MP RVU changes % Impact of PE RVU changes % Combined impact % (A) (B) (C) (D) (E) TOTAL $86,384 0 0 0 01-ALLERGY/IMMUNOLOGY 200 0 2 2 02-ANESTHESIOLOGY 1,817 0 2 2 03-CARDIAC SURGERY 369 0 −1 −1 04-CARDIOLOGY 6,733 −1 −2 −2 05-COLON AND RECTAL SURGERY 153 0 2 2 06-CRITICAL CARE 263 0 1 1 07-DERMATOLOGY 3,024 0 0 0 08-EMERGENCY MEDICINE 2,839 0 0 0 09-ENDOCRINOLOGY 437 0 1 1 10-FAMILY PRACTICE 5,943 2 5 7 11-GASTROENTEROLOGY 1,896 0 0 0 12-GENERAL PRACTICE 587 0 1 1 13-GENERAL SURGERY 2,283 0 1 1 14-GERIATRICS 220 1 3 5 15-HAND SURGERY 135 0 1 1 16-HEMATOLOGY/ONCOLOGY 1,909 0 2 2 17-INFECTIOUS DISEASE 629 0 1 1 18-INTERNAL MEDICINE 11,163 1 3 5 19-INTERVENTIONAL PAIN MGMT 538 0 1 1 20-INTERVENTIONAL RADIOLOGY 204 0 −2 −3 21-MULTISPECIALTY CLINIC/OTHER PHY 81 0 0 0 22-NEPHROLOGY 2,080 0 0 0 23-NEUROLOGY 1,604 −2 −5 −7 24-NEUROSURGERY 687 0 0 0 25-NUCLEAR MEDICINE 49 0 −2 −3 27-OBSTETRICS/GYNECOLOGY 704 0 0 0 28-OPHTHALMOLOGY 5,645 −3 0 −3 29-ORTHOPEDIC SURGERY 3,643 0 0 0 30-OTOLARNGOLOGY 1,076 0 2 2 31-PATHOLOGY 1,210 0 −6 −6 32-PEDIATRICS 65 1 3 3 33-PHYSICAL MEDICINE 999 −1 −3 −4 34-PLASTIC SURGERY 356 0 1 1 35-PSYCHIATRY 1,170 −1 3 2 36-PULMONARY DISEASE 1,703 0 1 1 37-RADIATION ONCOLOGY 1,988 0 −7 −7 38-RADIOLOGY 4,818 0 −3 −3 39-RHEUMATOLOGY 548 0 0 0 40-THORACIC SURGERY 343 0 −1 −1 41-UROLOGY 1,918 0 −1 −2 42-VASCULAR SURGERY 888 0 −2 −2 43-AUDIOLOGIST 57 0 −4 −4 44-CHIROPRACTOR 746 0 1 1 45-CLINICAL PSYCHOLOGIST 575 1 −3 −2 46-CLINICAL SOCIAL WORKER 406 1 −3 −2 47-DIAGNOSTIC TESTING FACILITY 888 0 −7 −7 48-INDEPENDENT LABORATORY 1,073 0 −14 −14 49-NURSE ANES/ANES ASST 1,008 0 2 2 50-NURSE PRACTITIONER 1,623 1 3 4 51-OPTOMETRY 1,061 −1 1 1 52-ORAL/MAXILLOFACIAL SURGERY 45 0 1 1 53-PHYSICAL/OCCUPATIONAL THERAPY 2,636 0 4 4 54-PHYSICIAN ASSISTANT 1,229 1 2 3 55-PODIATRY 1,925 0 2 2 56-PORTABLE X-RAY SUPPLIER 106 0 5 5 57-RADIATION THERAPY CENTERS 72 0 −9 −9 98-OTHER 19 0 1 1 * Table 134 shows only the final payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law. 27. On pages 69347 through 69348, we are correcting Table 135: CY 2013 PFS Final Rule with Comment Period Estimated Impact on Total Allowed Charges by Specialty by Selected Policy* and the text in the first footnote (*) for Table 135 that reads “*Table 135 shows only the proposed payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law.” to read as follows: Table 135—CY 2013 PFS Final Rule With Comment Period Estimated Impact on Total Allowed Charges by Specialty by Selected Policy* Estimated Impact for RVU Changes* Specialty Allowed charges (mil) Impact of end of PPIS transition % New, revised, potentially misvalued codes, MPPR, new utilization and other factors % Updated equipment interest rate assumption % Transitional care management % Input changes for certain radiation therapy procedures % Total (cumulative impact) % (A) (B) (C) (D) (E) (F) (G) (H) TOTAL 86,384 0 0 0 0 0 0 01-ALLERGY/IMMUNOLOGY 200 0 0 2 0 0 2 02-ANESTHESIOLOGY 1,817 1 1 0 0 0 2 03-CARDIAC SURGERY 369 −1 0 0 0 0 −1 04-CARDIOLOGY 6,733 −2 0 0 −1 0 −2 05-COLON AND RECTAL SURGERY 153 1 0 0 0 0 2 06-CRITICAL CARE 263 0 0 0 0 0 1 07-DERMATOLOGY 3,024 0 0 1 −1 0 0 08-EMERGENCY MEDICINE 2,839 0 0 0 0 0 0 