Federal Register / Vol. 78, No. 32 / Friday, February 15, 2013 / Notices 11189 

specifically questioning the 

government’s calculation of the public 

burden. 

Comment: The respondent 

commented that the extension of the 

information collection would violate the 

fundamental purposes of the Paperwork 

Reduction Act because of the burden it 

puts on the entity submitting the 

information and the agency collecting 

the information. The respondent 

opposes granting the extension of the 

information collection requirement. 

Response: In accordance with the 

Paperwork Act (PRA), agencies can 

request OMB approval of an existing 

information collection. The PRA 

requires that agencies use the Federal 

Register notice and comment process to 

extend the OMB’s approval every three 

years. This extension to a previously 

approved information collection 

pertains to the provision at GSAR 

552.211–77, Packing List, which 

requires contractors to include a 

packing list that verifies the placement 

of the order and identifies the items 

shipped, a normal commercial practice. 

In addition to the information 

contractors would normally include on 

packing lists, the government requires 

identification of the name of the 

government credit cardholder, 

telephone number and the term ‘‘Credit 

Card’’ on the packing list in supply 

contracts. 

The purpose of the information 

collection is to facilitate administration 

of government credit card purchases. 

Often the government credit cardholder 

is different from the consignee receiving 

shipment of the supplies. Providing the 

additional information ensures the 

recipient of the packing list, the 

consignee, notifies the government 

credit cardholder that the shipment has 

been received. Once the notification of 

successful shipment has been received, 

the cardholder can then authorize 

payment. This feedback is essential for 

the cardholder to reconcile his/her 

monthly statements. This is especially 

important if the micropurchase 

threshold is raised to support a 

contingency operation declaration 

under FAR subpart 18.2. Not granting 

this extension would increase costs to 

the Government during the 

reconciliation process and may delay 

payments to contractors for shipments 

of supplies received. 

Comment: The respondent challenged 

the estimates used by the agency to 

calculate the public burden, stating that 

the burden was insufficient and 

inadequate to reflect the actual total 

burden. Specifically, the respondent 

noted that it was unclear as to how the 

estimated 4,000 information collection 

respondents were derived and the 

estimated number of packing lists in a 

given year. Therefore, the respondent 

stated the agency should utilize actual 

data from the last fiscal year or an 

estimate of the last three to five fiscal 

years, reassess the estimated burden, 

and revise it upwards to be more 

accurate as was done in FAR Case 2007– 

006. The respondent also found the 

‘‘less than one minute per response 

estimate’’ to be unrealistically low 

stating the burden requires creating the 

packing list. 

Response: Serious consideration is 

given during the open comment period 

to all comments received and 

adjustments are made to the paperwork 

burden estimate when necessary. The 

burden is prepared taking into 

consideration the necessary criteria in 

OMB guidance for estimating the 

paperwork burden put on the entity 

submitting the information. 

Consideration is given to an entity in 

reviewing the instruction; using 

technology to collect, process and 

disclose information; adjusting existing 

practices to comply with requirements; 

searching data sources; completing and 

reviewing the response and transmitting 

or disclosing information. Estimated 

burden hours only include those actions 

that exceed those a company would take 

in the normal course of business. 

Careful consideration went into 

assessing the burden for this collection. 

Packing lists accompanying shipments 

of supplies are customary in the normal 

course of business, including the 

information listed in paragraph (a) of 

clause 552.211–77. The public burden is 

limited to the annotation on the packing 

list the name and telephone number of 

the government credit cardholder and 

the phrase ‘‘Credit Card.’’ 

While there is no centralized database 

for the collection of the packing lists in 

a fiscal year, the agency found the 

respondent’s suggestion to use actual 

data reasonable to calculate the public 

burden. The annual reporting burden 

was revised, using actual data from the 

government-wide Federal Procurement 

Data System (FPDS) for Fiscal Year (FY) 

2012. Two types of actions were 

analyzed: GSA actions for supplies 

where the method of payment was made 

by government credit card; and, nonGSA actions for supplies where both 

payment was by a government credit 

card and a GSA indefinite delivery 

contract for supplies was referenced. 

Average costs were derived in order for 

the government to estimate the number 

of packing slips per order. Thus, an 

adjustment is made to the annual 

reporting burden after review of the 

methodology for computing the number 

of respondents and packing lists in a 

given year and the estimated hours per 

response. 

The government agreed with the 

respondent that the time per response 

did not allow for review and 

transmission of the government credit 

cardholder’s name and telephone 

number and the phrase ‘‘Credit Card’’ 

into its packing list system and adjusted 

the burden accordingly. 

Members of the public may submit 

comments for further consideration and 

are encouraged to provide data to 

support their request for an adjustment. 

C. Annual Reporting Burdens 

Respondents: 9,919. 

Responses per Respondent: 13. 

Hours per Response: .05. 

Total Burden Hours: 6447. 

Obtaining Copies of Proposals: 

Requesters may obtain a copy of the 

information collection documents from 

the General Services Administration, 

Regulatory Secretariat (MVCB), 1275 

First Street NE., Washington, DC 20417, 

telephone (202) 501–4755. Please cite 

OMB Control No. 3090–0246, Packing 

List Clause, in all correspondence. 

Dated: February 8, 2013. 

Joseph A Neurauter, 

Director, Office of Acquisition Policy, Senior 

Procurement Executive. 

[FR Doc. 2013–03558 Filed 2–14–13; 8:45 am] 

BILLING CODE 6820–61–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–9076–N] 

Medicare and Medicaid Programs; 

Quarterly Listing of Program 

Issuances—October Through 

December 2012 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This quarterly notice lists 

CMS manual instructions, substantive 

and interpretive regulations, and other 

Federal Register notices that were 

published from October through 

December 2012, relating to the Medicare 

and Medicaid programs and other 

programs administered by CMS. 

FOR FURTHER INFORMATION CONTACT: It is 

possible that an interested party may 

need specific information and not be 

able to determine from the listed 

information whether the issuance or 

regulation would fulfill that need. 

mstockstill on DSK4VPTVN1PROD with NOTICES

11190 Federal Register / Vol. 78, No. 32 / Friday, February 15, 2013 / Notices 

Consequently, we are providing contact 

persons to answer general questions 

concerning each of the addenda 

published in this notice. 

Addenda Contact Phone No. 

