Federal Register / Vol. 77, No. 2 / Wednesday, January 4, 2012 / Rules and Regulations 227 

C. Regulations Text Corrections 

§ 416.171 [Corrected] 

■ 1. On page 74582, in the second 

column, in § 416.171, ‘‘Determination of 

payment rates for ASC services,’’ in 

amendment 7, the instruction ‘‘a. 

Revising paragraph (b)’’ is corrected to 

read ‘‘a. Revising paragraph (b) 

introductory text.’’ 

(Catalog of Federal Domestic Assistance 

Program No. 93.778, Medical Assistance 

Program) 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: December 28, 2011. 

Jennifer Cannistra, 

Executive Secretary to the Department. 

[FR Doc. 2011–33751 Filed 12–30–11; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 410, 414, 415, and 495 

[CMS–1524–CN and CMS–1436–CN] 

RIN 0938–AQ25 and 0938–AQ00 

Medicare Program; Payment Policies 

Under the Physician Fee Schedule, 

Five-Year Review of Work Relative 

Value Units, Clinical Laboratory Fee 

Schedule: Signature on Requisition, 

and Other Revisions to Part B for CY 

2012; Corrections 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Correction of final rule with 

comment period. 

SUMMARY: This document corrects 

technical errors and typographical 

errors in the final rule with comment 

period entitled ‘‘Medicare Program; 

Payment Policies under the Physician 

Fee Schedule, Five-Year Review of 

Work Relative Value Units, Clinical 

Laboratory Fee Schedule: Signature on 

Requisition, and Other Revisions to Part 

B for CY 2012’’ which appeared in the 

November 28, 2011 Federal Register. 

DATES: This correcting document is 

effective January 1, 2012. 

FOR FURTHER INFORMATION CONTACT: 

Ryan Howe, (410) 786–3355, or Chava 

Sheffield, (410) 786–2298, for issues 

related to the physician fee schedule 

practice expense methodology and 

direct expense inputs. 

Sara Vitolo, (410) 786–5714, for issues 

related to work RVUs. 

Christine Estella, (410) 786–0485, for 

issues related to the Physician Quality 

Reporting System, incentives for 

Electronic Prescribing (eRx) and 

Physician Compare. 

Jamie Hermansen, or (410) 786–2064, or 

Stephanie Frilling, (410) 786–4507, 

for issues related to Annual Wellness 

Visit. 

Rebecca Cole, (410) 786–4497, for issues 

related to physician payment not 

previously identified. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In FR Doc. 2011–28597 of November 

28, 2011 (76 FR 73026), the final rule 

with comment period entitled 

‘‘Medicare Program; Payment Policies 

under the Physician Fee Schedule, FiveYear Review of Work Relative Value 

Units, Clinical Laboratory Fee Schedule: 

Signature on Requisition, and Other 

Revisions to Part B for CY 2012’’ 

(hereinafter referred to as the CY 2012 

PFS final rule with comment period) 

there were a number of technical errors 

that are identified and corrected in the 

Correction of Errors section. 

Accordingly, the corrections are 

effective January 1, 2012. 

We note that this correction notice 

corrects the CY 2012 PFS final rule with 

comment period which reflects laws in 

effect as of November 1, 2011. Any 

statutory changes to PFS payment after 

November 1, 2011 were not reflected in 

the CY 2012 PFS final rule with 

comment period and are therefore not 

reflected in this correction notice. 

Payment files reflecting current law as 

of January 1, 2012 were made available 

through usual CMS notices and data 

files. 

II. Summary of Errors and Corrections 

to the Addenda Posted on the CMS Web 

Site 

A. Errors in the Preamble 

1. Errors in Work Relative Value Units 

(RVUs) and Time Information 

On pages 73028 and 73208, a 

discussion of CPT codes 96110 

(Developmental screening, with 

interpretation and report, per 

standardized instrument form) and 

G0451 (Development testing, with 

interpretation and report, per 

standardized instrument form) was 

omitted from the final rule due to an 

inadvertent error. We note that we had 

cited a discussion regarding these two 

codes several times throughout the 

preamble. We are correcting this error 

by including our intended discussion 

through this correcting document. 

On page 73141, we are correcting our 

response to comments to accurately 

reflect our policy regarding CPT codes 

53445 (Insertion of inflatable urethral/ 

bladder neck sphincter, including 

placement of pump, reservoir, and cuff) 

and 54410 (Removal and replacement of 

all component(s) of a multi-component, 

inflatable penile prosthesis at the same 

operative session). Due to an 

inadvertent error, the discussion of 

these codes did not reflect our 

discussion of revisions to the times for 

these codes for CY 2012. We include our 

discussion of time policies for these 

codes on an interim final basis for CY 

2012. 

On page 73166, we are correcting an 

inadvertent error in Table 15: CY 2012 

Work RVUs for Services Reviewed in 

the CY 2011 PFS Final Rule with 

Comment Period, the Fourth-Five Year 

Review, and the CY 2012 PFS Proposed 

Rule. This table incorrectly identified 

that no time change had occurred for 

CPT code 53445. 

