[Federal Register Volume 65, Number 70 (Tuesday, April 11, 2000)]
[Rules and Regulations]
[Pages 19329-19334]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-8717]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 410, 411, 414, 415, and 485

[HCFA-1065-CN]
RIN 0938-AJ61


Medicare Program; Revisions to Payment Policies Under the 
Physician Fee Schedule for Calendar Year 2000

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

ACTION: Correction of final rule with comment period.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical errors that appeared in the 
final rule with comment period published in the Federal Register on 
November 2, 1999, entitled ``Medicare Program; Revisions to Payment 
Policies Under the Physician Fee Schedule for Calendar Year 2000.''

EFFECTIVE DATE: January 1, 2000.

FOR FURTHER INFORMATION CONTACT: Diane Milstead, (410) 786-3355.

SUPPLEMENTARY INFORMATION:

Background

    In FR Doc. 99-28367 of November 2, 1999, (64 FR 59380), there were 
a number of technical errors. The errors relate to the omission of 
language discussing payment for pulse oximetry, temperature gradient 
studies and venous pressure determinations and the removal of the x-ray 
requirement before chiropractic manipulation; acceptance of the RUC 
recommendations for work relative value units (RVUs); RUC 
recommendations for CPT codes 17276 and 95165; a comment on codes in 
the ``zero work'' pool; discussion of CPT code 61862 and the correct 
billing procedures; and regulations text definitions concerning the 
coverage of prostate screening. Additionally there are various 
revisions to Addenda B and C.
    The provisions in this correction notice are effective as if they 
had been included in the document published in the Federal Register on 
November 2, 1999, that is, January 1, 2000.

Discussion of Addenda B and C

    1. On page 39626 of the July 22, 1999 proposed rule, we discussed 
revising the work RVUs for certain pediatric surgical services to 
reflect more appropriate data. We inadvertently omitted these work RVU 
changes from Addendum B of the November 2, 1999 final rule. Entries on 
the pages listed below are corrected as follows: Page 59451 for CPT 
code 21740; page 59476 for CPT codes 38550 and 38555; page 59477 for 
CPT code 39503; page 59479 for CPT codes 42810 and 42815; page 59480 
for CPT codes 43305, 43310, 43312, and 43831; page 59482 for CPT codes 
45120 and 45121; page 59483 for CPT codes 46715, 46716, 46730, 46735,

[[Page 19330]]