I CMS Manual Instructions ....................................................................................... Ismael Torres .......................................... (410) 786–1864 

II Regulation Documents Published in the Federal Register ................................. Terri Plumb ............................................. (410) 786–4481 

III CMS Rulings ........................................................................................................ Tiffany Lafferty ........................................ (410) 786–7548 

IV Medicare National Coverage Determinations ...................................................... Wanda Belle ........................................... (410) 786–7491 

V FDA-Approved Category B IDEs .......................................................................... John Manlove ......................................... (410) 786–6877 

VI Collections of Information .................................................................................... Mitch Bryman .......................................... (410) 786–5258 

VII Medicare-Approved Carotid Stent Facilities ....................................................... Sarah J. McClain .................................... (410) 786–2294 

VIII American College of Cardiology-National Cardiovascular Data Registry Sites JoAnna Baldwin, MS .............................. (410) 786–7205 

IX Medicare’s Active Coverage-Related Guidance Documents .............................. Lori Ashby ............................................... (410) 786–6322 

X One-time Notices Regarding National Coverage Provisions ............................... Lori Ashby ............................................... (410) 786–6322 

XI National Oncologic Positron Emission Tomography Registry Sites .................... Stuart Caplan, RN, MAS ........................ (410) 786–8564 

XII Medicare-Approved Ventricular Assist Device (Destination Therapy) Facilities JoAnna Baldwin, MS .............................. (410) 786–7205 

XIII Medicare-Approved Lung Volume Reduction Surgery Facilities ....................... JoAnna Baldwin, MS .............................. (410) 786–7205 

XIV Medicare-Approved Bariatric Surgery Facilities ................................................ Kate Tillman, RN, MAS .......................... (410) 786–9252 

XV Fluorodeoxyglucose Positron Emission Tomography for Dementia Trials ........ Stuart Caplan, RN, MAS ........................ (410) 786–8564 

All Other Information ................................................................................................ Annette Brewer ....................................... (410) 786–6580 

I. Background 

Among other things, the Centers for 

Medicare & Medicaid Services (CMS) is 

responsible for administering the 

Medicare and Medicaid programs and 

coordination and oversight of private 

health insurance. Administration and 

oversight of these programs involves the 

following: (1) Furnishing information to 

Medicare and Medicaid beneficiaries, 

health care providers, and the public; 

and (2) maintaining effective 

communications with CMS regional 

offices, state governments, state 

Medicaid agencies, state survey 

agencies, various providers of health 

care, all Medicare contractors that 

process claims and pay bills, National 

Association of Insurance Commissioners 

(NAIC), health insurers, and other 

stakeholders. To implement the various 

statutes on which the programs are 

based, we issue regulations under the 

authority granted to the Secretary of the 

Department of Health and Human 

Services under sections 1102, 1871, 

1902, and related provisions of the 

Social Security Act (the Act) and Public 

Health Service Act. We also issue 

various manuals, memoranda, and 

statements necessary to administer and 

oversee the programs efficiently. 

Section 1871(c) of the Act requires 

that we publish a list of all Medicare 

manual instructions, interpretive rules, 

statements of policy, and guidelines of 

general applicability not issued as 

regulations at least every 3 months in 

the Federal Register. 

II. Revised Format for the Quarterly 

Issuance Notices 

While we are publishing the quarterly 

notice required by section 1871(c) of the 

Act, we will no longer republish 

duplicative information that is available 

to the public elsewhere. We believe this 

approach is in alignment with CMS’ 

commitment to the general principles of 

the President’s Executive Order 13563 

released January 2011 entitled 

‘‘Improving Regulation and Regulatory 

Review,’’ which promotes modifying 

and streamlining an agency’s regulatory 

program to be more effective in 

achieving regulatory objectives. Section 

6 of Executive Order 13563 requires 

agencies to identify regulations that may 

be ‘‘outmoded, ineffective, insufficient, 

or excessively burdensome, and to 

modify, streamline, expand or repeal 

them in accordance with what has been 

learned.’’ This approach is also in 

alignment with the President’s Open 

Government and Transparency Initiative 

that establishes a system of 

transparency, public participation, and 

collaboration. 

Therefore, this quarterly notice 

provides only the specific updates that 

have occurred in the 3-month period 

along with a hyperlink to the full listing 

that is available on the CMS Web site or 

the appropriate data registries that are 

used as our resources. This information 

is the most current up-to-date 

information and will be available earlier 

than we publish our quarterly notice. 

We believe the Web site list provides 

more timely access for beneficiaries, 

providers, and suppliers. We also 

believe the Web site offers a more 

convenient tool for the public to find 

the full list of qualified providers for 

these specific services and offers more 

flexibility and ‘‘real time’’ accessibility. 

In addition, many of the Web sites have 

listservs; that is, the public can 

subscribe and receive immediate 

notification of any updates to the Web 

site. These listservs avoid the need to 

check the Web site, as notification of 

updates is automatic and sent to the 

subscriber as they occur. If assessing a 

Web site proves to be difficult, the 

contact person listed can provide 

information. 

III. How To Use the Notice 

This notice is organized into 15 

addenda so that a reader may access the 

subjects published during the quarter 

covered by the notice to determine 

whether any are of particular interest. 

We expect this notice to be used in 

concert with previously published 

notices. Those unfamiliar with a 

description of our Medicare manuals 

should view the manuals at http:// 

www.cms.gov/manuals. 

Authority: (Catalog of Federal Domestic 

Assistance Program No. 93.773, Medicare— 

Hospital Insurance, Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program, and Program No. 93.714, 

Medical Assistance Program) 

Dated: February 8, 2013. 

Kathleen Cantwell, 

Director, Office of Strategic Operations and 

Regulatory Affairs. 

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Publication Dates for the Previous Four Quarterly Notices 

We publish this notice at the end of each quarter reflecting 

information released by CMS during the previous quarter. The publication 

dates of the previous four Quarterly Listing of Program Issuances notices 

are: February 21,2012 (77 FR 9931), May 18,2012 (77 FR 29648), August 

17,2012 (77 FR 49799) and November 9,2012 (77 FR 67368). For the 

purposes of this quarterly notice, we are providing only the specific updates 

that have occurred in the 3-month period along with a hyperlink to the 

website to access this information and a contact person for questions or 

additional information. 

Addendum I: Medicare and Medicaid Manual Instructions 

(October through December 2012) 

The CMS Manual System is used by CMS program components, 

partners, providers, contractors, Medicare Advantage organizations, and 

State Survey Agencies to administer CMS programs. It ofTers day-to-day 

operating instructions, policies, and procedures based on statutes and 

regulations, guidelines, models, and directives. In 2003, we transfonned the 

CMS Program Manuals into a web user-friendly presentation and renamed 

it the CMS Online Manual System. 

How to Obtain Manuals 

The Internet-only Manuals (lOMs) are a replica of the Agency's 

official record copy. Paper-based manuals are CMS manuals that were 

officially released in hardcopy. The majority of these manuals were 

transferred into the Internet-only manual (10M) or retired. Pub 15-1, Pub 

15-2 and Pub 45 are exceptions to this rule and are still active paper-based 

manuals. The remaining paper-based manuals are for reference purposes 

only. If you notice policy contained in the paper-based manuals that was 

not transferred to the 10M, send a message via the CMS Feedback tool. 