On pages 73172 and 73178, we are 

correcting Table 16: CY 2011 and AMA 

RUC-Recommended Physician Time 

and Work Values for CY 2012 to 

accurately reflect time values for CPT 

codes 23415 (Coracoacromial ligament 

release, with or without acromioplasty), 

as well as revisions to the times for 

53445 and 54410 already noted. The 

time values for CPT code 23415 that 

were listed in the CY 2012 PFS final 

rule time file were correct, but were 

inadvertently left out of Table 16. The 

time values for CPT codes 53345 and 

54410 that were listed in the CY 2012 

PFS final rule time file were not correct; 

the time file has been corrected to 

reflect correct times for CPT codes 

53445 and 54410, previously discussed. 

We note that the time file that we used 

to calculate RVUs for the CY 2012 PFS 

final rule with comment period did not 

reflect the correct finalized published 

times in Table 16 on pages 73170 

through 73181 for a limited number of 

codes. Specifically, we also have 

corrected the time values in the time file 

for CPT codes 28725 (Arthrodesis; 

subtalar), 28730 (Arthrodesis, midtarsal 

or tarsometatarsal, multiple or 

transverse), 62223 (Creation of shunt; 

ventriculo-peritoneal, -pleural, other 

terminus), 65285 (Repair of laceration; 

cornea and/or sclera, perforating, with 

reposition or resection of uveal tissue), 

73080 (Radiologic examination, elbow; 

complete, minimum of 3 views), 73610 

(Radiologic examination, ankle; 

complete, minimum of 3 views), and 

73630 (Radiologic examination, foot; 

complete, minimum of 3 views) to 

reflect the correct time values in Table 

16. 


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228 Federal Register / Vol. 77, No. 2 / Wednesday, January 4, 2012 / Rules and Regulations 

On page 73173, in Table 16, we are 

also correcting a typographical error for 

CPT code 28725 (Arthrodesis; subtalar). 

On page 73190, we are correcting the 

status indicator of molecular pathology 

CPT codes that are new for CY 2012. We 

had intended to set the status indicator 

to allow reporting of these codes along 

with the laboratory CPT codes currently 

used to report these services. Due to an 

inadvertent error identifying the 

appropriate status indicator for tracking 

purposes, the published status indicator 

was incorrect. 

On page 73265, in our discussion of 

the compression system services, we are 

updating our references to sections of 

the CY 2012 PFS final rule with 

comment period to correspond to the 

corrections identified elsewhere in this 

correcting document. 

2. Errors in the Annual Wellness Visit 

On pages 73306 through 73309, in our 

discussion of the Annual Wellness Visit, 

we made several technical and 

typographical errors in summarizing 

and responding to comments regarding 

the health risk assessment (HRA). 

On page 73310, in our discussion 

regarding personalized prevention plans 

as part of the annual wellness visit, we 

inadvertently made technical and 

typographical errors. 

On page 73311, in our discussion 

regarding a response to commenters on 

the physician’s wellness team, we 

inadvertently made a technical error in 

our description of who comprises the 

wellness team. 

3. Errors in the PE RVUs 

On page 73313, we are correcting a 

typographical error in Table 39: Final 

RVUs for AWV Services for HCPCS code 

G0438 (Annual wellness visit, includes 

a personalized prevention plan of 

service (PPPS), first visit). 

We are correcting a series of Practice 

Expense (PE) RVUs that appeared in 

Addenda B and C for CPT codes 90867 

(Therapeutic repetitive transcranial 

magnetic stimulation (TMS) treatment; 

initial, including cortical mapping, 

motor threshold determination, delivery 

and management), 90868 (Therapeutic 

repetitive transcranial magnetic 

stimulation (TMS) treatment; 

subsequent delivery and management, 

per session), and 90869 (Therapeutic 

repetitive transcranial magnetic 

stimulation (TMS) treatment; 

subsequent motor threshold redetermination with delivery 

management) that were incorrect as a 

result of a technical error. The price 

input for the new direct practice 

expense equipment item ‘‘NeuroStar 

TMS Therapy System’’ (EQ342) was 

incorrectly calculated. The corrected 

price is included in the corrected final 

CY 2012 direct PE database. The final 

PE RVUs displayed in the corrected 

versions of Addendum B and C reflect 

values resulting from the correction of 

this error. 

We also note that because work RVUs 

factor into the calculation for PE RVUs, 

and time values factor into direct PE 

input values and specialty-level 

allocation of indirect PE, PE RVUs for 

CPT codes with corrected work RVUs or 

time values may have also changed as 

a result of the corrected work RVUs and 

time values. These changes are reflected 

in Addenda B and C and the direct PE 

database. 

Further, we note that changes in PE 

RVUs for other codes not previously 

identified may occur due to various 

factors related to the relativity of the 

system including budget neutrality, 

changes in aggregate physician times, 

and adjustments to maintain PE RVU 

shares. These changes also are reflected 

in Addenda B and C. In order to account 

for these corrected values, we are 

correcting errors in Table 85: Impact of 

Final Rule With Comment Period and 

Estimated Physician Update on CY 2012 

Payment for Selected Procedures. 

4. Errors in the Physician Quality 

Reporting System 

On page 73333, in our discussion of 

core measures directly below Table 42, 

we inadvertently made a typographical 

error in referencing a Table number. 

