MLN Matters® Number: MM6484
Related Change Request (CR) #: 6484
Related CR Release Date: May 29, 2009
Effective Date: January 1, 2009
Related CR Transmittal #: R1748CP
Implementation Date: July 6, 2009
Provider Types Affected
Physicians, non-physician practitioners and providers who submit claims to Palmetto GBA 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 CR 6484, which amends payment files that were issued to Medicare contractors based on the 2009 MPFS Final Rule. Be sure billing staff are aware of the Current Procedure Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) changes made in this July Update to the 2009 MPFSDB.
Background
Payment files were issued to contractors based upon the 2009 MPFS Final Rule. CR 6484 amends those payment files. Changes included in the July Update to the 2009 MPFSDB are as follows:
The following changes are effective for dates of service on and after January 1, 2009:
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CPT Code/HCPCS Modifier
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Action
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50593
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Bilateral indicator = 1
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77421
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Global Physician Supervision Diagnostic Indicator = 09
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77421 TC
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Physician Supervision Diagnostic Indicator = 02
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92025
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Global Bilateral Indicator = 2
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92025 TC
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Bilateral Indicator = 2
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92025 26
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Bilateral Indicator = 2
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Note: Changes to CPT code 93351 were included in the April Update to the MPFSDB. Fully implemented facility practice expense relative value units (PE RVUs) were inadvertently not listed in Attachment 1 of the April update but were included on the payment files. Below are the fully implemented facility PE RVUs for CPT code 93351. This service is typically not paid under the Medicare physician fee schedule when provided in a facility setting and the fully implemented facility PE RVUs listed below are informational only.
- 93351 Global - Fully Implemented Facility PE RVU: 5.07
- 93351 TC (HCPCS modifier) - Fully Implemented Facility PE RVU: 4.15
- 93351 26 (CPT modifier) - Fully Implemented Facility PE RVU: 0.92
The following changes are effective for dates of service on and after July 1, 2009:
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CPT Code
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Descriptor
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90670
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- Long Descriptor: Pneumococcal conjugate vaccine, 13 valent, for intramuscular use
- Short descriptor: Pneumococcal vacc, 13 val im
- Procedure Status: X
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92507
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PC/TC Indicator = 7
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92508
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PC/TC Indicator = 7
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92526
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PC/TC Indicator = 7
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92597
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PC/TC Indicator = 7
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92607
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PC/TC Indicator = 7
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92608
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PC/TC Indicator = 7
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92609
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PC/TC Indicator = 7
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96125
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PC/TC Indicator = 7
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0199T
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- Long descriptor: Physiologic recording of tremor using accelerometer(s) and gyroscope(s), (including frequency and amplitude) including interpretation and report
- Short descriptor: Physiologic tremor record
- Procedure Status: C
|
|
0200T
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- Long descriptor: Percutaneous sacral augmentation
- (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device (if utilized), one or more needles
- Short descriptor: Perq sacral augmt unilat inj
- Procedure Status: C
|
|
0201T
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Long descriptor: Percutaneous sacral augmentation
- (sacroplasty), bilateral injections, including the use of a balloon or mechanical device (if utilized), two or more needles
- Short descriptor: Perq sacral augmt bilat inj
- Procedure Status: C
|
|
0202T
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- Long descriptor: Posterior vertebral joint(s) arthroplasty (e.g., facet joint[s] replacement) including facetectomy, laminectomy, foraminotomy and vertebral column fixation, with or without injection of bone cement, including fluoroscopy, single level, lumbar spine
- Short descriptor: Post vert arthrplst 1 lumbar
- Procedure Status: C
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|
HCPCS Code
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Descriptor
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Q2023
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- Long descriptor: Injection, factor viii (antihemophilic factor, recombinant) (Xyntha), per i.u.
- Short descriptor: Xyntha, inj
- Procedure Status: E
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Q4115
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- Long descriptor: Skin substitute, alloskin, per square centimeter
- Short descriptor: Alloskin skin sub
- Procedure Status: E
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Q4116
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- Long descriptor: Skin substitute, alloderm, per square centimeter
- Short descriptor: Alloderm skin sub
- Procedure Status: E
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Additional Information
If you have questions, please contact our Provider Contact Center at our toll free number (866) 332-7025 (Ohio and West Virginia) or (888) 828-2092 (South Carolina Part B).
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.