# Vol. 78 Monday, No. 155 August 12, 2013

Part III



# Department of Health and Human Services

Center for Medicare & Medicaid Services 42 CFR Parts 410, 414, 415, et al. 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; Final Rule


# 48996 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

**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 inadvertentlyomitted language regarding the claimsbased 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 thedescriptors for G-codes in Table 21: GCodes 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


# 48997 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

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:


# 48998 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and RegulationsTABLE3—CALCULATION OFPE RVUS UNDERMETHODOLOGY FORSELECTEDCODESStep Source Formula99213Office visit, estnonfacility33533CABG, arterial,singlefacility71020Chest x-raynonfacility71020–TCChest x-raynonfacility71020–26Chest x-raynonfacility93000ECG, completenonfacility93005ECG, tracingnonfacility93010ECG, reportnonfacility(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) Equipmentcost (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) AdjustedLabor.Steps 2–4 ...... =Labor * DirAdj.=(1)*(5) 7.96 46.30 3.43 3.43 0.00 3.66 3.66 0.00(7) AdjustedSupplies.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) AdjustedEquipment.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) AdjustedDirect.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. laborcost converted.Step 5 ............ =(Lab * DirAdj)/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 * DirAdj)/CF.=(7)/(10) 0.05 0.00 0.06 0.06 0.00 0.02 0.02 0.00(13) Adj.equipmentcost converted.Step 5 ............ =(Eqp * DirAdj)/CF.=(8)/(10) 0.00 0.01 0.13 0.13 0.00 0.00 0.00 0.00(14) Adj. directcost converted.Step 5 ............ ....................... =(11)+(12)+(13) 0.29 1.37 0.29 0.29 0.00 0.13 0.13 0.00(15) WorkRVU.Setup File ...... PFS ............... .......................... 0.97 33.75 0.22 0.00 0.22 0.17 0.00 0.17(16) Dir_pct .... Steps6,7 ....... Surveys ......... ..........................0.31 0.18 0.31 0.31 0.31 0.31 0.31 0.31(17) Ind_pct .... Steps6,7 ....... Surveys ......... ..........................0.69 0.82 0.69 0.69 0.69 0.69 0.69 0.69(18) Ind. Alloc.Formula (1stpart).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.(1stpart).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.(2ndpart).Step 8 ............ ....................... See 20 0.97 33.75 0.32 0.10 0.22 0.28 0.11 0.17(22) IndirectAllocator(1st + 2nd).Step 8 ............ ....................... =(19)+(21) 1.84 40.16 1.03 0.81 0.22 0.60 0.43 0.17(23) IndirectAdjustment(Ind. Adj.).Steps 9–11 .... SeeFootnote**........................... 0.40 0.40 0.40 0.40 0.40 0.40 0.40 0.40


# 48999 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations(24) AdjustedIndirect 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 CostIndex (IPCI).Steps 12–16 .. ....................... .......................... 1.08 0.79 0.92 0.92 0.92 0.92 0.92 0.92(26) AdjustedIndirect.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)) *budn1.10 14.15 0.67 0.59 0.08 0.35 0.29 0.06


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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.


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G9164 ............... Spoken language expression functional limitation, discharge status at discharge from therapy or to end repo rting.

**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, nonextremity (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 tasksassociated with both the base and addon 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


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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 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

CPT Code CPT Code description CMS Code CMS Code description NonFac/Fac Labor activity (if applicable) RUC recommendation or current value

(min or qty) CMS refinement (min or qty) Comment

11300 ..................... Shave skin lesion 0.5 cm/< ED004 camera, digital (6 mexapixel). NF .............................. 29 14 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 29 14 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 29 14 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 29 14 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 29 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500- $1499). NF .............................. 29 24 Refined equipment time to reflecttypical use exclusive to patient. EQ351 SmokeEvacuator(tubing, covering, etc.) with stand. NF .............................. 29 14 Refined equipment time to reflecttypical 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.


# 49003 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11301 ..................... Shave skin lesion 0.6–1.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 32 17 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 32 17 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 32 17 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 32 17 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 32 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500- $1499). NF .............................. 32 27 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 32 17 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11302 ..................... Shave skin lesion 1.1–2.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 37 20 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 37 20 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 37 20 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 37 20 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 37 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500- $1499). NF .............................. 37 30 Refined equipment time to reflecttypical use exclusive to patient.


# 49004 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 37 20 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11303 ..................... Shave skin lesion >2.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 41 22 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 41 22 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 41 22 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 41 22 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, 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 reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 41 22 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11305 ..................... Shave skin lesion 0.5 cm/< ED004 camera, digital (6 mexapixel). NF .............................. 29 17 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 29 17 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 29 17 Refined equipment time to reflecttypical use exclusive to patient.


# 49005 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EF031 table, power ......... NF .............................. 29 17 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 29 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500– $1499). NF .............................. 29 27 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 29 17 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11306 ..................... Shave skin lesion 0.6–1.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 31 25 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 31 25 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 31 25 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 31 25 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 31 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500– $1499). NF .............................. 31 35 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 31 25 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Assist physician inperforming procedure. 10 18 Conforming to physician time.

L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review.


# 49006 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

11307 ..................... Shave skin lesion 1.1–2.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 37 21 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 37 21 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 37 21 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 37 21 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 37 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500– $1499). NF .............................. 37 31 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 37 21 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11308 ..................... Shave skin lesion >2.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 42 24 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 42 24 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 42 24 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 42 24 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, 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 reflecttypical use exclusive to patient.


# 49007 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 42 24 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11310 ..................... Shave skin lesion 0.5 cm/< ED004 camera, digital (6 mexapixel). NF .............................. 34 20 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 34 20 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 34 20 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 34 20 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 34 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500– $1499). NF .............................. 34 30 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 34 20 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11311 ..................... Shave skin lesion 0.6–1.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 34 24 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 34 24 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 34 24 Refined equipment time to reflecttypical use exclusive to patient.


# 49008 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EF031 table, power ......... NF .............................. 34 24 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 34 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500– $1499). NF .............................. 34 34 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 34 24 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Assist physician inperforming procedure. 11 17 Conforming to physician time.

L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 1 10 Standardized time input.

SB003 cover, probe (cryosurgery). NF .............................. 1 0 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB033 mask, surgical ...... NF .............................. 2 1 Duplicative. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. 11312 ..................... Shave skin lesion 1.1–2.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 43 17 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 43 17 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 43 17 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 43 17 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 43 0 CMS clinical review; not described as typical in work vignette. EQ137 instrument pack, basic ($500– $1499). NF .............................. 43 37 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 43 17 Refined equipment time to reflecttypical 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.


# 49009 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

11313 ..................... Shave skin lesion >2.0 cm. ED004 camera, digital (6 mexapixel). NF .............................. 48 30 Refined equipment time to reflecttypical use exclusive to patient. EF014 light, surgical ........ NF .............................. 48 30 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 48 30 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 48 30 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, 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 reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 48 30 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 32 39 Refined equipment time to reflecttypical use exclusive to patient.


# 49010 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EF023 table, exam .......... NF .............................. 32 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 32 39 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 32 39 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 32 46 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 32 39 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 45 47 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 45 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 45 47 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 45 47 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 45 54 Refined equipment time to reflecttypical 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.


# 49011 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient. Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input. SJ041 povidone soln (Betadine). NF .............................. 5 0 Duplicative.

13120 ..................... Cmplx rpr s/a/l 1.1–2.5 cm. EF014 light, surgical ........ NF .............................. 86 27 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 86 41 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 86 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 86 41 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 86 41 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 86 48 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 86 41 Refined equipment time to reflecttypical use exclusive to patient.


# 49012 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

SB016 drape-cover, sterile, OR light handle. NF .............................. 2 1 CMS clinical review.

SB027 gown, staff, impervious. NF .............................. 2 0 Duplicative.

SB027 gown, staff, impervious. F .............................. 2 0 CMS clinical review. SB034 mask, surgical, with face shield. NF .............................. 2 1 Duplicative.

SB034 mask, surgical, with face shield. F .............................. 2 1 CMS clinical review. SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input. SJ041 povidone soln (Betadine). NF .............................. 5 0 Duplicative.