Those wishing to subscribe to old versions ofCMS manuals should 

contact the National Technical Information Service, Department of 

Commerce, 5301 Shawnee Road, Alexandria, VA 22312 Telephone (703-

605-6050). You can download copies of the listed material free of charge 

at: 

How to Review Transmittals or Program Memoranda 

Those wishing to review transmittals and program memoranda can 

access this information at a local Federal Depository Library (FDL). Under 

the FDL program, government publications are sent to approximately 1,400 

designated libraries throughout the United Statearrangements to transfer material to a local libr

FDL. Contact any library to locate the nearest 

available at 

In addition, individuals may contact re

that receive and retain at least one copy of most 

publications, either in printed or microfilm formpublic. These libraries provide reference servic

however, they are not sales outlets. Individuals 

about the location of the nearest regional depos

library. CMS publication and transmittal numb

entitled Medicare and Medicaid Manual Instruc

the materials, use the CMS publication and tran

example, to find the Medicare National Covera

titled Transcutaneous Electrical Nerve Stimulat

Low Back Pain (CLBP) use CMS-Pub. 100-03, 

Addendum I lists a unique CMS transm

instruction in our manuals or program memoran

A transmittal may consist of a single or multipl

necessary to use information in a transmittal in 

information currently in the manual. For the pu

notice, we list only the specific updates to the l

that have occurred in the 3-month period. This 

our website at 

Transmittal Manual/Subject/Publ

Number 

80 Manual Updates to Clarify SNF Claims Pr

(Part A) for Inpatient Hospital, Hospice. H

Facility (SNF) Services - A Brief Descrip

Starting a Benefit Period 

Ending a Benefit Period 

Definition of Inpatient for Ending a Bene

81 Update to Medicare Deductible, Coinsura

Basis for Determining the Pmt A Coinsu

Pm B Annual Deductible 

Part B Premium 

'«': ".': 

160 Effect of Beneficiary Agreements Not to U

Payment May be Made to a Beneficiary fo

Physician/Practitioner 

Requirements of a Private Contract 

Requirements of the Opt-Out A fiidavit 

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Failure to Maintain Opt-Out 2564 Issued to a specific audience, not posted t

Actions to Take in Cases of Failure to Maintain Opt-Out of Instruction 

Physician/Practitioner Who Has Never Enrolled in Medicare 2565 Reasonable Charge Update for 2013 for S

Excluded Physicians and Practitioners Intraocular Lenses 

Relationship between Opt-Out and Medicare Participation Agreements 2566 Medicare Physician Fee Schedule Databa

Participating Physicians and Practitioners Manual Addendum Maintaining Information on Opt-Out Physicians 2567 Issued to a specific audience, not posted t

Informing Medicare Managed Care Plans of the Identity of the Opt-Out of Instruction 

Physicians or Practitioners 

Informing the National Supplier Clearinghouse (NSC) of the Identity of the 

Opt-Out Physicians or Practitioners 

System Identification 

2568 January 2013 Quarterly Average Sales Pr

Pricing Files and Revisions to Prior Quart

2569 Modifications to the National Coordinatio

Crossover Process 

Emergency and Urgent Care Situations 

Denial of Payment to Employers of Opt-Out Physicians and Practitioners 

Coordination of Benefits Agreement (CO

Notification Process 

Denial of Payment to Beneficiaries and Others 

Paymenl [or Medically Necessary Services Ordered or Prescribed by an Oplout Physician or Practitioner 

Renewal of Opt-Out 

Early Tellnination of Opt-Out 

Application to the Medicare Advantage Program 

Claims Denial Notices to Opt-Out Physicians and Practitioners 

Claims Denial Notices to Beneficiaries 

161 Manual Updates to Clarify SNF Claims Processing 

Three-Day Prior Hospitalization 

General 

Daily Skilled Services Defined Definition of Durable Medical Equipment 

162 Issued to a specific audience, not posted to Internet/Intranet/ due to Sensitivity 

of Instruction 

163 Implementing the Claims-Based Data Collection Requirement for Outpatient 

Therapy Services -- Section 3005(g) of the Middle Class Tax Relief and Jobs 

Creation Act (MCTRJCA) of2012 

164 Expansion of Medicare Telehealth Services for CY 2013 

List of Medicare Telehealth Services 

Coordination of Benefits Agreement (CO

(COB) Requirements 

2570 Annual Type of Service (TOS) Update Ty

2571 Updated Billing Requirements for Outpat

Class Tax Reliefand Jobs Creation Act (M

Carrier Specific Requirements for Certai

Provider of Service or Supplier Informat

2572 Issued to a specific audience, not posted t

Confidentiality of Instruction 

2573 Manual Updates to Clarity SNF Claims P

Types of Services Subject to the Consoli

Services Included in Part A PPS Paymen

SNF 

Physician's Services and Other Professio

PPS Payment and the Consolidated Billin

Other Excluded Services Beyond the Sco

Emergency Services 

Services Excluded from Part A PPS Pay

Requirement on the Basis of Beneficiary 

and Dialysis-Related Services to a Benefi

Hospice Care for a Beneficiary'S Tel1l1i

148 Bariatric Surgery for the Treatment of Morbid Obesity National Coverage Other Services Excluded from SNF PPS 

Determination, Addition of Laparoscopic Sleeve Gastrostomy (LSG) Ambulance Services 

Bariatric Surgery for Treatment of Morbid Obesity Screening and Preventive Services 

149 Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low Back Therapy Services 

Pain (CLBP) Determine Utilization on Day of Dischar

.;;z,y::; Leave of Absence 

2562 Influenza Vaccine Payment Allowances - Annual Update for 2012-2013 2574 Payment of Global Surgical Split Care in 

Season (CAl-I) Submitted with Modifier 54 and/o

2563 Revised and Clarified Place of Service (POS) Coding Instructions 2575 Payment of Global Surgical Split-Care in 

Site of Service Payment Differential Modifier 54 and/or 55 

Place of Service (POS) Instructions for the Professional Component (PC or 2576 Affordable Care Act (ACA) Section 3025 

Interpretation) and the Technical Component (TC) of Diagnostic Tests Provider Specific File (PSF) 

Items 14-33-Provider of Service or Supplier Information Addendum A - Provider Specific File 

Place of Service Codes (POS) and Definitions 2577 Update to the Fiscal Intermediary Shared 

Carrier Instructions for Place of Service (POS) Codes Renal Disease (ESRD) Quality Incentive 

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Children's Hospitals Type of Service (TOS) 

2578 Enforcing Interim Billing for Partial Hospitalization Services Submitting Bills 2599 October 2012 Update of the Hospital Outp

In Sequence for a Continuous Inpatient Stay or Course of Treatment (OPPS) 