46740, and 46751; page 59484 for CPT codes 47700 and 47701; page 59485 
for CPT codes 49215, 49495, 49580, 49600, 49605, and 49606; page 59488 
for CPT code 51940; and page 59495 for CPT code 60280. These 
corrections are reflected in correction number 8 to follow.
    2. On page 59421 of the November 2, 1999 final rule, we assigned 
5.85 work RVUs to CPT code 61885. We inadvertently omitted this value 
from Addenda B and C. Entries on the pages listed below are corrected 
as follows: Page 59497 and page 59582 for CPT code 61885. These 
corrections are reflected in correction number 9 to follow.
    3. In Addendum B, we assigned incorrect status indicators for the 
following CPT codes: Page 59553 for CPT codes 94760 and 94761; and page 
59578 for HCFA Common Procedure Coding System (HCPCS) codes Q0183, 
Q0184, Q0185, Q0186, Q1001, Q1002, Q1003, Q1004, and Q1005. These 
corrections are reflected in correction number 10 to follow.
    4. On page 39630 of the July 22, 1999 proposed rule, we discussed 
accepting the RUC work RVU recommendations for five CPT codes that were 
carrier priced for 1999. The status of these codes would also change 
from Carrier Priced (C) to Active (A) in the final rule. We 
inadvertently omitted the work RVUs, status indicator, and correct 
global indicator changes from Addendum B of the final rule. Entries on 
the pages listed below are corrected as follows: Page 59473 for CPT 
code 35500; page 59475 for CPT code 36823; page 59476 for CPT code 
38792; page 59495 for CPT 60650 (renumbered from CPT code 56321 for 
which we accepted the RUC recommendation); page 59476 for CPT code 
38120 (renumbered from CPT code 56345 for which we accepted the RUC 
recommendation); and page 59481 for CPT code 44201 (renumbered from CPT 
code 56347 for which we accepted the RUC recommendation). In addition, 
we failed to reflect the practice expense values assigned to these 
codes. These corrections are reflected in correction 11 to follow.
    5. In Addendum B, we inadvertently published incorrect global 
periods for CPT codes 33968, 47560, 62263, 96570 and 96571. Entries on 
pages listed below are corrected as follows: Pages 59472 and 59582 for 
CPT code 33968; page 59484 for CPT code 47560; pages 59497 and 59582 
for CPT code 62263; and pages 59556 and 59583 for CPT codes 96570 and 
96571. These corrections are reflected in correction number 12 to 
follow.
    6. On page 39629 of the July 22, 1999 proposed rule, we proposed 
changing ventricular assist device insertions, CPT codes 33975 and 
33976, to an XXX global and reducing the work RVUs accordingly. In the 
November 2, 1999 final rule, in Addendum B, we changed the global 
periods to XXX but inadvertently failed to reduce the work RVUs as 
stated in the proposed rule. Entries on the page listed below are 
corrected as follows: Page 59472 for CPT codes 33975 and 33976. In 
addition, we failed to show the adjustments to the CPEP data made to 
accommodate the changing global periods. These corrections are 
reflected in correction number 13 to follow.
    7. In Addendum B, we inadvertently assigned incorrect practice 
expense and malpractice RVUs to HCPCS codes G0102, G0104, G0105, and 
incorrect malpractice relative value units for CPT codes 59000 through 
59899. Entries on the pages listed below are corrected as follows: Page 
59571 for HCPCS codes G0102, G0104, and G0105; pages 59494 and 59495 
for CPT codes 59000 through 59899. These corrections are reflected in 
correction number 14 to follow.
    8. On pages 59448 and 59582 of Addendum B, we assigned an incorrect 
procedure status and global period to CPT code 20979. Entries on pages 
listed below are corrected as follows: Pages 59448 and 59582 for CPT 
code 20979. These corrections are reflected in correction number 15 to 
follow.
    9. In Addendum B, we inadvertently assigned incorrect practice 
expense RVUs for HCPCS codes G0106, G0106-26, G0106-TC, G0120, G0120-
26, G0120-TC, G0170, G0171 and CPT code 45378-53. Entries on pages 
listed below are corrected as follows: Page 59571 for HCPCS codes 
G0106, G0106-26, G0106-TC, G0120, G0120-26 and G0120-TC; page 59572 and 
page 59583 for G0170 and G0171; and page 59482 for CPT 45378-53. These 
corrections are reflected in correction number 16 to follow.
    10. We incorrectly denoted that CPT code 40814 was not applicable 
in a non-facility setting. On page 59477 of Addendum B, the applicable 
practice expense values are included for the nonfacility setting for 
CPT code 40814. These corrections are reflected in correction number 17 
to follow.
    11. In Addendum B, we assigned incorrect practice expense and/or 
malpractice RVUs for HCPCS codes G0163, G0163-26, G0163-TC, G0164, 
G0164-26, G0164-TC, G0165, G0165-26, and G0165-TC. Entries on the pages 
listed below are corrected as follows: Page 59571 for HCPCS codes 
G0163, G0163-26, and G0163-TC and page 59572 for G0164, G0164-26, 
G0164-TC, G0165, G0165-26 and G0165-TC. These corrections are reflected 
in correction number 18 to follow.