13121 ..................... Cmplx rpr s/a/l 2.6–7.5 cm. EF014 light, surgical ........ NF .............................. 129 27 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 129 48 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 129 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 129 48 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 129 48 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 129 55 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 129 48 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 15 10 Standardized time input.

SB016 drape-cover, sterile, OR light handle. NF .............................. 2 1 CMS clinical review.

SB027 gown, staff, impervious. NF .............................. 2 0 Duplicative.

SB034 mask, surgical, with face shield. NF .............................. 2 1 Duplicative.

SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input. SJ041 povidone soln (Betadine). NF .............................. 10 0 Duplicative.

13122 ..................... Cmplx rpr s/a/l addl 5 cm/> EF015 mayo stand .......... NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient.


# 49013 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EF031 table, power ......... NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 30 20 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 30 20 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 45 48 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 45 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 45 48 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 45 48 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 45 55 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 45 48 Refined equipment time to reflecttypical 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.


# 49014 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

13132 ..................... Cmplx rpr f/c/c/m/ n/ax/g/h/f. EF014 light, surgical ........ NF .............................. 50 27 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 50 51 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 50 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 50 51 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 50 51 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 50 58 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 50 51 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 35 23 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 35 23 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 35 23 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 35 23 Refined equipment time to reflecttypical use exclusive to patient. Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input.


# 49015 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

SJ041 povidone soln (Betadine). NF .............................. 5 0 Duplicative.

13150 ..................... Cmplx rpr e/n/e/l 1.0 cm/< EF014 light, surgical ........ NF .............................. 30 27 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 30 44 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 30 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 30 44 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 30 44 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 30 51 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 30 44 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Assist physician inperforming procedure. 20 26 Conforming to physician time.

SB016 drape-cover, sterile, OR light handle. NF .............................. 2 1 CMS clinical review.

SB027 gown, staff, impervious. NF .............................. 2 0 Duplicative.

SB034 mask, surgical, with face shield. NF .............................. 2 1 Duplicative.

SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input. SJ041 povidone soln (Betadine). NF .............................. 5 0 Duplicative.

13151 ..................... Cmplx rpr e/n/e/l 1.1–2.5 cm. EF014 light, surgical ........ NF .............................. 45 27 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 45 48 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 45 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 45 48 Refined equipment time to reflecttypical use exclusive to patient.


# 49016 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ114 electrosurgical generator, up to 120 watts. NF .............................. 45 48 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 45 55 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 45 48 Refined equipment time to reflecttypical use exclusive to patient.SB016 drape-cover, sterile, OR light handle. NF .............................. 2 1 CMS clinical review.

SB027 gown, staff, impervious. NF .............................. 2 0 Duplicative.

SB034 mask, surgical, with face shield. NF .............................. 2 1 Duplicative.

SC029 needle, 18–27g .... NF .............................. 1 0 CMS clinical review. Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input. SJ041 povidone soln (Betadine). NF .............................. 5 0 Duplicative.

13152 ..................... Cmplx rpr e/n/e/l 2.6–7.5 cm. EF014 light, surgical ........ NF .............................. 50 27 Refined equipment time to reflecttypical use exclusive to patient. EF015 mayo stand .......... NF .............................. 50 51 Refined equipment time to reflecttypical use exclusive to patient. EF023 table, exam .......... NF .............................. 50 27 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 50 51 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 50 51 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 50 58 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 50 51 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF .............................. 15 10 Standardized time input.SB016 drape-cover, sterile, OR light handle. NF .............................. 2 1 CMS clinical review.

SB027 gown, staff, impervious. NF .............................. 2 0 Duplicative.

SB034 mask, surgical, with face shield. NF .............................. 2 1 Duplicative.

Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input. SJ041 povidone soln (Betadine). NF .............................. 10 0 Duplicative.


# 49017 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

13153 ..................... Cmplx rpr e/n/e/l addl 5cm/< EF015 mayo stand .......... NF .............................. 45 30 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 45 30 Refined equipment time to reflecttypical use exclusive to patient. EQ114 electrosurgical generator, up to 120 watts. NF .............................. 45 30 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 45 30 Refined equipment time to reflecttypical use exclusive to patient. EQ351 Smoke Evacuator(tubing, covering, etc.) with stand. NF .............................. 45 30 Refined equipment time to reflecttypical use exclusive to patient. SC029 needle, 18–27g .... NF .............................. 2 0 CMS clinical review. Electrocautery

Supply Pack. NF .............................. 1 0 Non-standard direct practice expense input. SJ041 povidone soln (Betadine). NF .............................. 5 0 Duplicative.

20600 ..................... Drain/inject joint/ bursa. EF023 table, exam .......... NF .............................. 19 16 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 19 16 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... F Discharge day management. 6 0 CMS clinical review. L037D RN/LPN/MTA ....... F Conduct phonecalls/call in prescriptions. 0 3 CMS clinical review.

SC029 needle, 18–27g .... NF .............................. 4 2 CMS clinical review. SC055 syringe 3ml .......... NF .............................. 2 1 CMS clinical review. 20605 ..................... Drain/inject joint/ bursa. EF023 table, exam .......... NF .............................. 19 16 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 19 16 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... F Discharge day management. 6 0 CMS clinical review. L037D RN/LPN/MTA ....... F Conduct phonecalls/call in prescriptions. 0 3 CMS clinical review.

SC029 needle, 18–27g .... NF .............................. 4 2 CMS clinical review. SC055 syringe 3ml .......... NF .............................. 2 1 CMS clinical review. 20610 ..................... Drain/inject joint/ bursa. EF023 table, exam .......... NF .............................. 19 16 Refined equipment time to reflecttypical use exclusive to patient.


# 49018 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ168 light, exam ........... NF .............................. 19 16 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... F Discharge day management. 6 0 CMS clinical review. L037D RN/LPN/MTA ....... F Conduct phonecalls/call in prescriptions. 0 3 CMS clinical review.

SC029 needle, 18–27g .... NF .............................. 4 2 CMS clinical review. SC057 syringe 5–6ml ...... NF .............................. 2 1 CMS clinical review.23472 ..................... Reconstruct shoulder joint. SA052 pack, post-op incision care (staple). F .............................. 0 1 CMS clinical review.

SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

23473 ..................... Revis reconst shoulder joint. SA052 pack, post-op incision care (staple). F .............................. 0 1 CMS clinical review.

SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

23474 ..................... Revis reconst shoulder joint. SA052 pack, post-op incision care (staple). F .............................. 0 1 CMS clinical review.

SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

24363 ..................... Replace elbow joint. SA052 pack, post-op incision care (staple). F .............................. 0 1 CMS clinical review.

SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

24370 ..................... Revise reconst elbow joint. SA052 pack, post-op incision care (staple). F .............................. 0 1 CMS clinical review.

SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

24371 ..................... Revise reconst elbow joint. SA052 pack, post-op incision care (staple). F .............................. 0 1 CMS clinical review.

SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

31231 ..................... Nasal endoscopy dx. ED032 printer, laser, paper. NF .............................. 43 35 Refined equipment time to reflecttypical use exclusive to patient.EF008 chair with headrest, exam, reclining. NF .............................. 43 35 Refined equipment time to reflecttypical use exclusive to patient. EQ138 instrument pack, medium ($1500 and up). NF .............................. 0 47 Refined equipment time to reflecttypical use exclusive to patient. EQ167 light source, xenon NF .............................. 43 35 Refined equipment time to reflecttypical use exclusive to patient. EQ170 light, fiberopticheadlight wsource. NF .............................. 43 35 Refined equipment time to reflecttypical use exclusive to patient.


# 49019 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ234 suction and pressure cabinet, ENT (SMR). NF .............................. 43 35 Refined equipment time to reflecttypical use exclusive to patient. ES013 endoscope, rigid, sinoscopy. NF .............................. 63 42 Refined equipment time to reflecttypical use exclusive to patient. ES013 endoscope, rigid, sinoscopy. NF .............................. 63 0 CMS clinical review.ES031 video system, endoscopy (processor, digitalcapture, monitor, printer, cart). NF .............................. 43 35 Refined equipment time to reflecttypical use exclusive to patient. ES036 Nasal Endoscopy Instrument Package. NF .............................. 63 0 Non-standard direct practice expense input. L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 2 0 CMS clinical review.

