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January 25, 2018

Four Tests Added to List of CLIA Waived Tests

In early January, the Centers for Medicare and Medicaid Services (CMS) announced new waived tests... Learn More

New and Revised Vaccine Codes Added to 2018 CPT Code Book

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OIG Recommends Measures for Curbing Opioid Misuse and Fraud

Office of Inspector General testimony before the House Committee on Ways and Means in January ... Learn More

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Medical Coding News Archives

April Update to MPFSDB Results in Minor Tweaks Only

March 18, 2011:
Providers will be happy to know that the changes in the most recent update to the Medicare physician fee schedule database (MPFSDB) are very minor.

Among the revisions, the following codes have had a status indicator change:

HCPCS CodeShort DescriptorIndicator
31579Diagnostic laryngoscopyGlobal Surgery: 000
57155Insert uteri tandems/ovoidsCo-Surgeons: 2
64613Destroy nerve neck muscleBilateral Surgery: 2
64614Destroy nerve extrem muscBilateral Surgery: 2
77071X-ray stress viewBilateral Surgery: 2
92511NasopharyngoscopyGlobal Surgery: 000
93464 26Exercise w/hemodynamic measMultiple Surgery: 0

The practice expense portion of the relative value units were slightly revised on the following codes. Providers can expect to see information from their Medicare contractors about the procedures, along with slightly revised payments.

93503 Insertion and placement of flow-directed catheter (e.g., Swan-Ganz) for monitoring purposes
93224 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, physician review and interpretation
93225 recording (includes connection, recording, and disconnection)
93226 Scanning analysis with report
Q2040 Injection, incobotulinum toxin a, 1 unit

Additionally, CMS corrected the outpatient prospective payment system (OPPS) cap for CPT code 92227 (Remote Dx retinal imaging). This code, which is subject to the OPPS payment cap determination, has an Imaging Cap indicator of 1. The calendar year 2011 Medicare physician fee schedule (MPFS) relative value file correctly lists OPPS payment amounts (PE=0.53 and MP=0.02) for this code; however, these values were not carried over to the Imaging Payment Amount field in the contractor payment files, which listed the values as 0.00 for all carriers.

Deborah C. Hall
Clinical/Technical Editor


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