On page 73334, in our discussion of 

zero percent performance rates, we 

made a typographical error. Although 

the final requirement to not count 

measures with a zero percent 

performance rate is indicated 

throughout the rule, including Tables 

40, 41, and 42, in a response on page 

73334, we erroneously stated ‘‘only’’ 

instead of ‘‘not.’’ 

On page 73336, in our discussion of 

measures groups, we made a 

typographical error in referencing a 

Table number. 

On page 73337, in our summary of the 

CY 2012 proposed rule regarding the 

reporting criteria for the group practice 

reporting option (GPRO), we 

inadvertently referenced the wrong 

Federal Register page number and also 

made a typographical error in 

referencing the number of NQFendorsed quality measures we 

proposed. 

On page 73339, in our discussion of 

GPROs we inadvertently made a 

typographical error in referencing the 

dates. The correct year is 2012, which 

is the year in which the reporting period 

for the 2012 Physician Quality 

Reporting System lies. 

On page 73343, we made 

typographical errors in referencing 

Table numbers of the CY 2012 proposed 

rule. In addition, in our discussion of 

contact information, we incorrectly 

referenced the 2011 Physician Quality 

Reporting System instead of the 2012 

Physician Quality Reporting System. 

On page 73345, in our discussion of 

core measures, we inadvertently made 

typographical errors in referencing 

Table numbers. 

On page 73348, in one of our 

responses to comments, we 

inadvertently made typographical errors 

in referencing two Table numbers. 

On page 73362, in Table 47, the 

measure entitled ‘‘Ischemic Vascular 

Disease (IVD): Complete Lipid Profile 

and LDL Control <100’’ was 

inadvertently listed twice. 

On page 73365, in Table 48, we are 

correcting measure numbers for several 

measures that were retired in 2010. 

Specifically, the Measure entitled ‘‘Use 

of Appropriate Medications for Asthma’’ 

and the Measure entitled ‘‘Smoking and 

Smoking and Tobacco Use Cessation, 

Medical Assistance: a. Advising 

Smokers to Quit, b. Discussing Smoking 

and Tobacco Use Cessation 

Medications, c. Discussing Smoking and 

Tobacco Use Cessation Strategies’’ were 

inadvertently listed with Physician 

Quality Reporting System numbers and 

should be listed as ‘‘TBD.’’ 

On page 73368, third column, first 

full paragraph, we inadvertently 

excluded the COPD measures group as 

a measures group that also contains 

measures available for reporting as 

individual measures. 

On page 73373, in reference to Table 

56, we inadvertently excluded a 

footnote to indicate that the CAD 

measures group contained measures that 

are also available for reporting as 

individual measures. 

On page 73383, in our response to 

commenters who urged CMS to reduce 

the number of GPRO measures a GPRO 

must report under the Physician Quality 

Reporting System, we inadvertently 

made an error in stating we finalized 30 

measures available for reporting under 

the GPRO. As indicated in Table 71 and 

in the third column, first full paragraph 

on page 73383, we finalized 29 

measures available for reporting under 

the GPRO. 

On page 73388, second column, first 

full paragraph, we incorrectly 

referenced the first quarter of 2012 

instead of the first quarter of 2013. 


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Federal Register / Vol. 77, No. 2 / Wednesday, January 4, 2012 / Rules and Regulations 229 

5. Errors in the Electronic Prescribing 

(eRx) Incentive Program 

On page 73415, we inadvertently 

made a typographical error by 

referencing G code G8642 instead of 

G9642 (G8642 was the G-Code created 

in 2011 for the significant hardship 

exemption for professionals in rural 

areas with limited high speed Internet 

access). 

6. Errors in the Impact Analysis 

On page 73457, In Table 85: Impact of 

Final Rule with Comment Period and 

Estimated Physician Update on CY 2012 

Payment for Selected Procedures, we 

discuss the corrected work RVUs in 

section II.A.3. of this document, entitled 

‘‘Errors in the PE RVUs’’. 

7. Errors in the Addenda Listing 

On page 73469, in our discussion of 

the Addenda, we inadvertently listed 

Addendum C as reserved. 

B. Errors in the Addenda Posted on the 

CMS Web Site 

On page 73469 of the CY 2012 PFS 

final rule with comment period, we 

noted that the Addenda A through H for 

the CY 2012 PFS final rule with 

comment period would only be 

available via the Internet. In this 

document, we note that we will be 

correcting the following Addenda: 

• Addendum B—Relative Value Units 

and Related Information Used in 

Determining Medicare Payments for CY 

2012. 

• Addendum C.—Codes with 

Proposed RVUs Subject to Comment for 

CY 2012. 

We are removing HCPCS code G0450 

from Addendum B. This code was 

incorrectly included in the final rule 

Addenda due to a technical error. In 

addition, we are correcting the status 

indicator in Addendum B for CPT code 

96110. 

Additionally, due to a typographical 

error, we are correcting the physician 

work and malpractice RVUs that 

appeared in Addenda B and C for CPT 

code 90845 (Psychoanalysis). The 

correct physician work and malpractice 

RVUs were listed in the preamble text. 

Due to the changes previously noted 

in this section and in section II.A.3. of 

this document, we are correcting errors 

in these Addenda by replacing the 

Addenda in their entirety. In addition, 

we are correcting supporting tables that 

are available online, such as the time 

file and the direct PE input database. 