L037D RN/LPN/MTA ....... NF Obtain vital signs 1 0 CMS clinical review. L037D RN/LPN/MTA ....... NF Clean Surgical Instrument Package. 10 15 Standardized time input.

L037D RN/LPN/MTA ....... NF Review/read Xray, lab, and pathology reports. 5 0 CMS clinical review.

SB027 gown, staff, impervious. NF .............................. 2 1 Duplicative.

SB034 mask, surgical, with face shield. NF .............................. 2 1 Duplicative.

31647 ..................... Bronchial valve init insert. L047C RN/Respiratory Therapist. F Complete preservice diagnostic & referral forms. 3 5 CMS clinical review.

L047C RN/Respiratory Therapist. F Coordinate presurgery services. 5 3 CMS clinical review. 32554 ..................... Aspirate pleura w/ o imaging. EF023 table, exam .......... NF .............................. 56 52 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 0 52 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Complete preservice diagnostic & referral forms. 5 0 CMS clinical review.

L037D RN/LPN/MTA ....... NF Coordinate presurgery services. 3 1 CMS clinical review. L037D RN/LPN/MTA ....... NF Monitor pt. following service/ check tubes, monitors, drains. 5 10 CMS clinical review.

SA048 pack, minimum multi-specialty visit. NF .............................. 0 1 CMS clinical review.

SA067 tray, shave prep ... NF .............................. 0 1 CMS clinical review. ................ kit, thoracentesis .. NF .............................. 1 0 CMS clincial review. SA070 tray, thoracentesis NF .............................. 0 1 CMS clincial review.SA077 kit, pleural catheter insertion. NF .............................. 0 1 CMS clinical review. SB001 cap, surgical ........ NF .............................. 0 2 CMS clinical review.


# 49020 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

SB006 drape, non-sterile, sheet 40in x 60in. NF .............................. 1 0 CMS clinical review.

SB024 gloves, sterile ....... NF .............................. 1 2 CMS clinical review. SB034 mask, surgical, with face shield. NF .............................. 0 2 CMS clinical review.SB039 shoe covers, surgical. NF .............................. 0 2 CMS clinical review. SB044 underpad 2ft x 3ft (Chux). NF .............................. 0 1 CMS clinical review. SG056 gauze, sterile 4in x 4in (10 pack uou). NF .............................. 1 0 CMS clinical review.

32555 ..................... Aspirate pleura w/ imaging. ED024 film processor, dry, laser. NF .............................. 58 7 Refined equipment time to reflecttypical use exclusive to patient. EF019 stretcher chair ...... NF .............................. 15 10 CMS clinical review. EL015 room, ultrasound, general. NF .............................. 33 30 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 58 7 Refined equipment time to reflecttypical use exclusive to patient.L041B Radiologic Technologist. NF Complete preservice diagnostic & referral forms. 5 0 CMS clinical review.

L041B Radiologic Technologist. NF Coordinate presurgery services. 3 1 CMS clinical review.L041B Radiologic Technologist. NF Monitor pt. following service/ check tubes, monitors, drains. 15 10 CMS clinical review.

L041B Radiologic Technologist. NF Process images, complete data sheet, present images and datato the interpreting physician. 5 2 CMS clinical review.

kit, thoracentesis .. NF .............................. 1 0 CMS clinical review. SA070 tray, thoracentesis NF .............................. 0 1 CMS clinical review.SA077 kit, pleural catheter insertion. NF .............................. 0 1 CMS clinical review. SB001 cap, surgical ........ NF .............................. 0 3 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 0 1 CMS clinical review.SB039 shoe covers, surgical. NF .............................. 0 3 CMS clinical review. SB044 underpad 2ft x 3ft (Chux). NF .............................. 0 1 CMS clinical review.SG078 tape, surgical occlusive 1in (Blenderm). NF .............................. 0 15 CMS clinical review.

SM012 disinfectant spray (Transeptic). NF .............................. 10 0 CMS clinical review.SM021 sanitizing clothwipe (patient). NF .............................. 2 0 CMS clinical review. 32556 ..................... Insert cath pleura w/o image. EQ168 light, exam ........... NF .............................. 0 76 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Complete preservice diagnostic & referral forms. 5 0 CMS clinical review.


# 49021 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

L037D RN/LPN/MTA ....... NF Coordinate presurgery services. 3 1 CMS clinical review. SA044 pack, moderate sedation. NF .............................. 0 1 CMS clinical review. SA048 pack, minimum multi-specialty visit. NF .............................. 0 1 CMS clinical review.

SA067 tray, shave prep ... NF .............................. 0 1 CMS clinical review. SB001 cap, surgical ........ NF .............................. 0 2 CMS clinical review. SB006 drape, non-sterile, sheet 40in x 60in. NF .............................. 1 0 CMS clinical review.

SB034 mask, surgical, with face shield. NF .............................. 0 2 CMS clinical review.SB039 shoe covers, surgical. NF .............................. 0 2 CMS clinical review. SB044 underpad 2ft x 3ft (Chux). NF .............................. 0 1 CMS clinical review.SC010 closed flush system, angiography. NF .............................. 0 1 CMS clinical review.

SG056 gauze, sterile 4in x 4in (10 pack uou). NF .............................. 1 0 CMS clinical review.

SH065 sodium chloride0.9% flush syringe. NF .............................. 0 1 CMS clinical review.

SH069 sodium chloride 0.9% irrigation (500–1000ml uou). NF .............................. 0 1 CMS clinical review.

SL157 cup, sterile, 8 oz .. NF .............................. 0 1 CMS clinical review. 32557 ..................... Insert cath pleura w/image. ED024 film processor, dry, laser. NF .............................. 58 7 CMS clinical review. EF019 stretcher chair ...... NF .............................. 15 10 CMS clinical review. EL007 room, CT .............. NF .............................. 43 40 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 60 40 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 58 7 CMS clinical review.

L046A CT Technologist .. NF Complete preservice diagnostic & referral forms. 5 0 CMS clinical review.

L046A CT Technologist .. NF Coordinate presurgery services. 3 1 CMS clinical review. L046A CT Technologist .. NF Check dressings & wound/homecare instructions/coordinateoffice visits/prescriptions. 3 5 CMS clinical review.

L046A CT Technologist .. NF Assist physician inperforming procedure. 28 30 Conforming to physician time.

SA071 kit, AccuStick II Introducer System with RO Marker. NF .............................. 1 0 CMS clinical review.

SA077 kit, pleural catheter insertion. NF .............................. 0 1 CMS clinical review. SB001 cap, surgical ........ NF .............................. 2 3 CMS clinical review.SB011 drape, sterile, fenestrated 16in x 29in. NF .............................. 1 0 CMS clinical review.


# 49022 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

SB014 drape, sterile, three-quarter sheet. NF .............................. 1 0 CMS clinical review.

SB019 drape-towel, sterile 18in x 26in. NF .............................. 4 0 CMS clinical review. SB024 gloves, sterile ....... NF .............................. 2 1 CMS clinical review.SB027 gown, staff, impervious. NF .............................. 0 1 CMS clinical review.SB039 shoe covers, surgical. NF .............................. 2 3 CMS clinical review. SC049 stop cock, 3-way .. NF .............................. 1 0 CMS clinical review. SC056 syringe 50–60ml .. NF .............................. 2 0 CMS clinical review. SC058 syringe w-needle, OSHA compliant (SafetyGlide). NF .............................. 1 0 CMS clinical review.

SD043 dilator, vessel, angiographic. NF .............................. 1 0 CMS clinical review. SD088 guidewire ............. NF .............................. 1 0 CMS clinical review. SD146 catheter percutaneousfastener (PercuStay). NF .............................. 1 0 CMS clinical review.

SD161 drainage catheter, all purpose. NF .............................. 1 0 CMS clinical review. SD163 drainage pouch,nephrostomy-biliary. NF .............................. 1 0 CMS clinical review.

SF007 blade, surgical (Bard-Parker). NF .............................. 1 0 CMS clinical review. SG009 applicator, sponge-tipped. NF .............................. 4 0 CMS clinical review.SG078 tape, surgical occlusive 1in (Blenderm). NF .............................. 0 25 CMS clinical review.

