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CMS-1403-FC
We believe a status indicator of “B” (Bundled Code,
payments for covered services are always bundled into
payment for other services not specified) is most
appropriate because this service is currently being paid for
as part of an E&M service. (Note: Because neurologists and
physical therapists are the predominant providers of this
service to Medicare patients (each at 22 percent) it has
been assigned as a “sometimes therapy” service under the
therapy code abstract file.)
F. Additional Coding Issues
1. Reduction in the Technical Component (TC) Payment for
Imaging Services Paid Under the PFS to the Outpatient
Department (OPD) Amount
Effective January 1, 2007, section 5102(b)(1) of the
Deficit Reduction Act of 2005 (Pub. L. 109-171) (DRA)
capped the TC of most imaging services paid under the PFS
to the amount paid under the Outpatient Prospective Payment
System (OPPS) (71 FR 69659).
The list of codes subject to of OPPS cap has been
revised to reflect new and deleted CPT codes for 2009. CPT
Codes 78890 and 78891 have been deleted and have been
removed from the list. The following new CPT codes have
been added to the list:
922