Errors to all updated tables are a result 

of the technical and typographical errors 

identified and summarized in this 

correcting document. As stated in the 

CY 2012 PFS final rule with comment 

period, Addenda B and C are available 

online at http://www.cms.gov/ 

PhysicianFeeSched. To access 

supporting information on this 

correction notice, click on the link on 

the left side of the screen titled, ‘‘PFS 

Federal Regulations Notices’’ for a 

chronological list of PFS Federal 

Register and other related documents 

and select CMS–1524–CN. 

III. Waiver of Proposed Rulemaking 

and 30-Day Delay in Effective Date 

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 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 

2012 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 2012 PFS final rule 

with comment period. As a result, the 

corrections made through this correcting 

document are intended to ensure that 

the CY 2012 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 2012 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 

2012 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. 2011–28597 of November 

28, 2011 (76 FR 73026), the final rule 

with comment period, make the 

following corrections: 

■ 1. Page 73028, third column, 

■ a. After line 31 (item ‘‘(23)’’), the text 

is corrected by adding a new item to 

read as follows ‘‘(24) Central Nervous 

System Assessments/Tests (CPT codes 

96110, G0451)’’. 

■ b. Line 32 (Item ‘‘(24)’’), the reference 

‘‘(24)’’ is corrected to read ‘‘(25)’’. 

■ 2. Page 73141, second column, 

■ a. Second full paragraph that begins 

with the phrase ‘‘Response: We agree 

with the AMA RUC’’ and ends with the 

phrase ‘‘CPT code 53445 for CY 2012’’ 

is corrected to read as follows: 

‘‘Response: We agree with the AMA 

RUC that the 25th percentile work RVU 

of 13.00 is appropriate for this service. 

We are assigning an interim final work 

RVU of 13.00 to CPT code 53445 for CY 

2012. CPT code 53445 can be found in 

Addenda B and C to this CY 2012 PFS 

final rule. 

Regarding the physician time 

associated with CPT code 53445, in the 

CY 2012 PFS proposed rule (76 FR 

42799 through 42800) we stated that 

since Medicare claims data indicate that 

this service is predominantly performed 

in the outpatient setting, that we did not 

believe that this service should reflect 

work that is typically associated with an 

inpatient service. In the CY 2012 PFS 

proposed rule, we proposed to accept 

the AMA RUC-recommended physician 

times, understanding that the AMA RUC 

was collecting additional information 

on the physician time associated with 

this CPT code (and CPT code 54410) 

through a specialty society survey. 

Following publication of the CY 2012 

PFS proposed rule, we realized that we 

had not reviewed the additional 

specialty society survey information on 

physician time. After review, we do not 

believe it is appropriate for this service 

which is now predominantly furnished 

in the outpatient setting to continue to 

reflect work that is typically associated 

with an inpatient service. In order to 

ensure consistent treatment of physician 

time, we believe it is appropriate to 

apply our methodology described 


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230 Federal Register / Vol. 77, No. 2 / Wednesday, January 4, 2012 / Rules and Regulations 

previously to address 23-hour stay siteof-service anomalies. Therefore, on an 

interim final basis for CY 2012, we are 

removing the subsequent observation 

care visit, reducing the discharge 

management day service to one-half, 

and adjusting the times accordingly. We 

are assigning CPT code 53445 the 

following times on an interim final basis 

for CY 2012: 50 minutes pre-service 

evaluation, 15 minutes pre-service 

positioning, 20 minutes dress, scrub, 

and wait, 90 minutes intra-service time, 

35 minutes post-service time, half of a 

hospital discharge management day 

service, 1 Level 2 established patient 

office or other outpatient visit, and 3 

Level 3 established patient office or 

other outpatient visits. CMS time 

refinements can be found in Table 16. 

For CY 2009, CPT code 54410 

(Removal and replacement of all 

component(s) of a multi-component, 

inflatable penile prosthesis at the same 

operative session) was identified as 

potentially misvalued through the siteof-service anomaly screen. As detailed 

in the CY 2012 PFS proposed rule (76 

FR 42799), for CY 2012 we proposed a 

work RVU of 15.18, which 

corresponded to the current (CY 2011) 

work RVU and the AMA RUCrecommended work RVU for this 

service. Regarding the physician time 

assigned to CPT code 54410, in the PFS 

proposed rule we proposed to remove 

the subsequent hospital care visit and 

keep the AMA RUC-recommended 

physician times for the other 

components of this service, with the 

understanding that the AMA RUC was 

collecting additional information on the 

physician time associated with this CPT 

code (and CPT code 53445). We 

received no public comments on our 

proposal for CPT code 54410. 

We continue to believe that a work 

RVU of 15.18 appropriately reflects the 

physician work associated with this 

service. Therefore, we are assigning an 

interim final work RVU of 15.18 to CPT 

code 54410 for CY 2012. CPT code 

54410 can be found in Addenda B and 

C to this CY 2012 PFS final rule. 