09-ENDOCRINOLOGY 437 1 1 0 −1 0 1 10-FAMILY PRACTICE 5,943 1 1 0 4 0 7 11-GASTROENTEROLOGY 1,896 0 0 0 0 0 0 12-GENERAL PRACTICE 587 1 0 0 −1 0 1 13-GENERAL SURGERY 2,283 1 0 0 0 0 1 14-GERIATRICS 220 1 1 0 2 0 5 15-HAND SURGERY 135 1 0 0 −1 0 1 16-HEMATOLOGY/ONCOLOGY 1,909 −1 3 1 −1 0 2 17-INFECTIOUS DISEASE 629 1 1 0 0 0 1 18-INTERNAL MEDICINE 11,163 1 1 0 3 0 5 19-INTERVENTIONAL PAIN MGMT 538 1 0 0 −1 0 1 20-INTERVENTIONAL RADIOLOGY 204 −2 0 0 0 0 −3 21-MULTISPECIALTY CLINIC/OTHER PHY 81 0 0 0 0 0 0 22-NEPHROLOGY 2,080 0 0 0 0 0 0 23-NEUROLOGY 1,604 1 −8 0 0 0 −7 24-NEUROSURGERY 687 0 0 0 0 0 0 25-NUCLEAR MEDICINE 49 −2 0 −1 0 0 −3 27-OBSTETRICS/GYNECOLOGY 704 0 0 0 −1 0 0 28-OPHTHALMOLOGY 5,645 2 −4 0 0 0 −3 29-ORTHOPEDIC SURGERY 3,643 1 0 0 0 0 0 30-OTOLARNGOLOGY 1,076 1 1 1 −1 0 2 31-PATHOLOGY 1,210 −1 −5 0 0 0 −6 32-PEDIATRICS 65 1 0 0 3 0 3 33-PHYSICAL MEDICINE 999 1 −5 0 −1 0 −4 34-PLASTIC SURGERY $356 1 0 0 0 0 1 35-PSYCHIATRY 1,170 0 2 0 −1 0 2 36-PULMONARY DISEASE 1,703 0 1 0 −1 0 1 37-RADIATION ONCOLOGY 1,988 −4 2 −3 −1 −1 −7 38-RADIOLOGY 4,818 −2 0 −1 0 0 −3 39-RHEUMATOLOGY 548 0 1 0 −1 0 0 40-THORACIC SURGERY 343 −1 0 0 0 0 −1 41-UROLOGY 1,918 −2 0 0 −1 0 −2 42-VASCULAR SURGERY 888 −1 −1 0 0 0 −2 43-AUDIOLOGIST 57 −3 0 0 0 0 −4 44-CHIROPRACTOR 746 1 0 0 0 0 1 45-CLINICAL PSYCHOLOGIST 575 −2 1 0 0 0 −2 46-CLINICAL SOCIAL WORKER 406 −2 0 0 0 0 −2 47-DIAGNOSTIC TESTING FACILITY 888 −5 0 −2 −1 0 −7 48-INDEPENDENT LABORATORY 1,073 −2 −12 1 −1 0 −14 49-NURSE ANES/ANES ASST 1,008 2 0 0 0 0 2 50-NURSE PRACTITIONER 1,623 1 1 0 2 0 4 51-OPTOMETRY 1,061 2 −1 0 0 0 1 52-ORAL/MAXILLOFACIAL SURGERY 45 1 0 1 −1 0 1 53-PHYSICAL/OCCUPATIONAL THERAPY 2,636 2 2 0 0 0 4 54-PHYSICIAN ASSISTANT 1,229 1 0 0 2 0 3 55-PODIATRY 1,925 2 0 1 −1 0 2 56-PORTABLE X-RAY SUPPLIER 106 1 4 1 −1 0 5 57-RADIATION THERAPY CENTERS 72 −5 4 −5 −1 −1 −9 98-OTHER 19 1 0 0 0 0 1 “*Table 135 shows only the final payment policy impact on PFS services. We note that these impacts do not include the effects of the negative January 2013 conversion factor change under current law.” 28. On pages 69350 through 69351, we are correcting Table 136 Impact of Final Rule with Comment Period on CY 2013 Payment for Selected Procedures* to read as follows: ER12AU13.000 ER12AU13.001 29. On page 69351, a. Footnote 3 “Payments based on the 2012 conversion factor of 34.0376, adjusted to 34.0066 to include the budget neutrality adjustment” is corrected to read “Payments based on the 2012 conversion factor of 34.0376, adjusted to 34.0230 to include the budget neutrality adjustment.” b. Footnote 4 for Table 136 “Payments based on the 2013 conversion factor of 25.0008, which includes the budget neutrality adjustment” is corrected to read “Payments based on the 2013 conversion factor of 25.0070, which includes the budget neutrality adjustment.” (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program) Dated: August 2, 2013. Jennifer M. Cannistra, Executive Secretary to the Department, Department of Health and Human Services. [FR Doc. 2013-19378 Filed 8-9-13; 8:45 am] BILLING CODE 4120-01-P --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3A2013-19378. Public record. Not legal advice.