[Federal Register Volume 59, Number 135 (Friday, July 15, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-17222]


[[Page Unknown]]

[Federal Register: July 15, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 405 and 414

[BPD-770-CN]
RIN 0938-AG22

 

Medicare Program; Revisions to Payment Policies and Adjustments 
to the Relative Value Units Under the Physician Fee Schedule for 
Calendar Year 1994

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Correction of final rule with comment period.

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SUMMARY: This document corrects technical errors that appeared in the 
final rule with comment period published in the Federal Register on 
December 2, 1993 (58 FR 63626) entitled ``Revisions to Payment Policies 
and Adjustments to the Relative Value Units Under the Physician Fee 
Schedule for Calendar Year 1994.''

EFFECTIVE DATE: January 1, 1994.

FOR FURTHER INFORMATION CONTACT: Elizabeth Holland, (410) 966-1309.

SUPPLEMENTARY INFORMATION: In Federal Register Document [93-29362] 
beginning on page 63626, in the issue of December 2, 1993, make the 
following corrections:
A. Page 63626
    1. In the ADDRESSES section, in column 2, in line 12, the telephone 
number is corrected to read ``(202) 690-7890.''
    2. In column 3, in line 10, the Federal Register citation is 
corrected to read ``(57 FR 55914).''
B. Page 63628
    In column 3, in line 4, the Federal Register citation is corrected 
to read ``(56 FR 59502).''
C. Page 63642
    In column 2, in the paragraph designated I., the number of the 
fourth code in the listing is corrected to read ``84182.''
D. Page 63652
    In column 2, in the paragraph designated 2.a., the Federal Register 
citation is corrected to read ``(57 FR 55938).''
E. Pages 63653 and 63662, Table 3
    1. On page 63653, the following codes are corrected to read: 

----------------------------------------------------------------------------------------------------------------
                                                                                    Specialty                   
  HCPCS+                      MOD description                     RUC recommended  recommended    HCFA decision 
                                                                    work RVUs       work RVUs                   
----------------------------------------------------------------------------------------------------------------
*15788.....  Chemical peel, face, epiderm......................  None............         5.00  Decreased.      
*15789.....  Chemical peel, face, dermal.......................  None............         6.59  Decreased.      
*15792.....  Chemical peel, nonfacial..........................  None............         4.00  Decreased.      
*15793.....  Chemical peel, nonfacial..........................  None............         5.34  Decreased.      
----------------------------------------------------------------------------------------------------------------

    2. On page 63662, the following codes are corrected to read: 

----------------------------------------------------------------------------------------------------------------
                                                                                    Specialty                   
  HCPCS+                      MOD description                     RUC recommended  recommended    HCFA decision 
                                                                    work RVUs       work RVUs                   
----------------------------------------------------------------------------------------------------------------
97545......  Work hardening....................................  None............         1.70  (b).            
97546......  Work hardening....................................  None............          .85  (b).            
----------------------------------------------------------------------------------------------------------------

F. Pages 63722 through 63836, Addendum B
    1. On page 63722, the following codes are corrected to read:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
33401....  C              Valvuloplasty, open............................         0.00         0.00         0.00         0.00          090  S           
33403....  C              Valvuloplasty, w/cp bypass.....................          .00          .00          .00          .00          090  S           
33406....  C              Replacement, aortic valve......................          .00          .00          .00          .00          090  S           
33413....  C              Replacement, aortic valve......................          .00          .00          .00          .00          090  S           
33414....  C              Repair, aortic valve...........................          .00          .00          .00          .00          090  S           
33471....  C              Valvotomy, pulmonary valve.....................          .00          .00          .00          .00          090  S           
33475....  C              Replacement, pulmonary valve...................          .00          .00          .00          .00          090  S           
33505....  C              Repair artery w/tunnel.........................          .00          .00          .00          .00          090  S           
33506....  C              Repair artery, translocation...................          .00          .00          .00          .00          090  S           
33600....  C              Closure of valve...............................          .00          .00          .00          .00          090  S           
33602....  C              Closure of valve...............................          .00          .00          .00          .00          090  S           
33606....  C              Anastomosis/artery-aorta.......................          .00          .00          .00          .00          090  S           
33608....  C              Repair anomaly w/conduit.......................          .00          .00          .00          .00          090  S           
33610....  C              Repair by enlargement..........................          .00          .00          .00          .00          090  S           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