Following publication of the CY 2012 

PFS proposed rule, we realized that we 

had not reviewed the additional 

specialty society survey information on 

physician time for CPT code 54410 that 

we had received. After reviewing the 

additional information, we do not 

believe it is appropriate for this service 

which is now predominantly furnished 

in the outpatient setting to continue to 

reflect work that is typically associated 

with an inpatient service. In order to 

ensure consistent and appropriate 

treatment of physician time, we believe 

it is appropriate to apply our 

methodology described previously to 

address 23-hour stay site-of-service 

anomalies. Therefore, on an interim 

final basis for CY 2012, we are removing 

the subsequent observation care visit, 

reducing the discharge management day 

service to one-half, and adjusting the 

times accordingly. We are assigning CPT 

code 54410 the following times on an 

interim final basis for CY 2012: 40 

minutes pre-service evaluation, 10 

minutes pre-service positioning, 15 

minutes dress, scrub, and wait, 120 

minutes intra-service time, 40 minutes 

post-service time, half of a hospital 

discharge management day service, 1 

Level 2 established patient office or 

other outpatient visit, and 3 Level 3 

established patient office or other 

outpatient visits. CMS time refinements 

can be found in Table 16.’’ 

■ b. Third full paragraph, line 5 through 

9, the sentence, ‘‘Also, for CY 2012, we 

received no public comments on the CY 

2012 proposed work RVUs for CPT 

codes 52341, 52342, 52343, 52344, 

52345, 52346, 52400, 52500, 54410, and 

54530.’’ is corrected to read ‘‘For CY 

2012, we received no public comments 

on the CY 2012 proposed work RVUs for 

CPT codes 52341, 52342, 52343, 52344, 

52345, 52346, 52400, 52500, and 

54530’’. 

■ 3. On page 73166, Table 15: CY 2012 

Work RVUs for Services Reviewed in 

the CY 2011 PFS Final Rule with 

Comment Period, the Fourth-Five Year 

Review, and the CY 2012 PFS Proposed 

Rule, column 7, line 16 (CPT code 

53445), the ‘‘’’ (blank entry) is corrected 

to read ‘‘Yes’’. 

■ 4. Page 73172, Table 16: CY 2011 and 

AMA RUC-Recommended Physician 

Time and Work Values for CY 2012. 

■ a. Line 8 (CPT code 23415), 

■ (1) Column 15, the figure ‘‘0’’ is 

corrected to read ‘‘0.5’’. 

■ (2) Column 20, the figure ‘‘0’’ is 

corrected to read ‘‘2.0’’. 

■ (3) Column 21, the figure ‘‘0’’ is 

corrected to read ‘‘2.0’’. 

■ b. Line 9 (CPT code 23415), 

■ (1) Column 15, the figure ‘‘0’’ is 

corrected to read ‘‘0.5’’. 

■ (2) Column 20, the figure ‘‘0’’ is 

corrected to read ‘‘2.0’’. 

■ (3) Column 21, the figure ‘‘0’’ is 

corrected to read ‘‘2.0’’. 

■ 5. Page 73173, line 10—CPT code 

28725, column 21, the figure ‘‘0’’ is 

corrected to read ‘‘3.0’’. 

■ 6. Page 73178, 

■ a. Line 17 (CPT code 53445), 

■ (1) Column 9, the figure ‘‘25’’ is 

corrected to read ‘‘35’’. 

■ (2) Column 15, the figure ‘‘1’’ is 

corrected to read ‘‘0.5’’. 

■ (3) Column 17, the figure ‘‘1’’ is 

corrected to read ‘‘0’’. 

■ b. Line 20 (CPT code 54410), 

■ (1) Column 9, the figure ‘‘30’’ is 

corrected to read ‘‘40’’. 

■ (2) Column 15, the figure ‘‘1’’, is 

corrected to read ‘‘0.5’’. 

■ 7. Page 73190, upper fourth of the 

page, second column, first partial 

paragraph, and third column first partial 

paragraph, the sentences beginning with 

‘‘These molecular pathology codes’’ and 

ending with ‘‘payment for these 

services’’ are corrected to read as 

follows: 

‘‘These molecular pathology codes 

appear in Addendum B to this final rule 

with the procedure status indicator of B 

(Bundled code. Payments for covered 

services are always bundled into 

payment for other services not specified. 

If RVUs are shown, they are not used for 

Medicare payment. If these services are 

covered, payment for them is subsumed 

by the payment for the services to which 

they are incident (for example, a 

telephone call from a hospital nurse 

regarding care of a patient)). While these 

services would traditionally be assigned 

a procedure status indicator of I (Not 

Valid for Medicare purposes. Medicare 

uses another code for the reporting of, 

and the payment for these services), 

assigning these CPT codes a procedure 

status indicator of B will allow CMS to 

gather claims information important to 

evaluating eventual pricing of these new 

molecular pathology CPT codes.’’ 

