2006 proposed fee schedule - American Society of Clinical Oncology
2006 proposed fee schedule - American Society of Clinical Oncology 2006 proposed fee schedule - American Society of Clinical Oncology
the Act, we are proposing to eliminate the separate HCPCS codes for these casting supplies and to again include these supplies in the PE database. This will allow for payment for these supplies whether based on section 1861(s)(5) of the Act or section 1861(s)(2)(A) of the Act, while ensuring that no duplicate payments are made. In addition, by bundling the cost of the cast and splint supplies into the PE component of the applicable procedure codes under the PFS, physicians will no longer need to bill Q-codes in addition to the procedure codes to be paid for these materials. Because these supplies were removed from the PE database prior to the refinement of these services by the PEAC, we are proposing to add back the original CPEP supply data for casts and splints to each applicable CPT code. For this reason, it is imperative that the relevant medical societies review the “Direct Practice Expense Inputs” on our website at www.cms.hhs.gov/physicians/pfs (under the supporting documents for the 2006 proposed rule) and provide us with feedback regarding the appropriateness of the type and amount of casting and splinting supplies. We are also requesting specific information about the amount of casting supplies needed for the 10-day and 90-day global procedures, because these supplies may not be required at each follow-up visit; therefore, the number of follow-up visits may not 66
eflect the typical number of cast changes required for each service. The following cast and splint supplies have been reincorporated as direct inputs: fiberglass roll, 3 inch and 4 inch; cast padding, 4 inch; webril (now designated as cast padding, 3 inch); cast shoe; stockingnet/stockinette, 4 inch and 6 inch; dome paste bandage; cast sole; elastoplast roll; fiberglass splint; ace wrap, 6 inch; and kerlix (now designated as bandage, kerlix, sterile, 4.5 inch) and malleable arch bars. The cast and splint supplies have been added to the following CPT codes: 23500 through 23680, 24500 through 24685, 25500 through 25695, 26600 through 26785, 27500 through 27566, 27750 through 27848, 28400 through 28675, and 29000 through 29750. Because we are proposing to pay for splint and cast through the PE component of the PFS, we would no longer make separate payment for these items using the HCPCS Q-codes. (6) Miscellaneous PE Issues In this section, we discuss our specific proposals related to PE inputs. ● Supply Items for CPT Code 95015 We are proposing to change the supply inputs for CPT code 95015, intracutaneous (intradermal) tests, sequential and incremental, with drugs, biologicals or venoms, immediate type reaction, specify number of tests, based on 67
- Page 15 and 16: PLI Professional liability insuranc
- Page 17 and 18: Initially, only the physician work
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- Page 29 and 30: November 1, 2001 (66 FR 55246).) Th
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- Page 39 and 40: ● The unscaled indirect expense a
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- Page 87 and 88: Effective January 1, 2006, this pro
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- Page 105 and 106: ● Category #1: Services that are
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eflect the typical number <strong>of</strong> cast changes required for each<br />
service.<br />
The following cast and splint supplies have been<br />
reincorporated as direct inputs: fiberglass roll, 3 inch<br />
and 4 inch; cast padding, 4 inch; webril (now designated as<br />
cast padding, 3 inch); cast shoe; stockingnet/stockinette, 4<br />
inch and 6 inch; dome paste bandage; cast sole; elastoplast<br />
roll; fiberglass splint; ace wrap, 6 inch; and kerlix (now<br />
designated as bandage, kerlix, sterile, 4.5 inch) and<br />
malleable arch bars. The cast and splint supplies have been<br />
added to the following CPT codes: 23500 through 23680,<br />
24500 through 24685, 25500 through 25695, 26600 through<br />
26785, 27500 through 27566, 27750 through 27848, 28400<br />
through 28675, and 29000 through 29750.<br />
Because we are proposing to pay for splint and cast<br />
through the PE component <strong>of</strong> the PFS, we would no longer make<br />
separate payment for these items using the HCPCS Q-codes.<br />
(6) Miscellaneous PE Issues<br />
In this section, we discuss our specific proposals<br />
related to PE inputs.<br />
● Supply Items for CPT Code 95015<br />
We are proposing to change the supply inputs for CPT<br />
code 95015, intracutaneous (intradermal) tests, sequential<br />
and incremental, with drugs, biologicals or venoms,<br />
immediate type reaction, specify number <strong>of</strong> tests, based on<br />
67
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