SH047 lidocaine 1%–2% inj (Xylocaine). NF .............................. 10 0 CMS clinical review. SJ041 povidone soln (Betadine). NF .............................. 60 0 CMS clinical review.SL036 cup, biopsy-specimen sterile 4oz. NF .............................. 1 0 CMS clinical review. SL156 cup, sterile, 12–16

oz. NF .............................. 1 0 CMS clinical review. 33361 ..................... Replace aortic valve perq. L037D RN/LPN/MTA ....... F Coordinate presurgery services. 40 10 Standardized time input. L037D RN/LPN/MTA ....... F Schedule space and equipment in facility. 8 5 Standardized time input.

L037D RN/LPN/MTA ....... F Provide pre-service education/ obtain consent. 20 7 Standardized time input.

L037D RN/LPN/MTA ....... F Follow-up phonecalls & prescriptions. 7 3 Standardized time input.

33362 ..................... Replace aortic valve open. L037D RN/LPN/MTA ....... F Coordinate presurgery services. 40 10 Standardized time input. L037D RN/LPN/MTA ....... F Schedule space and equipment in facility. 8 5 Standardized time input.

L037D RN/LPN/MTA ....... F Provide pre-service education/ obtain consent. 20 7 Standardized time input.

L037D RN/LPN/MTA ....... F Follow-up phonecalls & prescriptions. 7 3 Standardized time input.

33363 ..................... Replace aortic valve open. L037D RN/LPN/MTA ....... F Coordinate presurgery services. 40 10 Standardized time input. L037D RN/LPN/MTA ....... F Schedule space and equipment in facility. 8 5 Standardized time input.

L037D RN/LPN/MTA ....... F Provide pre-service education/ obtain consent. 20 7 Standardized time input.

L037D RN/LPN/MTA ....... F Follow-up phonecalls & prescriptions. 7 3 Standardized time input.


# 49023 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

33364 ..................... Replace aortic valve open. L037D RN/LPN/MTA ....... F Coordinate presurgery services. 40 10 Standardized time input. L037D RN/LPN/MTA ....... F Schedule space and equipment in facility. 8 5 Standardized time input.

L037D RN/LPN/MTA ....... F Provide pre-service education/ obtain consent. 20 7 Standardized time input.

L037D RN/LPN/MTA ....... F Follow-up phonecalls & prescriptions. 7 3 Standardized time input.

33365 ..................... Replace aortic valve open. L037D RN/LPN/MTA ....... F Coordinate presurgery services. 40 10 Standardized time input. L037D RN/LPN/MTA ....... F Schedule space and equipment in facility. 8 5 Standardized time input.

L037D RN/LPN/MTA ....... F Provide pre-service education/ obtain consent. 20 7 Standardized time input.

L037D RN/LPN/MTA ....... F Follow-up phonecalls & prescriptions. 7 3 Standardized time input.

33366 ..................... #N/A ..................... L037D RN/LPN/MTA ....... F Coordinate presurgery services. 40 10 Standardized time input. L037D RN/LPN/MTA ....... F Schedule space and equipment in facility. 8 5 Standardized time input.

L037D RN/LPN/MTA ....... F Provide pre-service education/ obtain consent. 20 7 Standardized time input.

L037D RN/LPN/MTA ....... F Follow-up phonecalls & prescriptions. 7 3 Standardized time input.

33405 ..................... Replacement of aortic valve. L051A RN ........................ F Other Clinical Activity—specify: for reference code 33406 and codes 33405and 33430: Additional coordination betweenmultiple specialties for complex procedures (tests, meds, scheduling, etc) prior to patient arrival at site of service.. 15 0 CMS clinical review.

L051A RN ........................ F Other Clinical Activity—specify: for reference code 33406 and codes 33405and 33430: Additional coordination betweenmultiple specialties for complex procedures (tests, meds, scheduling, etc) prior to patient arrival at site of service.. 15 0 CMS clinical review.

35475 ..................... Repair arterial blockage. EL011 room, angiography NF .............................. 51 52 Refined equipment time to reflecttypical use exclusive to patient. EQ011 ECG, 3-channel (with SpO2, NIBP, temp, resp). NF .............................. 212 285 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient.


# 49024 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ032 IV infusion pump .. NF .............................. 212 285 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient. EQ168 light, exam ........... NF .............................. 120 52 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... F Complete preservice diagnostic & referral forms. 5 3 CMS clinical review.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review.L041B Radiologic Technologist. NF Prepare room,equipment, supplies. 4 2 Standardized time input.

SB019 drape-towel, sterile 18in x 26in. NF .............................. 4 2 CMS clinical review. 35476 ..................... Repair venous blockage. Ef027 table, instrument, mobile. NF .............................. 302 277 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient. EL011 room, angiography NF .............................. 43 44 Refined equipment time to reflecttypical use exclusive to patient. EQ011 ECG, 3-channel (with SpO2, NIBP, temp, resp). NF .............................. 137 277 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient. EQ032 IV infusion pump .. NF .............................. 137 277 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient. EQ168 light, exam ........... NF .............................. 120 44 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... F Schedule space and equipment in facility. 3 5 CMS clinical review.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review.L041B Radiologic Technologist. NF Prepare room,equipment, supplies. 4 2 Standardized time input.

SB019 drape-towel, sterile 18in x 26in. NF .............................. 4 2 CMS clinical review.36221 ..................... Place cath thoracic aorta. EF018 stretcher ............... NF .............................. 272 0 CMS Code correction. EF027 table, instrument, mobile. NF .............................. 0 272 CMS Code correction. EL011 room, angiography NF .............................. 49 45 Refined equipment time to reflecttypical use exclusive to patient.


# 49025 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ088 contrast media

warmer. NF .............................. 49 45 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 49 45 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 5 3 Standardized time input.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review. L041A Angio Technician NF Image Post Processing. 5 0 CMS clinical review.L041B Radiologic Technologist. NF Prepare room,equipment, supplies. 2 7 CMS clinical review.

L041B Radiologic Technologist. NF Prepare and position patient/monitor patient/set up IV. 2 7 CMS clinical review.

SD249 Sterile Radioopaque ruler (leMaitre, documentation available). NF .............................. 1 0 CMS clinical review.

36222 ..................... Place cath carotid/ inom art. EF018 stretcher ............... NF .............................. 282 0 CMS Code correction. EF027 table, instrument, mobile. NF .............................. 0 282 CMS Code correction. EL011 room, angiography NF .............................. 59 55 Refined equipment time to reflecttypical use exclusive to patient. EQ088 contrast media

warmer. NF .............................. 59 55 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 59 55 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 5 3 Standardized time input.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review. SD147 catheter, (Glide) ... NF .............................. 1 0 CMS clinical review.SD249 Sterile Radioopaque ruler (leMaitre, documentation available). NF .............................. 1 0 CMS clinical review.

36223 ..................... Place cath carotid/ inom art. EF018 stretcher ............... NF .............................. 287 0 CMS Code correction. EF027 table, instrument, mobile. NF .............................. 0 287 CMS Code correction. EL011 room, angiography NF .............................. 64 60 Refined equipment time to reflecttypical use exclusive to patient.


# 49026 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ088 contrast media

warmer. NF .............................. 64 60 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 64 60 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 5 3 Standardized time input.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review.SD249 Sterile Radioopaque ruler (leMaitre, documentation available). NF .............................. 1 0 CMS clinical review.

36224 ..................... Place cath carotd art. EF018 stretcher ............... NF .............................. 292 0 CMS Code correction. EF027 table, instrument, mobile. NF .............................. 0 292 CMS Code correction. EL011 room, angiography NF .............................. 69 65 Refined equipment time to reflecttypical use exclusive to patient. EQ088 contrast media

warmer. NF .............................. 69 65 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 69 65 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 5 3 Standardized time input.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review.36225 ..................... Place cath subclavian art. EF018 stretcher ............... NF .............................. 287 0 CMS Code correction. EF027 table, instrument, mobile. NF .............................. 0 287 CMS Code correction. EL011 room, angiography NF .............................. 64 60 Refined equipment time to reflecttypical use exclusive to patient. EQ088 contrast media

warmer. NF .............................. 64 60 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 64 60 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 5 3 Standardized time input.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review.