■ 8. Page 73208, third column, 

■ a. Immediately after the end of the 

first partial paragraph ending with ‘‘CPT 

code 95939,’’ the paragraph is corrected 

by adding a new paragraph to read as 

follows: 

‘‘(24) Central Nervous System 

Assessments/Tests (CPT Codes 96110, 

G0451) 

For CY 2012, the CPT Editorial Panel 

revised the long descriptor for CPT code 

96110 from (Developmental testing; 

limited (e.g., Developmental Screening 

Test II, Early Language Milestone 

Screen), with interpretation and report) 

to (Developmental screening, with 

interpretation and report, per 

standardized instrument form). With 

this change, we believe that the service 

described by CPT code 96110 is a 

screening service and no longer falls 

within the scope of benefits of the 

Medicare program, as defined by the 

Social Security Act. Therefore, for CY 

2012, we assigned CPT code 96110 a 

procedure status indicator of N (Noncovered service. These codes are noncovered services. Medicare payment 

may not be made for these codes. If 

RVUs are shown, they are not used for 

Medicare payment). In order to continue 

to make payment under the PFS for the 


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Federal Register / Vol. 77, No. 2 / Wednesday, January 4, 2012 / Rules and Regulations 231 

testing services previously described 

under CPT code 96110, for CY 2012 we 

created HCPCS code G0451 

(Developmental testing, with 

interpretation and report, per 

standardized instrument form). In order 

to calculate resource-based RVUs for 

HCPCS code G0451, we crosswalked the 

utilization, direct practice expense 

inputs, and malpractice risk factor from 

CPT code 96110 to HCPCS code G0451. 

We note that CPT code 96110 did not 

have physician work RVUs, therefore no 

physician work RVUs have been 

assigned to HCPCS code G0451. The CY 

2012 interim final RVUs assigned to 

HCPCS code G0451 are included in 

Addenda B to this final rule with 

comment period.’’ 

■ b. First full paragraph, line 1, the 

reference number ‘‘(24)’’ is corrected to 

read ‘‘(25)’’. 

■ 9. Page 73265, 

■ a. First column, second partial 

paragraph, line 1, the reference 

‘‘III.B.1.b.’’ is corrected to read 

‘‘III.C.1.a.’’. 

■ b. Second column, 

■ (1) First partial paragraph, line 10, the 

reference ‘‘III.B.1.b.’’ is corrected to read 

‘‘III.C.1.a.’’. 

■ (2) Second partial paragraph, line 6, 

the reference, ‘‘III.B.1.b.’’ is corrected to 

read ‘‘III.C.1.a.’’. 

■ 10. On page 73306, 

■ a. Second column, first partial 

paragraph, lines 9 through 16, the 

sentence ‘‘The remaining 22 comments 

provided feedback about the impact of 

the annual wellness visit as a whole 

requested modifications or additional 

elements to the annual wellness visit, 

and coverage for additional preventive 

serves and vaccines.’’ is corrected to 

read ‘‘The remaining 22 comments 

provided feedback about the impact of 

the annual wellness visit as a whole, 

requested modifications to, or 

additional elements added to the annual 

wellness visit, and coverage for 

additional preventive services and 

vaccines.’’ 

■ b. Third column, first partial 

paragraph, line 2, the word ‘‘supports’’ 

is corrected to read ‘‘supported’’. 

■ 11. On page 73308, first column, 

■ a. First full paragraph, lines 6 through 

20, the sentence ‘‘If positive tobacco use 

is identified during the annual wellness 

visit, additional questions can be asked 

by the health professional followed by 

the process of motivational interviewing 

(the health professional offers 

personalized information to the patient) 

and shared decision-making (the health 

professional work with the patient to 

discover what is important to the 

patient and the patient’s motivation to 

change behavior) in the development of 

the personalized prevention plan during 

the annual wellness visit encounter.’’ is 

corrected to read ‘‘If positive tobacco 

use is identified during the annual 

wellness visit, additional questions can 

be asked by the health professional 

followed by the process of motivational 

interviewing and shared decisionmaking (the health professional offers 

personalized information to the patient 

and works with the patient to discover 

what is important to the patient and his 

or her motivation to change behavior) in 

the development of the personalized 

prevention plan during the annual 

wellness visit encounter.’’ 

■ b. Second full paragraph, lines 8 

through 15, the sentence ‘‘We note that 

Medicare covers counseling to prevent 

tobacco use as an ‘‘additional preventive 

service’’ under Medicare Part B 

(additional information available in 

Pub. 100–3, Medicare National Coverage 

Determinations Manual, Chapter 1, 

Section 210.41).’’ is corrected to read 

‘‘We note that Medicare covers tobacco 

use cessation counseling as an 

‘‘additional preventive service’’ under 

Medicare Part B (additional information 

available in Pub. 100–03, Medicare 

National Coverage Determinations 

Manual, Chapter 1, Section 210.4.1).’’ 

■ c. Last partial paragraph, line 3 

through the second column, line 6, the 

sentence ‘‘One commenter agreed with 

the provisions of the proposed rule that 

did not include cognitive assessment as 

part of the HRA, however, the 

commenter believed that general 

questions about memory should be 

included in the HRA.’’ is corrected to 

read ‘‘One commenter agreed with the 

provisions of the proposed rule, which 

did not include cognitive assessment as 

part of the HRA. However, the 

commenter believed that general 

questions about memory should be 

included in the HRA.’’ 

■ 12. On page 73309, third column, 

second full paragraph, line 1, the phrase 

‘‘Comment: A few comments’’ is 

corrected to read ‘‘Comment: A few 

commenters’’. 

■ 13. On page 73310, first column, 

second full paragraph, lines 5 and 6, the 

phrase ‘‘but update the HRA’’ is 

corrected to read ‘‘but the patient 

should update the HRA.’’ 