Correction of Errors

    In FR Doc. 99-28367 of November 2, 1999, make the following 
corrections:
    1. On page 59395, second column, after the sixth full paragraph, 
add the following:

    CPT code 17276, Destruction, malignant lesion, any method scalp, 
neck, hands, feet, genitalia; lesion diameter over 4.0cm 
    The RUC forwarded a recommendation for supplies. We accepted the 
recommendation but deleted what appeared to be duplicated gauze 
supplies.''
    2. On page 59398, first column, after the last paragraph insert the 
following:

    ``CPT Code 95165, professional services for the supervision and 
provision of antigens for allergen immunotherapy. 
    The nature of the RUC's recommendation regarding this code was 
significantly different than its recommendations regarding other 
codes. The RUC did not examine the direct expense inputs for code 
95165 but commented on the definition of dose used for claims 
involving this code. Because the direct expense inputs have not been 
reviewed, we believe that it is not appropriate to revise the 
practice expense value at this time.''

    3. On page 59406, in the last line of column two, insert the words 
``, in Table 7,'' between the words ``95956'' and ``should''.
    4. On page 59413, column three, after line 7, add the following:

``Result of Evaluation of Comments:

    We are adopting our proposal to bundle payment for these 
services beginning January 2000 with the exception of code 94762, 
which we will continue to pay separately when continuous overnight 
monitoring is medically necessary as a separate procedure.

M. Removal of Requirement for X-ray Before Chiropractic 
Manipulation

    We are conforming our regulations to section 4513(a) of the BBA 
that deleted the requirement that a spinal subluxation be 
demonstrated by an x-ray for a chiropractor to receive payment under 
Medicare Part B for manual manipulation of the spine to correct a 
subluxation.
    Comment: We received one comment requesting we revise 
Sec. 410.22 (Limitations on services of a chiropractor) to recognize 
chiropractors as physicians for purposes of ordering and furnishing 
diagnostic tests and other services and supplies related to manual 
manipulation for treatment of subluxation of the spine.
    Response: We believe that extending the scope of services of the 
chiropractor to include other services, such as ordering and 
furnishing diagnostic tests, is inconsistent with section 1861(r) of 
the Act. Thus, we cannot implement this comment.

[[Page 19331]]

    Comment: Two commenters expressed concern that the x-ray 
requirement has been removed without being replaced by clear''

    5. On page 59418, in the third column, line 6 from the top, replace 
``69'' with ``85'', and line 9, replace ``31'' with ``15''.


Sec. 410.39  [Corrected]

    6. On page 59440, in the second column, Sec. 410.39 is corrected by 
adding paragraphs (a)(4) and (a)(5) as follows:

Sec. 410.39  Prostate cancer screening tests: Conditions for and 
limitations on coverage.

* * * * *
    (a) * * *
    (4) A physician for purposes of this provision means a doctor of 
medicine or osteopathy (as defined in section 1861(r)(1) of the Act) 
who is fully knowledgeable about the beneficiary, and who would be 
responsible for explaining the results of the screening examination or 
test.
    (5) A physician assistant, nurse practitioner, clinical nurse 
specialist, or certified nurse midwife for purposes of this provision 
means a physician assistant, nurse practitioner, clinical nurse 
specialist, or certified nurse midwife (as defined in sections 1861(aa) 
and 1861(gg) of the Act) who is fully knowledgeable about the 
beneficiary, and who would be responsible for explaining the results of 
the screening examination or test.
* * * * *


    7. On page 59440, in the second and third columns, in Sec. 410.39, 
paragraphs (b) and (d), add the phrase ``as defined in paragraphs 
(a)(4) or (a)(5) of this section,'' after the word ``midwife.''

