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CMS-1403-FC
TABLE 3: Equipment Items Needing Specialty Input for
Pricing
Code 2008/9 Description
2008/9
Price
Primary *CPT Prior
specialties code(s) Status
associated with associated on
item with item Table
Commenter response
and CMS Action
2009 Item
Status refer to
note(s)
Camera mount-floor 2300 Dermatology 96904 Yes Specialty to submit, asap. A and D
ED039
Cross slide attachment 500 Dermatology 96904 Yes Specialty to submit, asap. A and D
plasma pheresis machine 37,900
Psychology Testing
Equipment
Strobe, 400watts
(Studio)(2)
Cryosurgery system
( for tumor ablation) 1
Workstation, dual,
echocardiography
EQ136 Infrared Coagulator (with
hand applicator, includes
light guide)
Radiology,
Dermatology
Psychology
36481
G0341
96101
96102
Yes
Revised description based on
comments received that light source
was not part of item. Documentation
requested.
74
Yes Specialty to submit, asap. B
1500 Dermatology 96904 Yes Documentation requested. B
Urology,
Radiology,
Interventional
Radiology
50593 Yes New item 2008 A and D
85000 Cardiology 93351 No New item 2009, Specialty submitted
$173,509 – CMS accept $85,000
E
3659.50 46606
46608
46610
46612
46930
No New price for 2009 with addition of light
guide, Supply code, Eq136, descriptor
changed to include the light guide.
*CPT codes and descriptions only are copyright 2009 American Medical Association. All Rights Reserved. Applicable
FARS/DFARS apply.
Note: Acceptable documentation includes detailed description (including system, kit or product components), source (multiple
sources requested), and current pricing information. For most items, there will be multiple sources of documentation available –
multiple products/models that can be used as acceptable substitutes in performing a procedure. We ask that documentation from
multiple sources be submitted with verified prices of the various products which represent the price range. In these instances, only
one specific item/model/product is available on the market for use in a given procedure, one source of documentation is required.
However, CMS expects that all documentation reflect the market price for each product reflecting the manufacturer or vendor
discounts, rebates, etc. Invoices from physician purchases are the preferred documentation. In cases where this is not possible, CMS
may accept other documentation such as copies of catalog pages, hard copy from specific web pages, physician invoices, and typical
or average sales price “quotes” (letter format okay) from manufacturers, vendors, or distributors. Unacceptable documentation
includes phone numbers and addresses of manufacturer, vendors or distributors, web site links without pricing information, etc.
A. Additional documentation required. Need detailed description (including kit contents), source, and current pricing information
(including pricing per specified unit of measure in database). Accept copies of catalog pages or hard copy from specific Web pages.
Phone numbers or addresses of manufacturer, vendors, or distributors are not acceptable documentation.
B. No/Insufficient received. Retained price in database on an interim basis. Forward acceptable documentation promptly.
C. Submitted price accepted.
D. 2008/9 price, where specified, retained on an interim basis. Forward acceptable documentation promptly.
E. See discussion in section V. of this final rule with comment period. Forward requested documentation promptly, for example,
whether item is typical.
B
E