2579 Medicare System Update to Include Rendering Line Level National Provider Transitional Outpatient Payments (TOPs) 

Identifiers (NPls) for Primary Care Incentive Program (PClP) Payments to Fiscal Intermediary Billing Requirements 

Critical Access Hospitals (CAHs) 2600 Therapy Cap Values for Calendar Year (C

2580 Issued to a specific audience, not posted to Internet/Intranet/ due to 2601 Calendar Year (CY) 2013 Annual Update 

Confidentiality ofTnstruction Schedule and Laboratory Services Subjec

2581 Issued to a specific audience, not posted to Internet!Intranet/ due to Sensitivity 2602 New Place of Service (POS) Code for Pla

oflnstruction Place of Service Codes (POS) and DeJin

2582 New Erythropoietin Stimulating Agent (ESA) Pegincsatide Requirements for 2603 Implementing the Claims-Based Data Col

End Stage Renal Disease (ESRD) Coding for Adequacy of Dialysis, Vascular Therapy Services -- Section 3005(g) of th

Access and Infection Creation Act (MCTRJCA) of 2012 

2583 Erroneous Partial Episode Payment Adjustments on Certain Home Health 2604 Issued to a specific audience, not posted t

Dual-Eligible Claims Confidentiality ofTnstruction 

2584 Issued to a specific audience, not posted to Internet!lntranet! due to 2605 Transcutaneous Electrical Nerve Stimulat

Confidentiality of Instruction Pain (CLBP) 

2585 Issued to a specific audience, not posted to Internet!lntranet! due to 2606 Expansion of Medicare Telehealth Servic

Confidentiality of Instruction 2607 National Correct Coding Initiative (NCCI

2586 Issued to a specific audience, not posted to Internet!Intranet! due to Identical Letter, Dated December 19, 199

Contidentiality oflnstruction Initiative Add-On (ZZZ) Codes - ACTIO

2587 Issued to a specific audience, not posted to Internet!lntranet/ due to 2608 CY 2013 Update for Durable Medical Equ

Confidentiality of Instruction Supplies (DMEPOS) Fee Schedule 

2588 Implementation of Changes to the End-Stage Renal Disease (ESRD) Gap-tilling DMEPOS Fees 

Prospective Payment System (PPS) Consolidated Billing Requirements and a 2609 Quarterly Update to the Correct Coding In

Clarification of Outlier Services for Calendar Year 2013 Effective 

2589 Issued to a specific audience, not posted to Internet/lntranet/ due to 2610 Update To Publication 100-04, Claims Pr

Confidentiality of Instruction 12, Non-Physician Practitioners (NPPs) 

2590 Bariatric Surgery for the Treatment of Morbid Obesity National Coverage Assistant-at-Surgery Services 

Determination, Addition of Laparoscopic Sleeve Gastrectomy (LSG) Billing Physician Assistant (PA) Services Paym

Requirements for Special Services Global Surgical Payments 

General Limitations for Assistant-at-Surgery Ser

HCPCS Procedure Codes for Bariatric Surgery Assistants 

ICD-9 Procedure Codes for Bariatric Surgery (FIs only) Outpatient Mental Health Treatment Lim

ICD-9 Diagnosis Codes for BMI 2:35 PA Billing to the Contractor 

Claims Guidance for Payment Nurse Practitioner (NP) and Clinical Nur

2591 Instructions for Downloading the Medicare ZIP Code File tor April 2013 Payment Methodology 

2592 Home Health Prospective Payment System (HH PPS) Rate Update for Limitations for Assistant-at-Surgery Ser

Calendar Year (CY) 2013 Practitioners and Clinical Nurse Specialis

2593 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality oflnstruction 

2594 Testing HIPAA Transactions Following a System Change 

General Remittance Completion Requirements 

Outpatient Mental Health Treatment Lim

NP and CNS Billing to the Contractor 

Clinical Social Worker (CS W) Services 

2611 January 2013 Update of the Hospital Outp

2595 Announcement of Medicare Rural Health Clinic (RHC) and Federally 

Qualified Health Centers (FQHC) Payment Rate Increases 

2596 2013 Annual Update to the Therapy Code List 

2597 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality oflnstruction 

2598 Annual Type of Service erOS) Update 

(OPPS) 

Composite APCs 

Payment Adjustment for Certain Cancer 

2013 

Billing for "Sometimes Therapy" Servic

Services for Hospital Outpatients 

Special Partial Hospitalization Billing R

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Community Mental Health Centers, and Critical Access Hospitals IX 

[Jill Review for Partial Hospitalization Services Provided in Community Correspondence Address and E-mail Ad

Mental Health Centcrs (CMHC) Section 4 of the Form CMS-855A 

2612 Bill Review for Partial Hospitalization Services Provided in Community Section 4 of the Form CMS-855B 

Mental Health Centers (CMHC) Section 4 of the Form CMS-8551 

2613 Revised and Clarified Place of Service (POS) Coding Instructions Intervening Change of Ownership (CHO

Site of Service Payment DilTerential Reserved for Future Use 

Place of Service (POS) Instructions for the Professional Component (PC or Reserved for Future Use Denials 

Interpretation) and the Technical Component (TC) of Diagnostic Tests Ordering/CertifYing Suppliers Who Do N

Items 14-33 - Provider of Service or Supplier Information Place of Service Privileges 

Codes (POS) and Definitions Processing Initial Form CMS-8550 Sub

2614 Updated Billing Requirements for Outpatient Therapy Services -- Form CMS-8550 Revocations 

Middle Class Tax Relief and Jobs Creation Act (MCTRJCA) of2012 CMS or Contractor Issued Deactivations 

Carrier Specific Requirements for Certain Specialties/Services Revocations 

Provider of Service or Supplier Information Special Instructions Regarding Revocati

2615 Revisions of the Financial Limitation for Outpatient Therapy Services- Reserved for Future Use 

Section 3005 of the Middle Class Tax Relief and Job Creation Act of2012 436 Issued to a specific audience, not posted t

Application of Financial Limitations Confidentiality of Instmction 

Claims Processing Requirements for Financial Limitations 437 Revision to Section 15.5.20 of Chapter 15 

Notification for Beneficiaries Exceeding Financial Limitations (PIM) 

....• Processing Form CMS-855R Applicatio

00 None 438 Progress Notes and Forms 

\·0i·'\ .• Progress Notes and Forms 

213 Notice of New Interest Rate for Medicare Overpayments and Underpayments 

-1st qtr. Notification for FY 2013 

439 Issued to a specific audience, not posted t

Confidentiality of Instruction 

214 Medicare Financial Management Manual, Chapter 7, Internal Control 

Requirements 

CMS Contractor Internal Control Review Process and Timcline 

440 Revision to Appeals Section of Chapter 1

(pIM) 

Appeals Process 

Risk Assessment Appeals Involving Non-Certified Suppli

Certification Package for Internal Controls (CpIC) Requirements OMB Circular A-123, Appendix A: Internal Controls Ovcr Financial 

