X94-10804. Medicare Program; Revisions to Payment Policies and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 1994

  • [Federal Register Volume 59, Number 149 (Thursday, August 4, 1994)]
    [Unknown Section]
    [Page 0]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: X94-10804]
    
    
    [[Page Unknown]]
    
    [Federal Register: August 4, 1994]
    
    
                                                       VOL. 59, NO. 149
    
                                               Thursday, August 4, 1994
    
    DEPARTMENT OF HEALTH AND HUMAN SERVICES
    
    Health Care Financing Administration
    
    42 CFR Parts 405 and 414
    
    [BPD-770-CN]
    RIN 0938-AG22
    
     
    
    Medicare Program; Revisions to Payment Policies and Adjustments 
    to the Relative Value Units Under the Physician Fee Schedule for 
    Calendar Year 1994
    
    Correction
    
        In rule document 94-17222 beginning on page 36069 in the issue of 
    Friday, July 15, 1994, the tables appearing on pages 36069 through 
    36071 should have appeared as follows:
        1. On page 63653, the following codes are corrected to read: 
    
    ----------------------------------------------------------------------------------------------------------------
                                                                                        Specialty                   
      HCPCS+      MOD                   Description                   RUC recommended  recommended    HCFA decision 
                                                                        work RVUs       work RVUs                   
    ----------------------------------------------------------------------------------------------------------------
    *15788.....          Chemical peel, face, epiderm..............  None............         5.00  Decreased.      
    *15789.....          Chemical peel, face, dermal...............  None............         6.59  Decreased.      
    *15792.....          Chemical peel, nonfacial..................  None............         4.00  Decreased.      
    *15793.....          Chemical peel, nonfacial..................  None............         5.34  Decreased.      
    ----------------------------------------------------------------------------------------------------------------
    
        2. On page 63662, the following codes are corrected to read: 
    
    ----------------------------------------------------------------------------------------------------------------
                                                                                        Specialty                   
      HCPCS+      MOD                   Description                   RUC recommended  recommended    HCFA decision 
                                                                        work RVUs       work RVUs                   
    ----------------------------------------------------------------------------------------------------------------
    97545......          Work hardening............................  None............         1.70  (b).            
    97546......          Work hardening............................  None............          .85  (b).            
    ----------------------------------------------------------------------------------------------------------------
    