Addendum B  [Corrected]

    8. In the table of Addendum B, the following CPT codes are 
corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                     Fully
                                                    Physician     Fully       Year 2000      Fully       Year 2000                Implemented    Year 2000      Fully       Year 2000
 CPT\1\/     MOD       Status       Description        Work    implemented  transitional  implemented  transitional  Malpractice      non      transitional  implemented  transitional   Global
HCPCS\2\                                             RVUs\3\   nonfacility   nonfacility  facility PE   facility PE      RVUs       facility    nonfacility    facility     facility
                                                                 PE RVUs       PE RVUs        RVUs         RVUs                      total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   21740             A          Reconstruction of       16.80          NA           NA         15.80        12.78          1.95           NA           NA         34.55        31.53         090
                                 sternum.
   38550             A          Removal, neck/           6.92          NA           NA          5.24         4.38          0.50           NA           NA         12.66        11.80         090
                                 armpit lesion.
   38555             A          Removal, neck/          14.14          NA           NA         11.47         9.68          1.53           NA           NA         27.14        25.35         090
                                 armpit lesion.
   39503             A          Repair of               37.54          NA           NA         14.98        21.16          3.26           NA           NA         55.78        61.96         090
                                 diaphragm hernia.
   42810             A          Excision of neck         3.25        4.77         4.09          3.83         3.62          0.27         8.29         7.61          7.35         7.14         090
                                 cyst.
   42815             A          Excision of neck         7.07          NA           NA          6.06         7.35          0.55           NA           NA         13.68        14.97         090
                                 cyst.
   43305             A          Repair esophagus        17.39          NA           NA         12.60        13.74          1.32           NA           NA         31.31        32.45         090
                                 and fistula.
   43310             A          Repair of               27.47          NA           NA         17.64        18.04          3.07           NA           NA         48.18        48.58         090
                                 esophagus.
   43312             A          Repair esophagus        30.50          NA           NA         23.15        19.02          3.46           NA           NA         57.11        52.98         090
                                 and fistula.
   43831             A          Place gastrostomy        7.84          NA           NA          4.15         4.90          0.74           NA           NA         12.73        13.48         090
                                 tube.
   45120             A          Removal of rectum.      25.00          NA           NA         11.45        14.62          2.31           NA           NA         38.76        41.93         090
   45121             A          Removal of rectum       27.51          NA           NA         12.98        12.35          2.65           NA           NA         43.14        42.51         090
                                 and colon.
   46715             A          Repair of                7.46          NA           NA          4.31         4.06          0.86           NA           NA         12.63        12.38         090
                                 anovaginal
                                 fistula.
   46716             A          Repair of               12.85          NA           NA          6.50         6.54          1.21           NA           NA         20.56        20.60         090
                                 anovaginal
                                 fistula.
   46730             A          Construction of         22.39          NA           NA         11.74        11.70          1.91           NA           NA         36.04        36.00         090
                                 absent anus.
   46735             A          Construction of         27.02          NA           NA         12.15        13.15          2.59           NA           NA         41.76        42.76         090
                                 absent anus.
   46740             A          Construction of         24.19          NA           NA         10.40        11.47          2.31           NA           NA         36.90        37.97         090
                                 absent anus.
   46751             A          Repair of anal           8.77          NA           NA          5.53         4.98          0.86           NA           NA         15.16        14.61         090
                                 sphincter.
   47700             A          Exploration of          15.62          NA           NA          8.23         8.26          1.37           NA           NA         25.22        25.25         090
                                 bile ducts.
   47701             A          Bile duct revision      29.55          NA           NA         13.21        11.06          2.87           NA           NA         45.63        43.48         090
   49215             A          Excise sacral           23.20          NA           NA         10.50         9.86          2.18           NA           NA         35.88        35.24         090
                                 spine tumor.
   49495             A          Repair inguinal          5.84          NA           NA          3.67         4.54          0.56           NA           NA         10.07        10.94         090
                                 hernia, init.
   49580             A          Repair umbilical         3.34          NA           NA          2.74         3.47          0.34           NA           NA          6.42         7.15         090
                                 hernia.
   49600             A          Repair umbilical        10.96          NA           NA          5.66         5.69          0.95           NA           NA         17.57        17.60         090
                                 lesion.
   49605             A          Repair umbilical        24.94          NA           NA         11.31        10.31          2.20           NA           NA         38.45        37.45         090
                                 lesion.
   49606             A          Repair umbilical        21.31          NA           NA          8.89         8.96          1.91           NA           NA         32.11        32.18         090
                                 lesion.
   51940             A          Correction of           28.43          NA           NA         13.38        16.98          1.90           NA           NA         43.71        47.31         090
                                 bladder defect.
   60280             A          Remove thyroid           5.87          NA           NA          4.86         6.06          0.48           NA           NA         11.21        12.41        090
                                 duct lesion.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    9. In the table of Addenda's B and C, the following CPT code is 
corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  Fully       Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                            Physician  implemented  transitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
  HCPCS      MOD       Status       Description     work RVUs  nonfacility   nonfacility  facility PE   facility PE      RVUs     nonfacility  non-facility    facility     facility     Global
   \2\                                                 \3\     PE RVUs \4\   PE RVUs \4\    RVUs \4\     RVUs \4\                    total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   61885             A          Implant neurostim        5.85          NA           NA          4.86         6.06          0.48           NA           NA         11.21        12.41        090
                                 one array.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    10. In the table of Addendum B, the following HCPCS codes are 
corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  Fully       Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                            Physician  implemented  transitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
  HCPCS      MOD       Status       Description     work RVUs  nonfacility   nonfacility  facility PE   facility PE      RVUs     nonfacility  non-facility    facility     facility     Global
   \2\                                                 \3\     PE RVUs \4\   PE RVUs \4\    RVUs \4\     RVUs \4\                    total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   Q0183             X          Nonmetabolic             0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
                                 active tissue.
   Q0184             X          Metabolically            0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
                                 active tissue.
   Q0185             X          Metabolic active D/      0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
                                 E tissue.
   Q0186             X          Paramedic                0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
                                 intercept, rural.