Reporting (ICOFR) 

CPIC - Report of Internal Control Deficiencies 

Definitions of Control Deficiency, Significant Deficiency, and Material 

Weakness 

Corrective Action Plans (CAPs) 

Reconsideration Requests 

Additional Appeal Levels 

Appeals Involving Certified Providers an

Corrective Action Plans (CAPs) 

Reconsideration Requests 

Material Weaknesses Identified During the Reporting Period Additional Appeal Levels 

Statement on Standards for Attestation Engagements (SSAE) Number 16, 441 Retirement of the Program Integrity mana

Reporting on Controls at Service Providers Medical Review Definitions 

Corrective Action Plans Background 

Submission, Review, and Approval of Corrective Action Plans Background 

CMS Finding Numbers Definitions 

List ofCMS Contractor Control Objectives Automated Medical Review 

215 None Routine Medical Review 

216 Modification/Addition of Group Codes/Specialty Codes Non-Physician 

Practitioner/Supplier Specialty Codes 

'{'\>' ·.};.'.'i\;> {'Vi :.' {i •• i 

00 None 

Demand Bill Claims Review 

Medical Review Reopening 

Prepay Complex Provider Specific Revi

Prepay Complex Service Specific Revie

Prepay Complex Provider Specific Probe 

435 General Update to Chapter 15 ofthe Program Integrity Manual (pIM) - Part Prepay Complex Service Specific Probe 

Advanced Determination of Medicare C

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Postpay Complex Provider Specific Probe Review "; Postpay Complex Service Specific Probe Review 00 None 

Postpay Complex Provider Specific Review 

Postpay Complex Service Specific Review 00 None 

Data Analysis Policy Development Medical Review Edit Development Externally Directed Reviews 

85 Revisions to the Method of Cost Settleme

Hospitals Pmiicipating Under Demonstrat

the Medicare Modernization Act Section

Provider Compliance Group Directed Reviews 

Coding Decisions 

Monthly Reporting of Medical Review Savings 

Reserved 

Reserved 

Reserved 

Care Act authorizes an expansion of the d

an additional 5-year period. This CR mak

gives instructions for the additional 5-yea

86 Implementation of the Hospital Value-Ba

Hospital Readmission Reduction Program 

Demonstration 

442 Update for Amendments, Corrections and Delayed Entries in Medical 

Documentation 

Amendments, Corrections and Delayed Entries in Medical Documentation 

443 National Coverage Determinations (NCDs) 

Coverage Provisions in Interpretive Manuals 

Local Coverage Determinations (LCDs) 

Durable Medical Equipment Medicare Administrative Contractors (DME 

MACs) Adoption or Rejection ofLCDs Recommended by Durable Medical 

Equipment 

Program Safeguard Contractors (DME PSCs) 

Individual Claim Determinations 

When To Develop New/Revised LCDs 

Content of an LCD 

Reasonable and Necessary Provisions in LCDs 

Coding Provisions in LCDs 

Use of Absolute Words in LCDs 

1128 Recompiling of Application Data Structur

1129 Elimination of the Fiscal Intermediary Sh

User Releases 

1130 Implementation of the Redesigned MSN 

1l3l Issued to a specific audience, not posted t

of Instruction 

1132 Issued to a specific, audience not posted t

Con1identiality of Instruction 

1133 New Informational Unsolicited Response 

Previously Paid Claims for Services Furn

Classified as "Unlawfully Present" in the 

1134 New Informational Unsolicited Response 

Previously Paid Claims for Services Furn

1135 Issued to a specific audience, not posted t

LCD Requirements That Alternative Item or Service Be Tried First 

LCD Development Process 

Evidence Supporting LCDs 

of Instruction 

1136 National COITect Coding Initiative (NCC!

(Additions) 

The Comment Period 1137 PWK System Modifications for Processin

CAC Structure and Process 1138 Adding Bankruptcy Status Field to the Re

LCD Reconsideration Process Weekly Reports 

R Challenge of an LCD etired LCDs and The LCD Record 1139 Durable Medical Equipment (DME) Natio

The Challenge National Mail Order (NMO) Program Im

Subpoenas 1140 Termination of the Common Working Fil

Dismissals for Cause 1141 The Supplemental Security Income (SSJ)/

Effectuating the Decision Fiscal Year 20 I 0 for Inpatient Prospective 

Evaluation of Local Coverage Determination (LCD) Topics for National Hospitals, Inpatient Rehabilitation Facili

Coverage Determination (NCD) Consideration Hospitals (L TCHs) 

444 Retirement of the Program Integrity Management Reporting (PIMR) System 1142 Editing for Duplicate Payment of Non phy

During an Inpatient Hospital Admission 

00 None 1143 Issued to a specific, audience not posted t

.. ,: Confidentiality of Instruction 

00 None 1144 MCS/T ACs System Edits 

1145 Health Insurance Portability and Account

00 None Updates for April 2013 

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1146 Issued to a specific audience, not posted to Internet/Intranet due to Sensitivity 

oflnstruction 

1147 Implementation of the Revised Health Insurance Claim Form CMS-1500 

(02/12) (Analysis Only) 

1148 Fee for Service Beneficiary Data Streamlining (FFS BDS) 

1149 Multiple Procedure Payment Reduction (MPPR) on the Technical Component 

(TC) of Diagnostic Cardiovascular and Ophthalmology Procedures 

1150 Issued to a specific, audience not posted to Internet/Intranet due to 

Confidentiality of Instruction 

1151 Use ofQ6 Moditier for Locum Tenens by Providing Performing Provider NPI 

- Analysis only CR 

1152 New Screens and Processes for ICD-9/ICD-1O, ICD-1O/ICD-9 Diagnosis and 

Procedure Codes Conversions for Medicare Secondary (MSP) Claims Using 

the General Equivalence Mappings (GEMS) 2013 Table in CWF 

1153 Issued to a specific, audience not posted to Internet/Intranet due to 

Confidentiality ofInstruction 

1154 Issued to a specific, audience not posted to Internet/Intranet due to Sensitivity 

ofInstruction 

1155 Issued to a specific, audience not posted to Internet/lntranet due to Sensitivity 

of Instruction 

1156 Addition of New Common Working File (CWF) Medicare Secondary Payer 

(MSP) Utilization Edit Codes for CWF to Send the Shared Systems When the 

Diagnosis Code on the Claim is Considered a Match with the Family ofDX 

Codes in CWF for Non-Group Health Plan (NGHP) MSP Claims 

1157 Standardizing the Standard - Phase I 

Addendum II: Regulation Documents Published 

in the Federal Register (October through December 2012) 

Regulations and Notices 

Regulations and notices are published in the daily Federal 

Register. To purchase individual copies or subscribe to the Federal Register, contact GPO at When ordering individual 

copies, it is necessary to cite either the date of publication or the volume 

number and page number. 

