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 leads. CPT codes 93282 through 93284 (0.85 to 1.25 work RVUs, with a work RVU difference between the codes of 0.07 to 0.33) describe the programming of ICDs according to the number of leads. We note that the recommended difference in the work RVUs between CPT code 93279 (single lead programming pacemaker code) and CPT code 93282 (single lead ICD code) is 0.20 work RVUs, and that the difference between CPT code 93281 (multiple lead programming pacemaker code) and CPT code 93284 (multiple lead ICD code) is 0.35 work RVUs. The AMA RUC primarily used a comparison methodology to determine the value of the pacemaker codes and the surveyed 25 th percentile to determine the value of the implantable cardioverter defibrillator (ICD) codes. Even though different methodologies were utilized to develop the recommended values, we do not understand why the increments between various levels of the pacemaker programming codes are not also the appropriate increment between the various levels of ICD programming codes. Therefore, we are not accepting these recommendations and instead will establish work RVUs that maintain the same incremental difference between levels of programming codes. This change will help to ensure consistency and relativity within all cardiac device monitoring codes. The specific changes to the codes are discussed below. 916
CMS-1403-FC In addition, we believe that although the surveyed 25 th percentile of 1.18 work RVUs was chosen for valuation of CPT code 93283, the increment of 0.33 work RVUs between CPT codes 93282 and 93283 is excessive. Therefore, we believe that the appropriate value for CPT code 93283 is 1.05 work RVUs, slightly below the 25th percentile. We believe that an appropriate comparison CPT code for 93283 is CPT code 93890 (Transcranial Doppler study of the intracranial arteries; vasoreactivity study) which has a work RVU of 1.00. CPT code 93286 (0.30 work RVUs) describes periprocedural programming of a pacemaker. CPT code 93287 (0.45 work RVUs) describes periprocedural programming of an ICD. These codes have recommended work RVU differences of 0.15 work RVUs and 0.30 work RVUs between the pacemakers and ICDs for a single service and for services pre- and postsurgery, respectively. CPT code 93288 (0.43 work RVUs) describes in person interrogation of pacemakers. CPT Code 93289 (0.92 work RVUs, which was developed by means of a crosswalk to a 99213 office visit) describes in person interrogation of an ICD, a work RVU difference of 0.49 RVUs between the pacemakers and ICDs. As noted above, the work RVU difference between programming pacemakers and ICDs varies from 0.20 to 0.35. Therefore, we believe that the appropriate value for CPT 917
- Page 865 and 866: CMS-1403-FC furnishing services via
- Page 867 and 868: CMS-1403-FC required to furnish dir
- Page 869 and 870: CMS-1403-FC mental health services
- Page 871 and 872: CMS-1403-FC Skilled Nursing Facilit
- Page 873 and 874: CMS-1403-FC where the SNF resident
- Page 875 and 876: CMS-1403-FC describes the methodolo
- Page 877 and 878: CMS-1403-FC The RUC has created the
- Page 879 and 880: CMS-1403-FC Response: Although we r
- Page 881 and 882: CMS-1403-FC occurring code pairs. T
- Page 883 and 884: CMS-1403-FC a standing panel of exp
- Page 885 and 886: CMS-1403-FC extraction of the assoc
- Page 887 and 888: CMS-1403-FC TABLE 26: AMA RUC Recom
- Page 889 and 890: CMS-1403-FC AMA RUC Rec Site of Ser
- Page 891 and 892: CMS-1403-FC AMA RUC Rec Site of Ser
- Page 893 and 894: CMS-1403-FC AMA RUC Rec Site of Ser
- Page 895 and 896: CMS-1403-FC Note: The RUC reviewed
- Page 897 and 898: CMS-1403-FC C. Interim 2008 Codes 1
- Page 899 and 900: CMS-1403-FC national noncoverage de
- Page 901 and 902: CMS-1403-FC CPT codes for 2008. In
- Page 903 and 904: CMS-1403-FC associated work RVUs, t
- Page 905 and 906: CMS-1403-FC CPT 1 AMA RUC Work RVU
- Page 907 and 908: CMS-1403-FC # New CPT code. 1 All C
- Page 909 and 910: CMS-1403-FC ● 27218, Open treatme
- Page 911 and 912: CMS-1403-FC RVUs for G0412; 15.73 w
- Page 913 and 914: CMS-1403-FC Therefore, we disagree
- Page 915: CMS-1403-FC generally contractor pr
- Page 919 and 920: CMS-1403-FC RVU for CPT code 93289
- Page 921 and 922: CMS-1403-FC time to better understa
- Page 923 and 924: CMS-1403-FC ● 93306, Echocardiogr
- Page 925 and 926: CMS-1403-FC Although not discussed
- Page 927 and 928: CMS-1403-FC for New and Revised 200
- Page 929 and 930: CMS-1403-FC item. In addition, the
- Page 931 and 932: CMS-1403-FC 90956, 90957, 90958, 90
- Page 933 and 934: CMS-1403-FC place of these two new
- Page 935 and 936: CMS-1403-FC beneficiary or any othe
- Page 937 and 938: CMS-1403-FC ● Adding the followin
- Page 939 and 940: CMS-1403-FC Tables 29 and 30 also i
- Page 941 and 942: CMS-1403-FC RADIOLOGY AND CERTAIN O
- Page 943 and 944: CMS-1403-FC 93320 Doppler echo exam
- Page 945 and 946: CMS-1403-FC index data, that the hi
- Page 947 and 948: CMS-1403-FC TABLE 32: Increase in t
- Page 949 and 950: CMS-1403-FC C. The Update Adjustmen
- Page 951 and 952: CMS-1403-FC end of the prior year a
- Page 953 and 954: CMS-1403-FC CY 2009, the statute re
- Page 955 and 956: CMS-1403-FC Actual08 = Estimated Ac
- Page 957 and 958: CMS-1403-FC 1848(f)(3)(C)(i) of the
- Page 959 and 960: CMS-1403-FC ● Screening mammograp
- Page 961 and 962: CMS-1403-FC payments while promotin
- Page 963 and 964: CMS-1403-FC E. Final Sustainable Gr
- Page 965 and 966: CMS-1403-FC included in the SGR (us
<strong>CMS</strong>-1403-FC<br />
leads. CPT codes 93282 through 93284 (0.85 to 1.25 work<br />
RVUs, with a work RVU difference between the codes of 0.07<br />
to 0.33) describe the programming of ICDs according to the<br />
number of leads. We note that the recommended difference<br />
in the work RVUs between CPT code 93279 (single lead<br />
programming pacemaker code) and CPT code 93282 (single lead<br />
ICD code) is 0.20 work RVUs, and that the difference<br />
between CPT code 93281 (multiple lead programming pacemaker<br />
code) and CPT code 93284 (multiple lead ICD code) is 0.35<br />
work RVUs. The AMA RUC primarily used a comparison<br />
methodology to determine the value of the pacemaker codes<br />
and the surveyed 25 th percentile to determine the value of<br />
the implantable cardioverter defibrillator (ICD) codes.<br />
Even though different methodologies were utilized to<br />
develop the recommended values, we do not understand why<br />
the increments between various levels of the pacemaker<br />
programming codes are not also the appropriate increment<br />
between the various levels of ICD programming codes.<br />
Therefore, we are not accepting these recommendations and<br />
instead will establish work RVUs that maintain the same<br />
incremental difference between levels of programming codes.<br />
<strong>This</strong> change will help to ensure consistency and relativity<br />
within all cardiac device monitoring codes. The specific<br />
changes to the codes are discussed below.<br />
916