Judyann bigby, M. D



Download 111 Kb.
Date08.02.2017
Size111 Kb.
The Commonwealth of Massachusetts

Executive Office of Health and Human Services

Division of Health Care Finance and Policy

Two Boylston Street

B
DEVAL L. PATRICK

Governor
TIMOTHY P. MURRAY

Lieutenant Governor

JUDYANN BIGBY, M.D.

Secretary
DAVID MORALES

Commissioner


oston, MA 02116



617-988-3100 • Fax 617-727-7662 • TTY 617-988-3175

www.mass.gov/dhcfp

Administrative Bulletin 11-04



114.3 CMR 47.00 Freestanding Ambulatory Surgical Facilities
January 21, 2011

CPT/HCPCS 2011 Coding Updates

In accordance with 114.3 CMR 47.01(4), the following list specifies those codes that are added and codes that are deleted, with crosswalks to new codes that replace corresponding deleted codes. Codes with one-to-one crosswalks to deleted codes are reimbursed at the current payment rate of the deleted codes. Codes with one-to-one crosswalks to existing codes are reimbursed at the current payment rate of the existing codes. All other codes in this bulletin that require pricing are reimbursed at individual consideration (I.C.). Rates listed in this administrative bulletin are applicable until revised rates are issued by the Division. The updated rates apply to services provided on or after January 1, 2011. Deleted codes will no longer be available for use after 2010.



114.3 CMR 47.00 Code Additions:


Code

Descriptor

11045

Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

11046

Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

11047

Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

29914

Anthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)

29915

Anthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)

29916

Anthroscopy, hip, surgical; with labral repair

31295

Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa

31296

Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)

31297

Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)

31634

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed

37204

Transcatheter occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method, non-central nervous system,non-head or neck

37210

Uterine fibroid embolization (UFE, embolization of the uterine arteries to treat uterine fibroids, leiomyomata), percutaneous approach inclusive of vascular access, vessel selection, embolization, and all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the procedure

37220

Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty

37221

Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within same vessel, when performed

37222

Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)

37223

Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)

38900

Intraoperative identification (eg, mapping) of sentinel lymph node(s), includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)

41899

Unlisted procedure, dentoalveolar structures

43753

Gastric intubation and aspiration(s) therapeutic, necessitating physician’s skill (eg, for gastrointestinal hemorrhage), including lavage if performed

43754

Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)

43755

Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug administration

43756

Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture)

43757

Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration

49327

Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple ) (List separately in addition to code for primary procedure)

49418

Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation, percutaneous

50593

Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy

52649

Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)

53860

Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence

57156

Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy

61781

Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure)

61782

Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure)

61783

Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure)

64566

Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming

64568

Incision for implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator

64569

Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator

64570

Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator

64611

Chemodenervation of parotid and submandibular salivary glands, bilateral

65778

Placement of amniotic membrane on the ocular surface for wound healing; self-retaining

65779

Placement of amniotic membrane on the ocular surface for wound healing; single layer, sutured

66174

Transluminal dilation of aqueous outflow canal; without retention of devise or stent

66175

Transluminal dilation of aqueous outflow canal; with retention of devise or stent

C9800

Dermal injection procedure(s) for facial lipodystrophy syndrome (LDS) and provision of Radiesse or Sculptra dermal filler, including all items and supplies



114.3 CMR 47.00 Code Deletions:


Code

Descriptor

11040

Debridement; skin, partial thickness

11041

Debridement; skin, full thickness

20000

Incision of soft tissue abscess (eg, secondary to osteomyelitis); superficial

35473

Transluminal balloon angioplasty, percutaneous; iliac

35492

Transluminal peripheral atherectomy, percutaneous; iliac

43600

Biopsy of stomach; by capsule, tube, peroral (1 or more specimens)

49420

Insertion of intraperitoneal cannula or catheter for drainage or dialysis; temporary

61795

Stereotactic computer-assisted volumetric (navigational) procedure, intracranial, extracranial, or spinal (List separately in addition to code for primary procedure)

64573

Incision for implantation of neurostimulator electrodes; cranial nerve


Crosswalk Replacement Codes:

There are no one-to-one crosswalks.


114.3 CMR 47.03(4) Change to Modifier 50 Description:
The description of the modifier for bilateral procedures is revised as follows:
-50: Bilateral Procedure. Payment for bilateral procedures performed at the same operative session must be identified by the appropriate service code and the modifier ‘-50.’ Only one claim line is billed for both procedures. The addition of the modifier ‘-50’ to the bilateral code will allow 150% of the allowable fee contained in 114.3 CMR 47.00 to be paid to the eligible provider for performance of both bilateral procedures.
The payment for bilateral procedures does not change as a result of the new description.


Share with your friends:


The database is protected by copyright ©dentisty.org 2019
send message

    Main page