The Federal Register is available as an online database through 

GPO Access. The online database is updated by 6 a.m. each day the 

Federal Register is published. The database includes both text and 

graphics from Volume 59, Number 1 (January 2, 1994) through the present 

date and can be accessed at The 

following website provides 

information on how to access electronic editions, printed editions, and 

reference copies. 

This information is available on our website at: 

For questions or additional informatio

(410-786-4481). 

Addendum III: CMS R

CMS Rulings are decisions of the Adm

precedent final opinions and orders and stateme

interpretation. They provide clarification and i

ambiguous provisions ofthe law or regulations 

Medicaid, Utilization and Quality Control Peer 

insurance, and related matters. 

The rulings can be accessed at 

additional information, contact Tiffany Lafferty 

Addendum IV: Medicare National Cov

(October through Decemb

Addendum IV includes completed nat

determinations (NCDs), or reconsiderations of 

quarter covered by this notice. Completed deci

section of the NCD Manual (NCDM) in which 

title, the date the publication was issued, and th

decision. An NCD is a determination by the Se

particular item or service is covered nationally 

(title XVlIl of the Act), but does not include a d

any, that is assigned to a particular covered item 

determination for a particular covered item or s

include infonnation concerning completed deci

program and decision memoranda, which also a

some cases, explain why it was not appropriate 

Information on completed decisions as well as 

been posted on the CMS website. For the purp

we list only the specific updates that have occu

This information is available on our website at: 

For questions or additiona

Wanda Belle (410-786-7491 ). 

Title NCDM Transmitt

Section Number 

Update to Pub. 100-08, Program n/a R443 PI 

Integrity Manual, Chapter 13 

Transcutaneous Electrical Nerve NCD RI49'1CD 

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Stimulation (TENS) Chronic 160.27 

Low Back Pain 

Transcatheter Aortic Valve 

Replacement (TA VR) Bariatric Surgery for the 

Treatment for the Treatment of NCD R148NCD 11109/2012 06/27/2012 Morbid Obesity National 100.1 

Coverage Determination, 

Addition of Laparoscopic 

Sleeve Gastrostomy (LSG) 

Addendum V: FDA-Approved Category B Investigational Device 

Exemptions (IDEs) (October through December 2012) 

Addendum V includes listings of the FDA-approved 

investigational device exemption (IDE) numbers that the FDA assigns. The 

listings are organized according to the categories to which the devices are 

assigned (that is, Category A or Category B), and identified by the IDE 

number. For the purposes of this quarterly notice, we list only the specific 

updates to the Category B IDEs as of the ending date of the period covered 

by this notice and a contact person for questions or additional information. 

For questions or additional information, contact John Manlove (410-786-

6877). 

Under the Food, Drug, and Cosmetic Act (21 U.S.c. 360c) devices 

fall into one of three classes. To assist CMS under this categorization 

process, the FDA assigns one of two categories to each FDA-approved 

investigational device exemption (IDE). Category A refers to experimental 

IDEs, and Category B refers to non-experimental IDEs. To obtain more 

information about the classes or categories, please refer to the notice 

published in the April 21, 1997 Federal Register (62 FR 19328). 

IDE Device Start Date 

BB15207 Magnetic-Activated Cell Sorter (CliniMACS, Miltenyi) 10/09/12 

GI00294 Glucose Monitoring System 11/08112 GI10104 Medtronic Activa SC Implantable Neurostimulation System 11120112 

GllOl27 Carotid Stent 12/13112 GIIOJ39 Revive SE Thrombectomy Device 11130112 GII0190 Tandem Heart System 11108/12 GII0228 Zilver Vena Venous Stent 12/13112 GII0238 Cobalt Stage One Acrylic Spacer Cement 10103/12 GlI0246 Surgimend PRS Fctal Bovine 11128/12 

GI20002 Absorb Bioresorbable Vascular Scaffold 12/14112 GI20090 Libra Implantable Deep Brain Stimulation System for Adjunctive 10/05/12 

Treatment lor Treatment Resistance Major Depression 

G120091 Tecnis Multifocal Low-Add I-Piece Intraocular Lenses (I0LS), 10/17/12 

Modelss ZKBOO and ZLBOO 

G120110 Prostate Artery Embolization Device G120111 Microvention Flow Re-Directional Endolum

GI20121 Randomized, Double-Blinded, Sham Control

Repetitive Transcranial Magnetic Stimulation 

GI20156 Activa Parkinsons Control Therapy G120159 Impella RP System GI20168 ESVS Mesh G120192 !BV Valve System GI20204 Venascal Saphcon Closure Systcm G120207 Cool Path Ablation Catheter GI20208 AcrysoflQ Restor +8 Multitocal [ntraocular GI20211 Evolution Esophageal Stent System-Fully CoGI20212 Modell 06 With Automatic Stimulation G120213 Attain Performa Quadripolar Lead G120214 Nucleus 24 Auditory Brainstem Implant G[20221 Belt Applicator tor Non-[nvasive Fat Reduct

Thigh 

GI20222 Med IC Pharmdx Kit GI20223 Solidalrity Oral Endotracheal Tube StabilizeGI20226 EENTOV[S MR Conditional System G[20233 Small-Mo[ecule Functional Kinase Inhibitor G120234 Nucleus CI422 Gl20237 SIR-Spheres Microspheres GI20238 NRAS Mutation Clinical Trial Assay (CTA) GI20245 Tissu.g1u GI20246 Exab1ate Transcranial MRGFUS ThalmotomGI20247 Reset-VT GJ20249 Durolane 4.5 ML GI20260 Activated HH Pathway Gene Expression TesGI20261 NASHIDX Solesta 0120262 Enlite Glucose Sensor GI20265 Lenstec Tetraflex HD Posterior Chamber IntGI20267 Zenith T-Branch GI20271 VYSIS CLL CDX FlSl I KIT (List Number: GI20273 Sebacia's Acne Treatment System (SA TS) G120277 Heartmatc II Left Ventricular Assist System G120282 Epicel 

Addendum VI: Approval Numbers for Coll

(October through De

All approval numbers are available to 

Under the review process, approved infonnatio

assigned OMB control numbers. A single cont

several related infonnation collections. This in

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For questions or additional 

infonnation, contact Mitch Bryman (4lO-786-5258). 

Addendum VII: Medicare-Approved Carotid Stent Facilities, 

(October through December 2012) 

Addendum VII includes listings of Medicare-approved carotid 

stent facilities. All facilities listed meet CMS standards for performing 

carotid artery stenting for high risk patients. On March 17,2005, we issued 

our decision memorandum on carotid artery stenting. We detennined that 

carotid artery stenting with embolic protection is reasonable and necessary 

only ifperfonned in facilities that have been detennined to be competent in 

perfonning the evaluation, procedure, and follow-up necessary to ensure 

optimal patient outcomes. We have created a list of minimum standards for 

facilities modeled in part on professional society statements on competency. 

