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CMS-1403-FC relationship to the light guide. In the interim, while we await comments, we have assigned the new equipment price including the light guide to the new CPT code 46930 as well as the four other procedures that employ this infrared coagulator for CY 2009. 4. CPT Code 64632 For CPT code 64632, Destruction by neurolytic agent; plantar common digital nerve, the AMA RUC recommended that supply code SH062, a sclerosing solution for injection, be used as a proxy for the neurolytic agent needed to perform this procedure. We are concerned about the appropriateness of this substitution suggested by the specialty society. The society stated that it was not able to find pricing for either phenol or 4 percent ethyl alcohol, which the society believes are the commonly used analytics for this procedure. We ask commenters to provide us documentation for pricing of the phenol or 4 percent ethyl alcohol that are appropriately used in furnishing this service. In the interim, we will accept the recommendation to use the $2.029 sclerosing solution as the proxy for the analytic agent. 5. CPT Code Series 90951 through 90966 For the End-Stage Renal Disease (ESRD) Services including new CPT codes 90951, 90952, 90953, 90954, 90955, 930

CMS-1403-FC 90956, 90957, 90958, 90959, 90960, 90961, 90962, 90963, 90964, 90965 and 90966, the AMA RUC recommended PE direct inputs (36 minutes of clinical labor for the pre-service period and an additional 6 minutes in the post period for CPT codes 90960, 90961, 90962 and 90966) for the monthly capitation payments. For CPT codes 90967, 90968, 90969, and 90970, the ESRD codes representing per-day payments, the AMA RUC PE recommendations included 1.2 minutes of clinical labor per day. Prior to accepting these PE recommendations, we have asked the AMA RUC to review the PE inputs at an upcoming meeting to make certain that they accurately reflect the typical direct resources required for these services. In the interim, we will continue to use the established PE RVUs for these services. In addition, for CPT codes 90960 and 90961, we will ask the RUC to review the physician times for these services. 6. CPT Code 93306 The AMA RUC recommended PE direct inputs for CPT code 93306, Echocardiography, transthoracic real-time with image documentation (2D), including M-mode recording if performed, with spectral Doppler echocardiography, and with color flow Doppler echocardiography. However, the AMA RUC did not recommend any changes to the PE direct inputs for the related echocardiography codes 93307, 93320 and 93325. 931

<strong>CMS</strong>-1403-FC<br />

relationship to the light guide. In the interim, while we<br />

await comments, we have assigned the new equipment price<br />

including the light guide to the new CPT code 46930 as well<br />

as the four other procedures that employ this infrared<br />

coagulator for CY 2009.<br />

4. CPT Code 64632<br />

For CPT code 64632, Destruction by neurolytic agent;<br />

plantar common digital nerve, the AMA RUC recommended that<br />

supply code SH062, a sclerosing solution for injection, be<br />

used as a proxy for the neurolytic agent needed to perform<br />

this procedure. We are concerned about the appropriateness<br />

of this substitution suggested by the specialty society.<br />

The society stated that it was not able to find pricing for<br />

either phenol or 4 percent ethyl alcohol, which the society<br />

believes are the commonly used analytics for this<br />

procedure. We ask commenters to provide us <strong>document</strong>ation<br />

for pricing of the phenol or 4 percent ethyl alcohol that<br />

are appropriately used in furnishing this service. In the<br />

interim, we will accept the recommendation to use the<br />

$2.029 sclerosing solution as the proxy for the analytic<br />

agent.<br />

5. CPT Code Series 90951 through 90966<br />

For the End-Stage Renal Disease (ESRD) Services<br />

including new CPT codes 90951, 90952, 90953, 90954, 90955,<br />

930

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