Notice: This CMS-approved document has been submitted - Philips ...
Notice: This CMS-approved document has been submitted - Philips ... Notice: This CMS-approved document has been submitted - Philips ...
CMS-1403-FC 77620 Hyperthermia treatment 77750 Infuse radioactive materials 77761 Apply intrcav radiat simple 77762 Apply intrcav radiat interm 77763 Apply intrcav radiat compl 77776 Apply interstit radiat simpl 77777 Apply interstit radiat inter 77778 Apply interstit radiat compl 77785 HDR brachytx, 1 channel 77786 HDR brachytx, 2-12 channel 77787 HDR brachytx over 12 chan 77789 Apply surface radiation 77790 Radiation handling 77799 Radium/radioisotope therapy 79005 Nuclear rx, oral admin 79101 Nuclear rx, iv admin 79200 Nuclear rx, intracav admin 79300 Nuclr rx, interstit colloid 79403 Hematopoietic nuclear tx 79440 Nuclear rx, intra-articular 79445 Nuclear rx, intra-arterial 79999 Nuclear medicine therapy 92974 Cath place, cardio brachytx A9517 I131 iodide cap, rx A9527 Iodine I-125 sodium iodide A9530 I131 iodide sol, rx A9543 Y90 ibritumomab, rx A9545 I131 tositumomab, rx A9563 P32 Na phosphate A9564 P32 chromic phosphate A9600 Sr89 strontium A9605 Sm 153 lexidronm A9699 Radiopharm rx agent noc C1716 Brachytx, non-str, Gold-198 C1717 Brachytx, non-str,HDR Ir-192 C1719 Brachytx, NS, Non-HDRIr-192 C2616 Brachytx, non-str,Yttrium-90 C2634 Brachytx, non-str, HA, I-125 C2635 Brachytx, non-str, HA, P-103 C2636 Brachy linear, non-str,P-103 1456
CMS-1403-FC C2638 Brachytx, stranded, I-125 C2639 Brachytx,non-stranded,I-125 C2640 Brachytx, stranded, P-103 C2641 Brachytx, non-stranded,P-103 C2642 Brachytx, stranded, C-131 C2643 Brachytx, non-stranded,C-131 C2698 Brachytx, stranded, NOS C2699 Brachytx, non-stranded, NOS G0173 Linear acc stereo radsur com G0251 Linear acc based stero radio G0339 Robot lin-radsurg com, first G0340 Robt lin-radsurg fractx 2-5 Q3001 Brachytherapy Radioelements EPO AND OTHER DIALYSIS-RELATED DRUGS 1457 The physician self-referral prohibition does not apply to the following codes for EPO and other dialysis-related drugs furnished in or by an ESRD facility if the conditions in §411.355(g) are satisfied: J0630 Calcitonin salmon injection J0636 Inj calcitriol per 0.1 mcg J0882 Darbepoetin alfa, esrd use J0895 Deferoxamine mesylate inj J1270 Injection, doxercalciferol J1750 Inj iron dextran J1756 Iron sucrose injection J1955 Inj levocarnitine per 1 gm J2501 Paricalcitol J2916 Na ferric gluconate complex J2993 Reteplase injection J2995 Inj streptokinase /250000 IU J2997 Alteplase recombinant J3364 Urokinase 5000 IU injection P9041 Albumin (human),5%, 50ml P9045 Albumin (human), 5%, 250ml P9046 Albumin (human), 25%, 20ml P9047 Albumin (human), 25%, 50ml Q4081 Epoetin alfa, 100 units ESRD
- Page 1405 and 1406: CMS-1403-FC 30860 30980 31020 31084
- Page 1407 and 1408: CMS-1403-FC 33140 33260 33340 33460
- Page 1409 and 1410: CMS-1403-FC 35300 35380 35644 35660