# 49027 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

36226 ..................... Place cath vertebral art. EF018 stretcher ............... NF .............................. 292 0 CMS Code correction. EF027 table, instrument, mobile. NF .............................. 0 292 CMS Code correction. EL011 room, angiography NF .............................. 69 65 Refined equipment time to reflecttypical use exclusive to patient. EQ088 contrast media

warmer. NF .............................. 69 65 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 69 65 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 5 3 Standardized time input.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review. 36228 ..................... Place cath intracranial art. L041B Radiologic Technologist. NF Prepare room,equipment, supplies. 1 0 CMS clinical review.

L041B Radiologic Technologist. NF Assisting with flouroscopy/image acquisition (75%). 23 22 CMS clinical review.

SC057 syringe 5–6ml ...... NF .............................. 4 0 CMS clinical review. 37197 ..................... Remove intrvas foreign body. EF027 table, instrument, mobile. NF .............................. 305 302 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient. EL011 room, angiography NF .............................. 77 72 Refined equipment time to reflecttypical use exclusive to patient. EQ011 ECG, 3-channel (with SpO2, NIBP, temp, resp). NF .............................. 305 302 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient. EQ032 IV infusion pump .. NF .............................. 305 302 Moderate Sedation equipment— Time includes administeringanesthesia, procedure time, and monitoring patient. EQ088 contrast media

warmer. NF .............................. 77 0 CMS clinical review. EQ250 ultrasound unit, portable. NF .............................. 77 0 CMS clinical review.ER029 film alternator (motorized film viewbox). NF .............................. 77 72 Refined equipment time to reflecttypical use exclusive to patient.


# 49028 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

L037D RN/LPN/MTA ....... NF Greet patient, provide gowning,assure appropriate medical records are available. 5 3 Standardized time input.

L037D RN/LPN/MTA ....... NF Obtain vital signs 5 3 CMS clinical review.L041B Radiologic Technologist. NF Prepare room,equipment, supplies (includingimaging equipment). 7 5 CMS clinical review.

L041B Radiologic Technologist. NF Prepare and position patient/monitor patient/set up IV. 5 2 Standardized time input.

SB005 cover-condom, transducer or ultrasound probe. NF .............................. 1 0 CMS clinical review.

SB048 sheath-cover, sterile, 96in x 6in (transducer). NF .............................. 1 0 CMS clinical review.

SD147 catheter, (Glide) ... NF .............................. 1 0 CMS clinical review. SD252 guidewire, Amplatz wire 260 cm. NF .............................. 1 0 CMS clinical review. SH065 sodium chloride0.9% flush syringe. NF .............................. 2 0 CMS clinical review.

47600 ..................... Removal of gallbladder. SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

SA054 pack, post-op incision care (suture). F .............................. 0 1 CMS clinical review.

47605 ..................... Removal of gallbladder. SA053 pack, post-op incision care (suture & staple). F .............................. 1 0 CMS clinical review.

SA054 pack, post-op incision care (suture). F .............................. 0 1 CMS clinical review.

50590 ..................... Fragmenting of kidney stone. EL014 room, radiographicfluoroscopic. NF .............................. 86 0 Consistent with the AMA RUC’sCY2011 recommendation.EQ175 lithotriptor, with Carm (ESWL). NF .............................. 86 67 Refined equipment time to reflecttypical use exclusive to patient. 52214 ..................... Cystoscopy and treatment. EF027 table, instrument, mobile. NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient. EQ153 laser (gs, uro, obg,ge) (Indigo Optima). NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient. EQ167 light source, xenon NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient.


# 49029 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

ES006 endoscope forceps, biopsy. NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient.ES007 endoscope forceps, grasping. NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient.ES018 fiberscope, flexible, cystoscopy. NF .............................. 100 92 Refined equipment time to reflecttypical use exclusive to patient.ES031 video system, endoscopy (processor, digitalcapture, monitor, printer, cart). NF .............................. 100 65 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Review Chart ....... 3 0 CMS clinical review. SB019 drape-towel, sterile 18in x 26in. NF .............................. 1 0 Duplicative.

SB024 gloves, sterile ....... NF .............................. 0 1 CMS clinical review. SD270 Penis clamp ......... NF .............................. 1 0 Not a disposable according tosubmitted invoice. SH047 lidocaine 1%–2% inj (Xylocaine). NF .............................. 50 0 Duplicative.

52224 ..................... Cystoscopy and treatment. EF027 table, instrument, mobile. NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient. EQ153 laser (gs, uro, obg,ge) (Indigo Optima). NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient. EQ167 light source, xenon NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient.ES006 endoscope forceps, biopsy. NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient.ES007 endoscope forceps, grasping. NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient.ES018 fiberscope, flexible, cystoscopy. NF .............................. 105 94 Refined equipment time to reflecttypical use exclusive to patient.ES031 video system, endoscopy (processor, digitalcapture, monitor, printer, cart). NF .............................. 105 67 Refined equipment time to reflecttypical use exclusive to patient.


# 49030 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

L037D RN/LPN/MTA ....... NF Review Chart ....... 3 0 CMS clinical review. L037D RN/LPN/MTA ....... NF Prepare biopsy Specimen. 5 2 CMS clinical review. SB019 drape-towel, sterile 18in x 26in. NF .............................. 1 0 Duplicative.

SB024 gloves, sterile ....... NF .............................. 3 1 CMS clinical review. SD270 Penis clamp ......... NF .............................. 1 0 Not a disposable according tosubmitted invoice. SH047 lidocaine 1%–2% inj (Xylocaine). NF .............................. 50 0 Duplicative.

SL036 cup, biopsy-specimen sterile 4oz. NF .............................. 6 3 CMS clinical review. 52287 ..................... Cystoscopychemodenervation. EF027 table, instrument, mobile. NF .............................. 78 49 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 78 49 Refined equipment time to reflecttypical use exclusive to patient. EQ170 light, fiberopticheadlight wsource. NF .............................. 78 49 Refined equipment time to reflecttypical use exclusive to patient.ES018 fiberscope, flexible, cystoscopy. NF .............................. 78 76 Refined equipment time to reflecttypical use exclusive to patient.ES031 video system, endoscopy (processor, digitalcapture, monitor, printer, cart). NF .............................. 78 49 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Assist physician inperforming procedure. 20 21 Conforming to physician time.

SH048 lidocaine 2% jelly, topical (Xylocaine). NF .............................. 10 0 Duplicative.

53850 ..................... Prostatic microwave thermotx. EF020 stretcher, endoscopy. NF .............................. 99 85 Refined equipment time to reflecttypical use exclusive to patient. EF027 table, instrument, mobile. NF .............................. 99 85 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 169 152 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... F .............................. 169 152 Refined equipment time to reflecttypical use exclusive to patient. EQ037 TUMT system control unit. NF .............................. 99 85 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 169 152 Refined equipment time to reflecttypical use exclusive to patient.


# 49031 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ168 light, exam ........... F .............................. 169 152 Refined equipment time to reflecttypical use exclusive to patient. EQ250 ultrasound unit, portable. NF .............................. 99 85 Refined equipment time to reflecttypical use exclusive to patient. L037D RN/LPN/MTA ....... NF Prepare room,equipment, supplies. 2 4 CMS clinical review.