■ 14. On page 73311, third column, first 

partial paragraph, line 1, the phrase 

‘‘working on his or her wellness team 

are needed on a particular day’’ is 

corrected to read ‘‘working on the 

physician’s wellness team are needed 

on a particular day’’. 

■ 15. On page 73313, Table 39: Final 

RVUs for AWV Services, line 2 (CPT 

code G0438), column 4, the figure 

‘‘4.99’’ is corrected to read ‘‘4.89’’. 

■ 16. On page 73333, second line 

immediately following Table 42, the 

reference to ‘‘Table M 9’’ is corrected to 

read ‘‘Table 48’’. 

■ 17. On page 73334, third column, 

third full paragraph, line 9, the phrase 

‘‘proposal to only count measures’’ is 

corrected to read ‘‘proposal to not count 

measures’’. 

■ 18. On page 73336, third column, last 

paragraph, line 17, the reference ‘‘Table 

42’’ is corrected to read ‘‘Table 44’’. 

■ 19. On page 73337, lower third of the 

page, third column, 

■ a. Line 2, the reference ‘‘(76 FR 

32859)’’ is corrected to read ‘‘(76 FR 

42859)’’. 

■ b. Line 8, the phrase ‘‘30 NQFendorsed ’’ is corrected to read ‘‘44 

NQF-endorsed’’. 

■ 20. On page 73339, lower half of the 

page, second column, first full 

paragraph, 

■ a. Lines 20 and 21, the date, ‘‘January 

1, 2011’’ is corrected to read ‘‘January 1, 

2012’’. 

■ b. Line 22, the date ‘‘October 31, 

2011’’ is corrected to read ‘‘October 31, 

2012’’. 

■ 21. On page 73343, second column, 

first full paragraph, 

■ a. Line 19, the reference to ‘‘Tables 52 

through 55’’ is corrected to read ‘‘Tables 

29 through 56’’. 

■ b. Lines 20 and 21, the phrase ‘‘2011 

Physician Quality Reporting System’’ is 

corrected to read as ‘‘2012 Physician 

Quality Reporting System’’. 

■ 22. On page 73345, top of the page 

(before the table), first column, last line, 

the reference ‘‘Tables 48 and 49’’ is 

corrected to read ‘‘Tables 47 and 48’’. 

■ 23. On page 73348, first column, first 

response, line 9, the reference ‘‘Tables 

48 and 49’’ is corrected to read ‘‘Tables 

47 and 48’’. 

■ 24. On page 73362, in Table 47, last 

line, the entry for the measure 

‘‘Ischemic Vascular Disease (IVD): 

Complete Lipid Profile and LDL Control 

<100’’ is corrected by deleting the entry. 

■ 25. On page 73365, in Table 48, first 

column (Physician Quality Reporting 

System Number), 

■ a. Row 11, the figures ‘‘114 & 115’’ are 

corrected to read ‘‘TBD’’. 

■ b. Row 25, the figure ‘‘240’’ is 

corrected to read ‘‘TBD’’. 

■ 26. On page 73368, third column, 

second full paragraph, lines 11 and 12, 

the phrase ‘‘CAP, and Asthma’’ is 

corrected to read ‘‘CAP, COPD, and 

Asthma’’. 

■ 27. On page 73373, at the end of Table 

56: Measures Included in the 2012 CAD 

Measures Group, the table is corrected 

by adding a footnote to read as follows: 

‘‘The measures contained within this 

measures group are also available for 

reporting as individual measures.’’ 


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232 Federal Register / Vol. 77, No. 2 / Wednesday, January 4, 2012 / Rules and Regulations 

■ 28. On page 73383, first column, 

second full paragraph, line 2, the phrase 

‘‘30 of the 40 measures’’ is corrected to 

read ‘‘29 of the 41 measures’’. 

■ 29. On page 73388, second column, 

fourth full paragraph, line 7, the phrase 

‘‘than the end of the first quarter of 

2012.’’ is corrected to read ‘‘than the 

end of the first quarter of 2013.’’ 

■ 30. On page 73415, third column, 

second full paragraph, line 4, the 

parenthetical phrase ‘‘(report G-code 

G9642).’’ is corrected to read ‘‘(report GCode G8642).’’ 

■ 31. Page 73457, Table 85: Impact of 

Final Rule with Comment Period and 

Estimated Physician Update on CY 2012 

Payment for Selected Procedures, 

■ a. Line 10 (CPT code 43239), 

■ (1) Column 10, ‘‘351.95’’ is corrected 

to read ‘‘351.61’’. 

■ (2) Column 12, ‘‘255.10’’ is corrected 

to read ‘‘254.85’’. 

■ b. Line 11(CPT code 66821), 

■ (1) Column 10, ‘‘326.42’’ is corrected 

to read ‘‘326.08’’. 

■ (2) Column 12, ‘‘236.60’’ is corrected 

to read ‘‘236.35’’. 

■ c. Line 13, (CPT code 67210), 

■ (1) Column 10, ‘‘524.18’’ is corrected 

to read ‘‘523.84’’. 

■ (2) Column 12, ‘‘379.94’’ is corrected 

to read ‘‘379.69’’. 

■ 32. Page 73469, lower third of the 

page, second full paragraph, line 20, the 

title ‘‘Addendum C—[Reserved]’’ is 

corrected to read ‘‘Addendum C.— 

Codes With Proposed RVUs Subject to 

Comment for CY 2012’’. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: December 29, 2011. 