    2. On page 63723, the following codes are corrected to read:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
33611....  C              Repair double ventricle........................         0.00         0.00         0.00         0.00          090  S           
33612....  C              Repair double ventricle........................          .00          .00          .00          .00          090  S           
33615....  C              Repair (simple fontan).........................          .00          .00          .00          .00          090  S           
33617....  C              Repair by modified fontan......................          .00          .00          .00          .00          090  S           
33619....  C              Repair single ventricle........................          .00          .00          .00          .00          090  S           
33692....  C              Repair of heart defects........................          .00          .00          .00          .00          090  S           
33697....  C              Repair of heart defects........................          .00          .00          .00          .00          090  S           
33698....  C              Repair of heart defects........................          .00          .00          .00          .00          090  S           
33722....  C              Repair of heart defect.........................          .00          .00          .00          .00          090  S           
33732....  C              Repair heart-vein defect.......................          .00          .00          .00          .00          090  S           
33736....  C              Revision of heart chamber......................          .00          .00          .00          .00          090  S           
33766....  C              Major vessel shunt.............................          .00          .00          .00          .00          090  S           
33767....  C              Atrial septectomy/septostomy...................          .00          .00          .00          .00          090  S           
33770....  C              Repair great vessels defect....................          .00          .00          .00          .00          090  S           
33771....  C              Repair great vessels defect....................          .00          .00          .00          .00          090  S           
33853....  C              Repair septal defect...........................          .00          .00          .00          .00          090  S           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

    3. On page 63724, the following codes are corrected to read:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
33917....  C              Repair pulmonary artery........................         0.00         0.00         0.00         0.00          090  S           
33918....  C              Repair pulmonary atresia.......................          .00          .00          .00          .00          090  S           
33919....  C              Repair pulmonary atresia.......................          .00          .00          .00          .00          090  S           
33920....  C              Repair pulmonary atresia.......................          .00          .00          .00          .00          090  S           
33922....  C              Transect pulmonary artery......................          .00          .00          .00          .00          090  S           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

    4. On page 63733, HCPCS code 43248 is corrected to read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
43248....  A              Upper GI endoscopy/guidewire...................         3.18        *4.14         0.34         7.66          000  N           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

    5. On page 63749, the third appearance of HCPCS code 59020 is 
corrected to read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
59020....  A              Fetal contract stress test.....................         0.67        *0.87         0.19         1.73          000  S           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

    6. On page 63764, the following code is corrected to read:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
70551....  A              Magnetic image, brain (MRI)....................         1.50         0.67         0.10         2.27          XXX  N           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

    7. On page 63799, the following code is added to read:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
86423....  D              Radioimmunosorbent test IGE....................         0.00         0.00         0.00         0.00          XXX  O           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

    8. On page 63836, the following codes are corrected to read:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Practice                                                      
HCPCS\1\    MOD status                      Description                     Work RVUs     expense    Malpractice     Total        Global       Update   
                                                                                          RVUs\2\       RVUs                     period                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
J7030....  E              Infusion, normal saline solution...............         0.00         0.00         0.00         0.00          XXX  O           
J7040....  E              Infusion, normal saline solution...............          .00          .00          .00         0.00          XXX  O           
J7042....  E              5% dextrose/normal saline......................          .00          .00          .00         0.00          XXX  O           
J7050....  E              Infusion, normal saline solution...............          .00          .00          .00         0.00          XXX  O           
J7051....  E              Sterile saline or water........................          .00          .00          .00         0.00          XXX  O           
J7060....  E              5% dextrose/water..............................          .00          .00          .00         0.00          XXX  O           
J7070....  E              Infusion, d5w..................................          .00          .00          .00         0.00          XXX  O           
J7120....  E              Ringers lactate infusion.......................          .00          .00          .00         0.00          XXX  O           
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1993 American Medical Association.                                                                                   
\2\*Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                              

(Section 1848 of the Social Security Act (42 U.S.C. 1395w-4))

(Catalog of Federal Domestic Assistance Program No. 93.774, 
Medicare--Supplementary Medical Insurance Program)

      Dated: July 5, 1994.
Neil J. Stillman,
Deputy Assistant Secretary for Information Resources Management.
[FR Doc. 94-17222 Filed 7-14-94; 8:45 am]