L037D RN/LPN/MTA ....... NF Setup ultrasound probe. 5 0 CMS clinical review. L037D RN/LPN/MTA ....... NF Setup TUMT machine. 5 0 CMS clinical review. L037D RN/LPN/MTA ....... NF Clean TUMT machine. 3 0 CMS clinical review. SB022 gloves, non-sterile NF .............................. 3 2 CMS clinical review. SB024 gloves, sterile ....... NF .............................. 3 2 CMS clinical review. SH047 lidocaine 1%–2% inj (Xylocaine). NF .............................. 3 30 CMS clinical review. 64612 ..................... Destroy nerve face muscle. EL006 lane, screening (oph). F .............................. 39 27 Refined equipment time to reflecttypical use exclusive to patient. EL006 lane, screening (oph). NF .............................. 48 45 Refined equipment time to reflecttypical use exclusive to patient. SC031 needle, 30g .......... F .............................. 0 1 CMS clinical review. 64615 ..................... Chemodenerv musc migraine. EF023 table, exam .......... NF .............................. 24 18 Refined equipment time to reflecttypical use exclusive to patient. 65800 ..................... Drainage of eye ... EL006 Lane, Screening .. NF .............................. 21 22 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 21 22 Refined equipment time to reflecttypical use exclusive to patient. 67810 ..................... Biopsy eyelid & lid margin. EF014 light, surgical ........ NF .............................. 20 22 Refined equipment time to reflecttypical use exclusive to patient. EF031 table, power ......... NF .............................. 20 22 Refined equipment time to reflecttypical use exclusive to patient.EQ110 electrocauteryhyfrecator, up to 45 watts. NF .............................. 1 22 Refined equipment time to reflecttypical use exclusive to patient. EQ137 instrument pack, basic ($500– $1499). NF .............................. 1 30 Refined equipment time to reflecttypical use exclusive to patient.SB011 drape, sterile, fenestrated 16in x 29in. NF .............................. 0 1 CMS clinical review.

SB019 drape-towel, sterile 18in x 26in. NF .............................. 4 1 CMS clinical review.


# 49032 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

SC029 needle, 18–27g .... NF .............................. 1 0 Standardized time input. 72040 ..................... X-ray exam neck spine 3/<vws. ED025 film processor, wet NF .............................. 20 4 Refined equipment time to reflecttypical use exclusive to patient.EL012 room, basic radiology. NF .............................. 20 13 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 20 4 Refined equipment time to reflecttypical use exclusive to patient.Film jacket or jacket insert. NF .............................. 1 0 Non-standard direct practice expense input. 72050 ..................... X-ray exam neck spine 4/5vws. ED025 film processor, wet NF .............................. 28 6 Refined equipment time to reflecttypical use exclusive to patient.EL012 room, basic radiology. NF .............................. 28 19 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 28 6 Refined equipment time to reflecttypical use exclusive to patient.Film jacket or jacket insert. NF .............................. 1 0 Non-standard direct practice expense input. 72052 ..................... X-ray exam neck spine 6/>vws. ED025 film processor, wet NF .............................. 36 8 Refined equipment time to reflecttypical use exclusive to patient.EL012 room, basic radiology. NF .............................. 36 25 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 36 8 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient.L041B Radiologic Technologist. NF Retrieve prior appropriate imaging exams andhang for MD review, verify orders, review thechart to incorporate relevantclinical 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.


# 49033 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 andhang for MD review, verify orders, review thechart to incorporate relevantclinical 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.


# 49034 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 chloride0.9% 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 reflecttypical use exclusive to patient. EL008 room, MR ............. NF .............................. 63 33 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 63 33 Refined equipment time to reflecttypical use exclusive to patient.


# 49035 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 dueto 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 reflecttypical use exclusive to patient. EL008 room, MR ............. NF .............................. 63 33 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 63 33 Refined equipment time to reflecttypical 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 dueto 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.


# 49036 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 chloride0.9% 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 reflecttypical use exclusive to patient. EL007 room, CT .............. NF .............................. 65 39 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 15 7 Refined equipment time to reflecttypical use exclusive to patient. L046A CT Technologist .. NF Retrieve prior appropriate imaging exams andhang for MD review, verify orders, review thechart to incorporate relevantclinical information and confirm contrast protocol with interpreting MD. 7 4 CMS clinical review.

L046A CT Technologist .. NF Assist physician inperforming 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.


# 49037 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 chloride0.9% 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 reflecttypical use exclusive to patient.L041B Radiologic Technologist. NF Retrieve prior appropriate imaging exams andhang for MD review, verify orders, review thechart to incorporate relevantclinical 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.


# 49038 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

L046A CT Technologist .. NF Retrieve prior appropriate imaging exams andhang for MD review, verify orders, review thechart to incorporate relevantclinical 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.


# 49039 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 reflecttypical use exclusive to patient. EF034 table, ultrasound .. NF .............................. 0 36 Refined equipment time to reflecttypical 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 reflecttypical 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 reflecttypical 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 reflecttypical use exclusive to patient. EF034 table, ultrasound .. NF .............................. 68 34 Refined equipment time to reflecttypical use exclusive to patient. EQ250 ultrasound unit, portable. NF .............................. 68 34 Refined equipment time to reflecttypical use exclusive to patient. ER086 ultrasound probe .. NF .............................. 68 35 Refined equipment time to reflecttypical 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.


# 49040 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 clothwipe (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 reflecttypical use exclusive to patient.EL014 room, radiographicfluoroscopic. NF .............................. 9 18 Refined equipment time to reflecttypical use exclusive to patient.ER029 film alternator (motorized film viewbox). NF .............................. 3 2 Refined equipment time to reflecttypical 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 interpretingMD 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 reflecttypical 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, Farmertype. NF .............................. 45 47 Refined equipment time to reflecttypical use exclusive to patient.ER028 electrometer, PCbased, dual channel. NF .............................. 45 47 Refined equipment time to reflecttypical use exclusive to patient.


# 49041 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

ER050 phantom, solid water calibration check. NF .............................. 45 47 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient.ER063 thyroid uptake system. NF .............................. 40 30 Refined equipment time to reflecttypical use exclusive to patient. 78013 ..................... Thyroid imaging w/ blood flow. ER032 gamma camerasystem, singledual head. NF .............................. 48 38 Refined equipment time to reflecttypical use exclusive to patient. 78014 ..................... Thyroid imaging w/ blood flow. EF010 chair, thyroid imaging. NF .............................. 65 55 Refined equipment time to reflecttypical use exclusive to patient. ER032 gamma camerasystem, singledual head. NF .............................. 65 50 Refined equipment time to reflecttypical use exclusive to patient.ER063 thyroid uptake system. NF .............................. 65 55 Refined equipment time to reflecttypical use exclusive to patient. 78070 ..................... Parathyroid planar imaging. ER032 gamma camerasystem, singledual head. NF .............................. 73 68 Refined equipment time to reflecttypical use exclusive to patient. 78071 ..................... Parathyrd planar w/wo subtrj. ER032 gamma camerasystem, singledual head. NF .............................. 86 81 Refined equipment time to reflecttypical 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 BX41Fluorescent 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.


# 49042 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 perminute 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 perminute 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 perminute 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 perminute 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 perminute 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 .............................. .......................... .................... 20 12 Fully Implemented PERVUs maintained. 90832 ..................... Psytx pt&/family 30 minutes. ................ .............................. NF .............................. .......................... .................... 20 12 Fully Implemented PERVUs maintained.


# 49043 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

90834 ..................... Psytx pt&/family 45 minutes. ................ .............................. NF .............................. .......................... .................... 20 12 Fully Implemented PERVUs maintained. 90836 ..................... Psytx pt&/fam w/ e&m 45 min. ................ .............................. NF .............................. .......................... .................... 20 12 Fully Implemented PERVUs 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 reflecttypical use exclusive to patient. EQ029 Humphrey field analyzer. NF .............................. 12 17 Refined equipment time to reflecttypical use exclusive to patient. EQ165 lens set, trial, fulldiameter, wframe. 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 reflecttypical use exclusive to patient. EQ029 Humphrey field analyzer. NF .............................. 22 27 Refined equipment time to reflecttypical use exclusive to patient. EQ165 lens set, trial, fulldiameter, wframe. 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 reflecttypical use exclusive to patient. EQ029 Humphrey field analyzer. NF .............................. 32 37 Refined equipment time to reflecttypical use exclusive to patient. EQ165 lens set, trial, fulldiameter, wframe. NF .............................. 32 37 CMS clinical review.

92235 ..................... Eye exam with photos. ED008 camera, retinal(TRC 50IX, wICG, filters, motor drives). NF .............................. 60 35 Refined equipment time to reflecttypical use exclusive to patient.


# 49044 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EF030 table, motorized(for instrumentsequipment). NF .............................. 60 35 Refined equipment time to reflecttypical use exclusive to patient. EL005 lane, exam (oph) NF .............................. 60 35 Refined equipment time to reflecttypical 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 inperforming procedure. 40 20 CMS clinical review.