Jennifer M. Cannistra, 

Executive Secretary to the Department, 

Department of Health, Human Services. 

[FR Doc. 2011–33757 Filed 12–30–11; 4:15 pm] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HOMELAND 

SECURITY 

Coast Guard 

46 CFR Parts 1, 10, 11, 12, 13, 14, and 

15 

[Docket No. USCG–2004–17914] 

Implementation of the 2010 

Amendments to the International 

Convention on Standards of Training, 

Certification and Watchkeeping for 

Seafarers, 1978—Hours of Rest and 

Security-Related Training 

AGENCY: Coast Guard, DHS. 

ACTION: Notice of policy. 

SUMMARY: The Coast Guard announces 

steps for implementing the 2010 

amendments to the International 

Convention on Standards of Training, 

Certification and Watchkeeping for 

Seafarers, 1978, as amended, (STCW) 

concerning hours of rest and securityrelated training requirements. Because 

the final rule implementing the 2010 

amendments to the STCW will not be 

published before the 1 January 2012 

entry into force date, there is a need to 

provide guidance on implementation of 

the amendments related to these 

requirements, which will impact U.S. 

vessels and seafarers beginning on 1 

January 2012. This notice applies to all 

vessels subject to STCW under current 

regulations. 

DATES: This policy is effective January 1, 

2012. 

ADDRESSES: This notice is available in 

the docket and can be viewed by going 

to http://www.regulations.gov, inserting 

USCG–2004–17914 in the ‘‘Keyword’’ 

box, and then clicking ‘‘Search.’’ You 

may also visit the Docket Management 

Facility in Room W12–140 on the 

ground floor of the Department of 

Transportation West Building, 1200 

New Jersey, Avenue SE., Washington, 

DC 20590, between 9 a.m. and 5 p.m., 

Monday through Friday, except Federal 

holidays. 

FOR FURTHER INFORMATION CONTACT: If 

you have questions on this notice, call 

or email Mrs. Mayte Medina, Office of 

Vessel Activities (CG–522), (202) 372– 

1406, email Mayte.Medina2@uscg.mil. If 

you have questions on viewing or 

submitting material to the docket, call 

Renee V. Wright, Program Manager, 

Docket Operations, telephone (202) 

366–9826. 

SUPPLEMENTARY INFORMATION: 

Background and Purpose 

The International Convention on 

Standards of Training, Certification and 

Watchkeeping for Seafarers, 1978 as 

amended, (STCW) sets forth minimum 

training and hours of rest requirements 

for merchant mariners. In 2007, the IMO 

embarked on a comprehensive review of 

the entire STCW Convention and STCW 

Code, which sets forth provisions for 

implementing the STCW Convention. 

The Parties adopted these amendments 

on June 25, 2010 at the STCW 

Diplomatic Conference in Manila, 

Philippines. The amendments are 

scheduled to enter into force for all 

ratifying countries on January 1, 2012. 

The 2010 amendments include security 

training and certification requirements 

for vessel personnel working on board 

vessels; and changes to the hours of rest 

requirements applicable to personnel 

working on board U.S. vessels. 

The Convention is not selfimplementing; therefore, the United 

States, as a signatory to the STCW 

Convention, must initiate regulatory 

changes to ensure full implementation 

of the amendments to the STCW 

Convention and STCW Code. The 

United States implements these 

provisions under the Convention and 

under the authority of United States 

domestic laws at United States Code 

titles 5, 14, 33, and 46. 

The Coast Guard published a 

Supplemental Notice of Proposed 

Rulemaking (SNPRM) on August 1, 2011 

(76 FR 45908), proposing changes to 

implement the STCW Convention and 

Code, to address the comments received 

from the public in response to the 

Notice of Proposed Rulemaking (NPRM) 

published on November 17, 2009 (74 FR 

59354), and to incorporate the 2010 

amendments to the STCW Convention 

that will come into force on January 1, 

2012. The public comment period for 

the SNPRM ended on September 30, 

2011. The Coast Guard will be 

publishing a final rule (FR) to 

implement amendments to the STCW, 

including the 2010 amendments, and 

ensure that the U.S. is meeting its 

obligations under the Convention. The 

comments received will be discussed in 

the final rule. 

Discussion 

This notice applies to all vessels 

subject to STCW under current 

regulations. This includes all seagoing 

vessels, as defined in 46 CFR 15.1101, 

meaning self-propelled vessels engaged 

in commercial service that operate 

beyond the Boundary Line established 

by 46 CFR part 7, except those vessels 

that have been determined to be 

otherwise exempt from, or not subject to 

further obligation of, STCW under 46 

CFR 15.103(e) and (f). 

Although full implementation of the 

hours of rest and security training 

requirements necessitate regulatory 

changes, the Coast Guard is issuing this 

notice to implement mechanisms to 

lessen the port state control impact on 

United States vessels while operating 

abroad, and while the Coast Guard 

publishes the final rule. 

Hours of Rest 

The 2010 amendments to the STCW 

Convention and Code amended the rest 

hours requirements as follows: (1) 

Expanded the application for hours of 

work and rest periods for mariners to 

include all personnel with designated 

safety, prevention of pollution, and 


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