- Page 1411 and 1412: CMS-1403-FC 37340 37380 37460 37620
- Page 1413 and 1414: CMS-1403-FC 39300 39340 39380 39460
- Page 1415 and 1416: CMS-1403-FC 40580 40660 40900 40980
- Page 1417 and 1418: CMS-1403-FC 41940 41980 Sabana Gran
- Page 1419 and 1420: CMS-1403-FC 43340 43580 43620 43780
- Page 1421 and 1422: CMS-1403-FC 45940 46060 46140 46220
- Page 1423 and 1424: CMS-1403-FC 47940 48140 48260 48300
- Page 1425 and 1426: CMS-1403-FC 1425
- Page 1427 and 1428: CMS-1403-FC CBSA Code Nonurban Area
- Page 1429 and 1430: CMS-1403-FC HCPCS Descriptor 71260
- Page 1431 and 1432: CMS-1403-FC HCPCS Descriptor 74480
- Page 1433 and 1434: CMS-1403-FC HCPCS Descriptor 77012
- Page 1435 and 1436: CMS-1403-FC HCPCS Descriptor 93971
- Page 1437 and 1438: CMS-1403-FC 78122 Blood volume 7813
- Page 1439 and 1440: CMS-1403-FC 96125 Cognitive test by
- Page 1441 and 1442: CMS-1403-FC 70240 X-ray exam, pitui
- Page 1443 and 1444: CMS-1403-FC 72120 X-ray exam of low
- Page 1445 and 1446: CMS-1403-FC 73720 Mri lwr extremity
- Page 1447 and 1448: CMS-1403-FC 76856 Us exam, pelvic,
- Page 1449 and 1450: CMS-1403-FC 78456 Acute venous thro
- Page 1451 and 1452: CMS-1403-FC 93320 Doppler echo exam
- Page 1453 and 1454: CMS-1403-FC A9571 Indium In-111 aut
- Page 1455: CMS-1403-FC 77333 Radiation treatme
- Page 1459: CMS-1403-FC P3000 Screen pap by tec
<strong>CMS</strong>-1403-FC<br />
C2638 Brachytx, stranded, I-125<br />
C2639 Brachytx,non-stranded,I-125<br />
C2640 Brachytx, stranded, P-103<br />
C2641 Brachytx, non-stranded,P-103<br />
C2642 Brachytx, stranded, C-131<br />
C2643 Brachytx, non-stranded,C-131<br />
C2698 Brachytx, stranded, NOS<br />
C2699 Brachytx, non-stranded, NOS<br />
G0173 Linear acc stereo radsur com<br />
G0251 Linear acc based stero radio<br />
G0339 Robot lin-radsurg com, first<br />
G0340 Robt lin-radsurg fractx 2-5<br />
Q3001 Brachytherapy Radioelements<br />
EPO AND OTHER DIALYSIS-RELATED DRUGS<br />
1457<br />
The physician self-referral prohibition does not apply to the following codes for EPO and<br />
other dialysis-related drugs furnished in or by an ESRD facility if the conditions in<br />
§411.355(g) are satisfied:<br />
J0630 Calcitonin salmon injection<br />
J0636 Inj calcitriol per 0.1 mcg<br />
J0882 Darbepoetin alfa, esrd use<br />
J0895 Deferoxamine mesylate inj<br />
J1270 Injection, doxercalciferol<br />
J1750 Inj iron dextran<br />
J1756 Iron sucrose injection<br />
J1955 Inj levocarnitine per 1 gm<br />
J2501 Paricalcitol<br />
J2916 Na ferric gluconate complex<br />
J2993 Reteplase injection<br />
J2995 Inj streptokinase /250000 IU<br />
J2997 Alteplase recombinant<br />
J3364 Urokinase 5000 IU injection<br />
P9041 Albumin (human),5%, 50ml<br />
P9045 Albumin (human), 5%, 250ml<br />
P9046 Albumin (human), 25%, 20ml<br />
P9047 Albumin (human), 25%, 50ml<br />
Q4081 Epoetin alfa, 100 units ESRD
Change language