93015 ..................... Cardiovascular stress test. EF023 table, exam .......... NF .............................. 58 46 Refined equipment time to reflecttypical use exclusive to patient.EQ078 cardiac monitor wtreadmill (12- lead PC-based ECG). NF .............................. 58 46 Refined equipment time to reflecttypical use exclusive to patient. L051A RN ........................ NF Assist physician inperforming procedure. 20 14 CMS clinical review.

93017 ..................... Cardiovascular stress test. EF023 table, exam .......... NF .............................. 58 46 Refined equipment time to reflecttypical use exclusive to patient.EQ078 cardiac monitor wtreadmill (12- lead PC-based ECG). NF .............................. 58 46 Refined equipment time to reflecttypical use exclusive to patient. L051A RN ........................ NF Assist physician inperforming 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 reflecttypical use exclusive to patient. ED025 film processor, wet NF .............................. 10 7 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. ER067 x-ray view box, 4 panel. NF .............................. 10 7 Refined equipment time to reflecttypical 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.


# 49045 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

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 reflecttypical use exclusive to patient. ED025 film processor, wet NF .............................. 10 4 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. ER067 x-ray view box, 4 panel. NF .............................. 10 4 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. ED025 film processor, wet NF .............................. 10 7 Refined equipment time to reflecttypical use exclusive to patient. ED034 video SVHS VCR (medical grade). NF .............................. 71 0 CMS clinical review.


# 49046 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EL016 room, ultrasound, vascular. NF .............................. 71 52 Refined equipment time to reflecttypical use exclusive to patient. ER067 x-ray view box, 4 panel. NF .............................. 10 7 Refined equipment time to reflecttypical 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 reflecttypical use exclusive to patient. ED025 film processor, wet NF .............................. 10 4 Refined equipment time to reflecttypical 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 reflecttypical 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.


# 49047 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

95076 ..................... Ingest challenge ini 120 min. EF023 table, exam .......... NF .............................. 141 133 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 141 133 Refined equipment time to reflecttypical 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, walarm lock. NF .............................. 15 0 CMS clinical review.

95117 ..................... Immunotherapy injections. EF041 x-ray machine, portable. NF .............................. 17 0 CMS clinical review. 95782 ..................... Polysom <6 yrs 4/ > paramtrs. EF003 bedroom furniture (hospital bed, table, reclining chair). NF .............................. 660 602 Refined equipment time to reflecttypical use exclusive to patient. Crib ...................... NF .............................. 660 0 CMS clinical review. EQ134 impedance meter, 32-channel. NF .............................. 660 602 Refined equipment time to reflecttypical use exclusive to patient. EQ272 sleep diagnosticsystem, attended (w-acquisition station, review master, computer). NF .............................. 660 662 Refined equipment time to reflecttypical use exclusive to patient.

Capnograph ......... NF .............................. 660 0 Duplicative. ER088 Infrared illuminator NF .............................. 660 602 Refined equipment time to reflecttypical 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 andsecure 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.


# 49048 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

L047B REEGT ................ NF Other Clinical Activity—specify: Apply recording devices forcardio-respiratory, leg movements, body positioning and snoring. 0 15 CMS clinical review.

L047B REEGT ................ NF Other Clinical Activity—specify: Apply recording devices forcardio-respiratory, leg movements,body positioning, snoring and capnography. 20 0 CMS clinical review.

L047B REEGT ................ NF Other Clinical Activity—specify:Daytime tech reviews and edits recording, marks artifacts, scores sleep stages,performs evaluation of physiological changes. 100 97 CMS clinical review.

95783 ..................... Polysom <6 yrs cpap/bilvl. EF003 bedroom furniture (hospital bed, table, reclining chair). NF .............................. 660 647 Refined equipment time to reflecttypical use exclusive to patient. Crib ...................... NF .............................. 660 0 CMS clinical review. EQ134 impedance meter, 32-channel. NF .............................. 660 647 Refined equipment time to reflecttypical use exclusive to patient. EQ272 sleep diagnosticsystem, attended (w-acquisition station, review master, computer). NF .............................. 660 707 Refined equipment time to reflecttypical use exclusive to patient.

Capnograph ......... NF .............................. 660 0 Duplicative. ER088 Infrared illuminator NF .............................. 660 647 Refined equipment time to reflecttypical 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.


# 49049 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

L047B REEGT ................ NF Other Clinical Activity—specify: Measure and mark head and face. Apply andsecure 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 forcardio-respiratory, leg movements, body positioning and snoring. 0 15 CMS clinical review.

L047B REEGT ................ NF Other Clinical Activity—specify: Apply recording devices forcardio-respiratory, leg movements,body positioning, snoring and capnography. 20 0 CMS clinical review.

L047B REEGT ................ NF Other Clinical Activity—specify:Daytime tech reviews and edits recording, marks artifacts, scores sleep stages,performs evaluation of physiological changes. 100 97 CMS clinical review.

95861 ..................... Muscle test 2 limbs. EF023 table, exam .......... NF .............................. 44 41 Refined equipment time to reflecttypical use exclusive to patient. EQ024 EMG–NCV–EPsystem, 8 channel. NF .............................. 44 41 Refined equipment time to reflecttypical use exclusive to patient. L037A Electrodiagnostic Technologist. NF Assist physician inperforming procedure. 19 29 Conforming to physician time.

95863 ..................... Muscle test 3 limbs. EF023 table, exam .......... NF .............................. 58 52 Refined equipment time to reflecttypical use exclusive to patient. EQ024 EMG–NCV–EPsystem, 8 channel. NF .............................. 58 52 Refined equipment time to reflecttypical use exclusive to patient. 95864 ..................... Muscle test 4 limbs. EF023 table, exam .......... NF .............................. 71 62 Refined equipment time to reflecttypical use exclusive to patient.


# 49050 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ024 EMG–NCV–EPsystem, 8 channel. NF .............................. 71 62 Refined equipment time to reflecttypical use exclusive to patient. 95868 ..................... Muscle test cran nerve bilat. EF023 table, exam .......... NF .............................. 35 32 Refined equipment time to reflecttypical use exclusive to patient. EQ024 EMG–NCV–EPsystem, 8 channel. NF .............................. 35 32 Refined equipment time to reflecttypical use exclusive to patient. 95907 ..................... Motor&/sens 1–2 nrv cndj tst. SG051 gauze, non-sterile 4in x 4in. NF .............................. 0 4 CMS clinical review. SG055 gauze, sterile 4in x 4in. NF .............................. 4 0 CMS clinical review. SG079 tape, surgical paper 1in (Micropore). NF .............................. 12 0 CMS clinical review.

SJ022 electrode skin prep gel (NuPrep). NF .............................. 100 0 CMS clinical review.

95908 ..................... Motor&/sens 3–4 nrv cndj tst. SG051 gauze, non-sterile 4in x 4in. NF .............................. 0 8 CMS clinical review. SG055 gauze, sterile 4in x 4in. NF .............................. 8 0 CMS clinical review. SG079 tape, surgical paper 1in (Micropore). NF .............................. 24 0 CMS clinical review.

SJ022 electrode skin prep gel (NuPrep). NF .............................. 100 0 CMS clinical review.

95909 ..................... Motor&/sens 5–6 nrv cndj tst. SG051 gauze, non-sterile 4in x 4in. NF .............................. 0 12 CMS clinical review. SG055 gauze, sterile 4in x 4in. NF .............................. 12 0 CMS clinical review. SG079 tape, surgical paper 1in (Micropore). NF .............................. 36 0 CMS clinical review.

SJ022 electrode skin prep gel (NuPrep). NF .............................. 100 0 CMS clinical review.

95910 ..................... Motor&sens 7–8 nrv cndj test. L037A Electrodiagnostic Technologist. NF .............................. 50 40 Conforming to physician time. SG051 gauze, non-sterile 4in x 4in. NF .............................. 0 16 CMS clinical review. SG055 gauze, sterile 4in x 4in. NF .............................. 16 0 CMS clinical review. SG079 tape, surgical paper 1in (Micropore). NF .............................. 48 0 CMS clinical review.

SJ022 electrode skin prep gel (NuPrep). NF .............................. 100 0 CMS clinical review.