All facilities must at least meet our standards in order to receive coverage 

for carotid artery stenting for high risk patients. For the purposes of this 

quarterly notice, we are providing only the specific updates that have 

occurred in the 3-month period. This infonnation is available on our 

website at: 

For questions or additional infonnation, contact Sarah J. McClain 

(410-786-2294). 

Facility Provider Effective 

Number Date 

Ephraim McDowell Regional Medical Center 180048 09/28/2012 

217 South Third Street Danville, K Y 40422 

UC San Diego Sulpizio Cardiovascular Center 050025 10/24/2005 

9434 Medical Center Drive La Jolla, CA 92037 

Monroe Clinic 520028 10/12/2012 

515 22nd Avenue Monroe, WI 53566 

Northside Hospital Forsyth 1376574277 10/3112012 

1200 NOIihside Forsyth Drive Cumming, GA 30041 

Spring Vaney Hospital Medical Center 1346230323 11116/2012 

5400 South Rainbow Boulevard 

Las Vegas, NV 89118 

Marian Regional Medical Center 050107 12/28/2012 

1400 East Church Street Santa Maria, CA 93454 

FROM: UCSD La Jolla - John M. and Sally B. 050025 10/24/2005 

Thornton Hospital TO: UC San Diego Thornton Hospital 

9300 Campus Point Drive La Jolla, CA 92037 

State 

KY 

CA 

WI 

GA 

NV 

CA CA 

Facility P

N

FROM: University of California San Diego 0

Medical Center 

TO: UC San Diego Medical Center 

200 W. Arbor Drive San Diego, CA 92103 

FROM: St. Joseph's Healthcare 2

TO: Henry Ford Macomb Hospitals 

15855 Nineteen Mile Road 

Clinton Township, Ml 48038 

Addendum VIII: 

American College of Cardiology's Nation

Registry Sites (October through 

Addendum VIII includes a list of the A

Cardiology'S National Cardiovascular Data Reg

implantable cardioverter defibrillators (ICDs) f

indications, as long as infonnation about the pr

central registry. Detailed descriptions of the co

available in the NCO. In January 2005, CMS e

Abstraction Tool through the Quality Network 

temporary data collection mechanism. On Octo

announced that the American College of Cardio

Cardiovascular Data Registry (ACC-NCDR) IC

reporting requirements in the NCO. Hospitals n

ACC-NCDR lCD Registry by April 2006. 

Effective January 27, 2005, to obtain r

NCO policy requires that providers implanting 

clinical indications (that is, patients without a h

spontaneous arrhythmia) report data on each pr

procedure. Details of the clinical indications th

and their respective data reporting requirements 

Medicare NCO Manual, which is on the CMS W

A provider can use either of two mech

reporting requirement. Patients may be enrolle

Device Exemption trial studying ICDs as identi

ACC-NCDR ICD registry. Therefore, for a ben

Medicare-covered ICD implantation for primar

must receive the scan in a facility that participa

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registry. The entire list offacilities that participate in the ACC-NCDR lCD registry can be found at 

For the purposes of this quarterly notice, we are providing only the 

specific updates that have occurred in the 3-month period. This information 

is available by accessing our website and clicking on the link for the 

American College of Cardiology's National Cardiovascular Data Registry 

at: For questions or additional 

information, contact Joanna Baldwin, MS (410-786-7205). 

Facilit 

Sacred Heart on the Emerald Coast 

Bedford 

Tucson AZ 

Ruston LA 

Dyersburg Regional Medical Center Dyersburg TN 

Addendum IX: Active CMS Coverage-Related Guidance Documents 

(October through December 2012) 

There was one CMS coverage-related guidance documents 

published in the October through December 2012 quarter. To obtain the 

document, visit the CMS coverage website at 

For questions or additional 

infonnation, contact Lori Ashby (410-786-6322). 

Addendum X: 

List of Special One-Time Notices Regarding National Coverage 

Provisions (October through December 2012) 

There were no special one-time notices regarding national 

coverage provisions published in the October through December 2012 

quarter. This information is available at For 

questions or additional information, contact Lori Ashby (410-786-6322). 

Addendum XI: National Oncologic PET Registry (NOPR) 

(October through December 2012) 

Addendum XI includes a listing of National Oncologic Positron 

Emission Tomography Registry (NOPR) sites. We cover positron emission 

tomography (PET) scans for particular oncolog

perfonned in a facility that participates in the N

In January 2005, we issued our decisio

emission tomography (PET) scans, which stat

PET scans for particular oncologic indications, 

performed in the context of a clinical study. W

National Oncologic PET Registry as one of the

Therefore, in order for a beneficiary to receive 

scan, the beneficiary must receive the scan in a 

the registry. There were no updates to the listin

Positron Emission Tomography Registry (NOPDecember 2012 quarter. This information is av

For questions or additional information, contac

(410-786-8564) 

Facility P

N

FROM: Hospital of Saint Raphael 0

TO: YNHH- St. Raphael Campus 

1450 Chapel Street New Haven, CT 05611 

Addendum XII: Medicare-Approved 

(Destination Therapy) Facilities (October 

Addendum Xl[ includes a listing of M

that receive coverage for ventricular assist devi

destination therapy. All facilities were required order to receive coverage for VADs implanted 

October 1, 2003, we issued our decision memo

clinical indication of destination therapy. We d

as destination therapy are reasonable and neces

facilities that have been determined to have the 

infrastructure to ensure optimal patient outcome

standards and an application process. All facili

our standards in order to receive coverage for V 

destination therapy. 

For the purposes of this quarterly notic

specific updates that have occurred to the list o

facilities that meet our standards in the 3-month 

available on our website at 

EN15FE13.009</GPH>mstockstill on DSK4VPTVN1PROD with NOTICES

For questions or additional infonnation, contact JoAnna Baldwin, MS 

(410-786-7205). 

Facility Provider Number Date Approved 

The Medical Center of Central Georgia 110107 11/08/2012 

777 Hemlock Street 

Macon GA 31201 

Florida Hospital 100007 10/29/2012 

60 I East Rollins Street 

Orlando FL 32803 

Scripps Memorial Hospital La Jolla 050324 11126/2012 

9888 Genesee Avenue 

La Jolla, CA 92037 

Addendum XIII: Lung Volume Reduction Surgery (L VRS) 

(October through December 2012) 

State 

GA 

FL 

CA 

Addendum XIII includes a listing of Medicare-approved facilities 

that are eligible to receive coverage for lung volume reduction surgery. 

