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CPT codes, descriptions, and other data only are copyright 2008 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.
Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyrighted by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

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Ohio Part B Carrier
Emergency Update to the 2009 Medicare Physician Fee Schedule Database (MPFSDB)

MLN Matters Number: MM6351
Related Change Request (CR) #: 6351
Related CR Release Date: January 2, 2009
Effective Date: January 1, 2009
Related CR Transmittal #: R1661CP
Implementation Date: January 5, 2009
 
Provider Types Affected
Physicians and providers submitting claims to Medicare contractors (carriers, Fiscal Intermediaries (FIs), and/or Medicare Administrative Contractors (A/B MACs) for professional services provided to Medicare beneficiaries that are paid under the Medicare Physician Fee Schedule (MPFS).
 
Provider Action Needed
This article is based on Change Request (CR) 6351 which amends payment files that were issued to contractors based upon the 2009 Medicare Physician Fee Schedule (MPFS) Final Rule. Be sure billing staff are aware of these changes.
 
Background
Section 1848(c)(4) of the Social Security Act authorizes the Secretary to establish ancillary policies necessary to implement relative values for physicians’ services.
 
Specific changes included in the Emergency Update to the 2009 MPFSDB are detailed in Attachment 1 of CR 6351. That CR is available at www.cms.hhs.gov/Transmittals/downloads/R1661CP.pdf (PDF, 213 KB). Key changes, however, are summarized as follows:
 
Noncovered Services
Due to the National Coverage Determination for Thermal Intradiscal Procedures (TIPs), effective September 29, 2008, CPT codes 22526, 22527, 0962T and 0963T became noncovered services on or after September 29, 2008 for Medicare purposes.
 
Descriptor Changes
The long and/or short descriptors have been revised for the following codes:
 
CPT Code
Revised Long Descriptor
Revised Short Descriptor
4275F
Hepatitis B vaccine injection administered or previously received (HIV)
Hep b vac inj admin/ rcvd
CDT Code
 Revised Long Descriptor
Revised Short Descriptor
D0486 Laboratory accession of brush biopsy sample, microscopic examination, preparation and transmission of written report
N/A
D1203
Topical application of fluoride - child
Topical app fluoride child
D1204
Topical application of fluoride – adult
Topical app fluoride adult
D3310
Endodontic therapy, anterior tooth (excluding final restoration)
End thxpy, anterior tooth
D3320
Endodontic therapy, bicuspid tooth (excluding final restoration)
End thxpy, bicuspid tooth
D3330
Endodontic therapy, molar (excluding final
restoration)
End thxpy, molar
D4210
Gingivectomy or gingivoplasty - four or more contiguous teeth or tooth bounded spaces per quadrant
N/A
D4211
Gingivectomy or gingivoplasty - one to three contiguous teeth or tooth bounded spaces per quadrant
N/A
D4240
Gingival flap procedure, including root planing - four or more contiguous teeth or tooth bounded spaces per quadrant
N/A
D4241
Gingival flap procedure, including root planing - one to three contiguous teeth or tooth bounded spaces per quadrant
N/A
D4260
Osseous surgery (including flap entry and
closure) - four or more contiguous teeth or
tooth bounded spaces per quadrant
N/A
D4261
Osseous surgery (including flap entry and
closure) - one to three contiguous teeth or
tooth bounded spaces per quadrant
N/A
HCPCS code
Revised Long Descriptor
Revised Short Descriptor
 Q4114  Integra flowable wound matrix, injectable, 1 cc  N/A
 
 
New Dental Codes for 2009
 
CDT code
Long Descriptor
Short Descriptor
D0417
Collection and preparation of saliva sample for laboratory diagnostic testing
Collect & prep saliva sample
D0418
Analysis of saliva sample
Analysis of saliva sample
D3222
Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development
Part pulp for apexogenesis
 
D5991
Topical medicament carrier
Topical medicament carrier
 
Additional Information
The official instruction, CR 6351, issued to your carrier, FI, or MAC regarding this change may be viewed at
 
If you have any questions, please contact the appropriate Provider Contact Center at our toll free number:
  • Ohio and West Virginia: (866) 332-7025
  • South Carolina Part B: (888) 828-2092
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2008 American Medical Association.

 

last updated on 01/07/2009
CMS