95911 ..................... Motor&sen 9–10 nrv cndj test. L037A Electrodiagnostic Technologist. NF .............................. 64 50 Conforming to physician time. SG051 gauze, non-sterile 4in x 4in. NF .............................. 0 20 CMS clinical review. SG055 gauze, sterile 4in x 4in. NF .............................. 20 0 CMS clinical review. SG079 tape, surgical paper 1in (Micropore). NF .............................. 60 0 CMS clinical review.

SJ022 electrode skin prep gel (NuPrep). NF .............................. 100 0 CMS clinical review.

95912 ..................... Motor&sen 11–12 nrv cnd test. L037A Electrodiagnostic Technologist. NF .............................. 77 60 Conforming to physician time. SG051 gauze, non-sterile 4in x 4in. NF .............................. 0 24 CMS clinical review. SG055 gauze, sterile 4in x 4in. NF .............................. 24 0 CMS clinical review. SG079 tape, surgical paper 1in (Micropore). NF .............................. 72 0 CMS clinical review.


# 49051 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

SJ022 electrode skin prep gel (NuPrep). NF .............................. 100 0 CMS clinical review.

95913 ..................... Motor&sens 13/> nrv cnd test. L037A Electrodiagnostic Technologist. NF .............................. 87 70 Conforming to physician time. SG051 gauze, non-sterile 4in x 4in. NF .............................. 0 26 CMS clinical review. SG055 gauze, sterile 4in x 4in. NF .............................. 26 0 CMS clinical review. SG079 tape, surgical paper 1in (Micropore). NF .............................. 78 0 CMS clinical review.

SJ022 electrode skin prep gel (NuPrep). NF .............................. 100 0 CMS clinical review.

95921 ..................... Autonomic nrv parasym inervj. EF032 table, tilt (wtrendelenberg). NF .............................. 64 55 Refined equipment time to reflecttypical use exclusive to patient. EQ051 arterial tonometryacquisition system (WR Testworks). NF .............................. 64 55 Refined equipment time to reflecttypical use exclusive to patient. EQ052 arterial tonometry monitor (Colin Pilot). NF .............................. 64 55 Refined equipment time to reflecttypical 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 (wtrendelenberg). NF .............................. 79 70 Refined equipment time to reflecttypical use exclusive to patient. EQ051 arterial tonometryacquisition system (WR Testworks). NF .............................. 79 70 Refined equipment time to reflecttypical use exclusive to patient. EQ052 arterial tonometry monitor (Colin Pilot). NF .............................. 79 70 Refined equipment time to reflecttypical 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 acquisitionsystem (QSweat). NF .............................. 74 61 Refined equipment time to reflecttypical use exclusive to patient.


# 49052 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ124 stimulator, constant current, wstimulating andgrounding electrodes (Grass Telefactor). NF .............................. 74 61 Refined equipment time to reflecttypical use exclusive to patient.

EQ171 light, infra-red, ceiling mount. NF .............................. 74 61 Refined equipment time to reflecttypical use exclusive to patient. L037A Electrodiagnostic Technologist. NF Assist physician inperforming 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 (wtrendelenberg). NF .............................. 79 76 Refined equipment time to reflecttypical use exclusive to patient. EQ051 arterial tonometryacquisition system (WR Testworks). NF .............................. 79 76 Refined equipment time to reflecttypical use exclusive to patient. EQ052 arterial tonometry monitor (Colin Pilot). NF .............................. 79 76 Refined equipment time to reflecttypical use exclusive to patient. L037A Electrodiagnostic Technologist. NF Monitor pt. following service/ check tubes, monitors, drains. 5 2 CMS clinical review.

96920 ..................... Laser tx skin < 250 sq cm. EF031 table, power ......... NF .............................. 20 26 Refined equipment time to reflecttypical use exclusive to patient. EQ161 laser, excimer ...... NF .............................. 20 26 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 17 26 Refined equipment time to reflecttypical use exclusive to patient. Annual Laser

Service Package. NF .............................. 1 0 Included in equipment cost perminute calculation. L037D RN/LPN/MTA ....... NF Monitor pt. following service/ check tubes, monitors, drains. 3 1 CMS clinical review.

L037D RN/LPN/MTA ....... NF Clean room/equipment by physician staff. 3 2 CMS clinical review.

SF028 laser tip (single use). NF .............................. 1 0 CMS clinical review. SJ029 ice pack, instant ... NF .............................. 4 1 CMS Code correction. 96921 ..................... Laser tx skin 250– 500 sq cm. EF031 table, power ......... NF .............................. 23 29 Refined equipment time to reflecttypical use exclusive to patient.


# 49053 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

EQ161 laser, excimer ...... NF .............................. 23 29 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 23 29 Refined equipment time to reflecttypical use exclusive to patient. Annual Laser

Service Package. NF .............................. 1 0 Included in equipment cost perminute calculation. L037D RN/LPN/MTA ....... NF Monitor pt. following service/ check tubes, monitors, drains. 3 1 CMS clinical review.

L037D RN/LPN/MTA ....... NF Clean room/equipment by physician staff. 3 2 CMS clinical review.

SF028 laser tip (single use). NF .............................. 1 0 CMS clinical review. SJ029 ice pack, instant ... NF .............................. 4 2 CMS Code correction. 96922 ..................... Laser tx skin >500 sq cm. EF031 table, power ......... NF .............................. 33 39 Refined equipment time to reflecttypical use exclusive to patient. EQ161 laser, excimer ...... NF .............................. 33 39 Refined equipment time to reflecttypical use exclusive to patient. EQ168 light, exam ........... NF .............................. 30 39 Refined equipment time to reflecttypical use exclusive to patient. Annual Laser

Service Package. NF .............................. 1 0 Included in equipment cost perminute 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 reflecttypical use exclusive to patient. EQ269 blood pressuremonitor, 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 orcaretaker, surrogate decision makers, and/orother professionals) regarding aspects of care, etc.. 0 45 CMS clinical review.


# 49054 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 74—CPT CODES 

## W ITH 

## R EFINED 

## D IRECT 

## PE R ECOMMENDATIONS FOR 

## CY 2013 I NTERIM 

## CODES

## —Continued

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

99496 ..................... Trans care mgmt 7 day disch. L042A RN/LPN ................ NF Communication (with patient, family members, guardian orcaretaker, surrogate decision makers, and/orother professionals) regarding aspects of care, etc.. 60 70 CMS clinical review.

L042A RN/LPN ................ F Communication (with patient, family members, guardian orcaretaker, surrogate decision makers, and/orother 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


# 49055 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

Physician Quality Reporting System numbers for clarification.

◊Measures to be deleted in 2014. ‡Measures to be added in 2013.

ÆMeasures 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 F INAL 

## R ULE 

## W ITH 

## COMMENT 

## P ERIOD 

## E STIMATED 

## I MPACT ON 

## TOTAL 

## ALLOWED 

## C HARGES BY 

## S PECIALTY 

## * [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


# 49056 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 

## 134—CY 2013 F INAL 

## R ULE 

## W ITH 

## COMMENT 

## P ERIOD 

## E STIMATED 

## I MPACT ON 

## TOTAL 

## ALLOWED 

## C HARGES BY 

## S PECIALTY 

## *—Continued [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)

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 F INAL 

## R ULE 

## WITH 

## COMMENT 

## P ERIOD 

## E STIMATED 

## I MPACT ON 

## TOTAL 

## ALLOWED 

## C HARGES BY 

## S PECIALTY BY 

## S ELECTED 

## POLICY

## * E STIMATED 

## I MPACT FOR 

## RVU C HANGES

## *

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


# 49057 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

TABLE 

## 135—CY 2013 PFS F INAL 

## R ULE 

## WITH 

## COMMENT 

## P ERIOD 

## E STIMATED 

## I MPACT ON 

## TOTAL 

## ALLOWED 

## C HARGES BY 

## S PECIALTY BY 

## S ELECTED 

## POLICY

## * E STIMATED 

## I MPACT FOR 

## RVU C HANGES

## *—Continued

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)

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:


# 49058 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations


# 49059 Federal Register / Vol. 78, No. 155 / Monday, August 12, 2013 / Rules and Regulations

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**