Until May 17,2007, facilities that participated in the National Emphysema 

Treatment Trial were also eligible to receive coverage. The following three 

types of facilities are eligible for reimbursement for Lung Volume 

Reduction Surgery (L V RS): 

• National Emphysema Treatment Trial (NETT) approved (Beginning 

05/07/2007, these will no longer automatically quality and can quality only 

with the other programs); 

• Credentialed by the Joint Commission (fonnerly, the Joint 

Commision on Accreditation of Healthcare Organizations (JCAHO)) under 

their Disease Specific Certification Program for L VRS; and 

• Medicare approved for lung transplants. 

Only the first two types are in the list. There were no additions to 

the listing offacilities for lung volume reduction surgery published in the 

October through December 2012 quarter. This infonnation is available on 

our website at 

questions or additional infonnation, contact JoAnna Baldwin, MS 

(410-786-7205). 

Facility Provider Number Date Approved 

Temple University Hospital 3900027 11117/2012 

North Broad Street 

For 

State 

PA 

Addendum XIV: Medicare-Approved Ba

(October through Decemb

Addendum XIV includes a listing of M

that meet minimum standards for facilities mod

society statements on competency. All facilitie

order to receive coverage for bariatric surgery p

2006, we issued our decision memorandum on 

We detennined that bariatric surgical procedure

necessary for Medicare beneficiaries who have 

greater than or equal to 35, have at least one co

and have been previously unsuccessful with me

This decision also stipulated that covered baria

reasonable and necessary only when perfonned 

certified by the American College of Surgeons 

Surgery Center (program standards and require

15, 2006); or (2) certified by the American Soc

(ASBS) as a Bariatric Surgery Center of Excell

standards and requirements in effect on Februa

For the purposes of this quarterly notic

updates to Medicare-approved facilities that me

standards for bariatric surgery and have been ce

ASMBS in the 3-month period. This infonnati

website at 

questions or additional infonnation, contact Ka

(410-786-9252). 

Facility P

N

Duke Raleigh Hospital 

3400 Wake Forest Road Raleigh, NC 27609 

LiC San Diego Health System 200 West Arbor Drive #8401 San Diego, CA 92103 

Central Mississippi Medical Center 

1850 Chadwick Drive Jackson, MS 39204 

Renown South Meadows Medical Center 

10101 Double R BoulevardReno, NV 89521 
BILLING CODE 4120–01–P 

[FR Doc. 2013–03480 Filed 2–14–13; 8:45 am] 


EN15FE13.010</GPH>mstockstill on DSK4VPTVN1PROD with NOTICES

Jackson South Community Hospital 1174601397 07/3112012 FL 

9333 S.W. 152nd Street Miami, FL 33157 

North Mississippi Medical Center 1629049846 09/06/2012 MS 

830 South Gloster Street Tupelo, MS 38801 

Huntington Hospital 1508845322 10/06/2012 NY 

270 Park Avenue Huntington, NY 11743 

UT Southwestern Medical Center 45-0044 05/28/2012 TX 

5909 Harry Hines Boulevard Dallas, TX 75235 

St. Vincent's Medical Center 590-62-4449 12114/2012 FL 

1 ShircliffWay Jacksonville, FL 32204 

Center for Surgical Weight Management at Gwinnett 1790715381 11115/2012 GA 

Medical Center - Duluth 

3855 Pleasant Hill Road. Suite 210 Duluth, GA 30096 

Grinnell Regional Medical Center 1669420501 10/20/2012 lA 

210 Fourth Avenue Grinnell, IA 50112 

FROM: SUNY Upstate Medical University 1578554630 03/27/2009 NY 

TO: Upstate Medical University 

750 E. Adams Street, University Hospital 

Syracuse, NY 13210 

FROM: Marshall Medical Center North 01-0005 04/19/2010 AL 

TO: Marshall Medical Centers 

11491 US Hwy 431 

Guntersville, AL 35950 

FROM: Charleston Area Medical Center, Women 510022 04/04/2007 WV 

and Children's Hospital 

TO: Charleston Area Medical Center, General 

Hospital 

501 Morris Street Charleston, WV 25301 

Oregon Health & Science University 107708, 06/27/2012 OR 

3181 SW Sam Jackson Park Road, L223A 380009; 

Portland, OR 97239 1609824010 

Heartland Regional Medical Center 260006 011201/2012 MO 

5325 Faraon Street 

Saint Joseph, MO 64506 

FROM: St. John's Regional Health Center 260065 03/05/2008 MO 

TO: Mercy Hospital, Springfield 

1235 E. Cherokee Springfield, MO 65804 

Beth Israel Deaconess Medical Center 04-2103881 02/18/2012 MA 

330 Brookline Avenue Boston, MA 02215 

University of North Carolina 1932208576 08/23/2010 NC 

101 Manning Drive Chapel Hill, NC 27599 

Sentara Norfolk General Hospital 4900073 09/30/2012 VA 

600 Gresham Drive Norfolk, VA 23507 

Newton-Wellesley Hospital 1992737761 10/26/2012 MA 

2014 Washington Street Newton, MA 02462 

Our Lady of Lourdes Regional Medical 190102 05/24/2010 LA 

4801 Ambassador Caffery Parkway 

Lafayette, Louisiana 70506 

UMass Memorial Medical Center-Memorial Campus 

55 Lake Avenue North; Room HI-760 

Worcester, MA 01655 

Kaiser Permanente South Bay 

25825 S. Vermont Avenue Harbor City, CA 90710 

Cleveland Clinic Florida 

3100 Weston Road Weston, FL 33331 

Sinai Hospital of Baltimore 

2435 W. Belvedere Avenue Baltimore, MD 21215 

Highland Hospital 

1000 South A venue Rochester, NY 14620 

Saint Francis Hospital 

6161 South Yale Avenue Tulsa, OK 74136 

Hackensack University Medical Center 

30 Prospect Avenue Hackensack, NJ 0760 I 

FROM: Pitt County Memorial Hospital 

TO: Vidant Medical Center 

2100 Stantonsburg Road Greenville, NC 27835 

Princeton Baptist Medical Center 

917 Tuscaloosa Avenue, SW Birmingham, AL 35211 

Community Medical Center-Clovis 

2755 Herndon Avenue Clovis, CA 93611 

Saint Luke's Hospital of Kansas City 

4401 Womall Road Kansas City, MO 

River Oaks Hospital Flowood, MS 

West Hills Hospital and Medical Center 

West Hills, CA 

Phoebe North Campus Albany, GA 

AnMed Health Medical Center Anderson, SC 

Fletcher Allen Health Care 

111 Colchester Avenue Burlington, VT 05401 

Kettering Medical Center Kettering, OH 

Addendum XV: FDG-PET for Dement

Diseases Clinical Trials (October thr

There were no FDG-PET for Demen

Diseases Clinical Trials published in the Octo

quarter. 

This infonnation is available on our 

For questions or additional infonnation, conta

(410-786-8564).