    F. Pages 63722 through 63836, Addendum B
        1. On page 63722, the following codes are corrected to read:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    33401....          C              Valvuloplasty, open....................         0.00         0.00         0.00         0.00          090  S           
    33403....          C              Valvuloplasty, w/cp bypass.............          .00          .00          .00          .00          090  S           
    33406....          C              Replacement, aortic valve..............          .00          .00          .00          .00          090  S           
    33413....          C              Replacement, aortic valve..............          .00          .00          .00          .00          090  S           
    33414....          C              Repair, aortic valve...................          .00          .00          .00          .00          090  S           
    33471....          C              Valvotomy, pulmonary valve.............          .00          .00          .00          .00          090  S           
    33475....          C              Replacement, pulmonary valve...........          .00          .00          .00          .00          090  S           
    33505....          C              Repair artery w/tunnel.................          .00          .00          .00          .00          090  S           
    33506....          C              Repair artery, translocation...........          .00          .00          .00          .00          090  S           
    33600....          C              Closure of valve.......................          .00          .00          .00          .00          090  S           
    33602....          C              Closure of valve.......................          .00          .00          .00          .00          090  S           
    33606....          C              Anastomosis/artery-aorta...............          .00          .00          .00          .00          090  S           
    33608....          C              Repair anomaly w/conduit...............          .00          .00          .00          .00          090  S           
    33610....          C              Repair by enlargement..................          .00          .00          .00          .00          090  S           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
        2. On page 63723, the following codes are corrected to read:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    33611....          C              Repair double ventricle................         0.00         0.00         0.00         0.00          090  S           
    33612....          C              Repair double ventricle................          .00          .00          .00          .00          090  S           
    33615....          C              Repair (simple fontan).................          .00          .00          .00          .00          090  S           
    33617....          C              Repair by modified fontan..............          .00          .00          .00          .00          090  S           
    33619....          C              Repair single ventricle................          .00          .00          .00          .00          090  S           
    33692....          C              Repair of heart defects................          .00          .00          .00          .00          090  S           
    33697....          C              Repair of heart defects................          .00          .00          .00          .00          090  S           
    33698....          C              Repair of heart defects................          .00          .00          .00          .00          090  S           
    33722....          C              Repair of heart defect.................          .00          .00          .00          .00          090  S           
    33732....          C              Repair heart-vein defect...............          .00          .00          .00          .00          090  S           
    33736....          C              Revision of heart chamber..............          .00          .00          .00          .00          090  S           
    33766....          C              Major vessel shunt.....................          .00          .00          .00          .00          090  S           
    33767....          C              Atrial septectomy/septostomy...........          .00          .00          .00          .00          090  S           
    33770....          C              Repair great vessels defect............          .00          .00          .00          .00          090  S           
    33771....          C              Repair great vessels defect............          .00          .00          .00          .00          090  S           
    33853....          C              Repair septal defect...................          .00          .00          .00          .00          090  S           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
        3. On page 63724, the following codes are corrected to read:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    33917....          C              Repair pulmonary artery................         0.00         0.00         0.00         0.00          090  S           
    33918....          C              Repair pulmonary atresia...............          .00          .00          .00          .00          090  S           
    33919....          C              Repair pulmonary atresia...............          .00          .00          .00          .00          090  S           
    33920....          C              Repair pulmonary atresia...............          .00          .00          .00          .00          090  S           
    33922....          C              Transect pulmonary artery..............          .00          .00          .00          .00          090  S           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
        4. On page 63733, HCPCS code 43248 is corrected to read as follows:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    43248....          A              Upper GI endoscopy/guidewire...........         3.18        *4.14         0.34         7.66          000  N           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
        5. On page 63749, the third appearance of HCPCS code 59020 is 
    corrected to read as follows:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    59020....      26  A              Fetal contract stress test.............         0.67        *0.87         0.19         1.73          000  S           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
        6. On page 63764, the following code is corrected to read:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    70551....      26  A              Magnetic image, brain (MRI)............         1.50         0.67         0.10         2.27          XXX  N           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
        7. On page 63799, the following code is added to read:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    86423....          D              Radioimmunosorbent test IGE............         0.00         0.00         0.00         0.00          XXX  O           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
        8. On page 63836, the following codes are corrected to read:
    
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Practice                                                      
    HCPCS\1\    MOD       Status                    Description                 Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                              RVUs\2\       RVUs                     period                 
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    J7030....          E              Infusion, normal saline solution.......         0.00         0.00         0.00         0.00          XXX  O           
    J7040....          E              Infusion, normal saline solution.......          .00          .00          .00         0.00          XXX  O           
    J7042....          E              5% dextrose/normal saline..............          .00          .00          .00         0.00          XXX  O           
    J7050....          E              Infusion, normal saline solution.......          .00          .00          .00         0.00          XXX  O           
    J7051....          E              Sterile saline or water................          .00          .00          .00         0.00          XXX  O           
    J7060....          E              5% dextrose/water......................          .00          .00          .00         0.00          XXX  O           
    J7070....          E              Infusion, d5w..........................          .00          .00          .00         0.00          XXX  O           
    J7120....          E              Ringers lactate infusion...............          .00          .00          .00         0.00          XXX  O           
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    \1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
    \2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              
    
    
    
    
    
    

Document Information

Published:
08/04/1994
Department:
Health Care Finance Administration
Entry Type:
Uncategorized Document
Document Number:
X94-10804
Pages:
0-0 (1 pages)
Docket Numbers:
Federal Register: August 4, 1994, BPD-770-CN
RINs:
0938-AG22
CFR: (2)
42 CFR 405
42 CFR 414