[[Page 19332]]

 
   Q1001             X          Ntiol category 1..       0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
   Q1002             X          Ntiol category 2..       0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
   Q1003             X          Ntiol category 3..       0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
   Q1004             X          Ntiol category 4..       0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
   Q1005             X          Ntiol category 5..       0.00        0.00         0.00          0.00         0.00          0.00         0.00         0.00          0.00         0.00         XXX
   94760             T          Measure blood            0.00        0.08         0.18          0.08         0.18          0.02         0.10         0.20          0.10         0.20         XXX
                                 oxygen level.
   94761             T          Measure blood            0.00        0.15         0.42          0.15         0.42          0.05         0.20         0.47          0.20         0.47        XXX
                                 oxygen level.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    11. In the table of Addendum B, the following CPT codes are 
corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   Fully      Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                             Physician  implemented  trasitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
  HCPCS       MOD       Status       Description        work    nonfacility  nonfacility  facility PE   facility PE      RVUs     nonfacility    facility      facility     facility     Global
   \2\                                                RVUs\3\     PE RVUs      PE RVUs        RVUs         RVUs                      total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   35500  ..........  A          Harvest vein for         6.45          NA           NA         2.43         2.43          0.73           NA           NA          9.61         9.61         ZZZ
                                  bypass.
   36823  ..........  A          Insert cannula(s).      21.00          NA           NA        11.54        11.54          0.67           NA           NA         33.21        33.21         090
   38120  ..........  A          Laparoscopic            17.00          NA           NA         7.83         7.83          1.04           NA           NA         25.87        25.87         090
                                  splenectomy.
   38792  ..........  A          Identify sentinel        0.52          NA           NA         0.20         0.20          0.01           NA           NA          0.73         0.73         000
                                  node.
   44201  ..........  A          Laparoscopic             9.78          NA           NA         3.61         3.61          1.35           NA           NA         14.74        14.74         090
                                  jejunostomy.
   60650  ..........  A          Laparoscopy             20.00          NA           NA         9.10         9.10          1.35           NA           NA         30.45        30.45        090
                                  adrenalectomy.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    12. In the table of Addenda's B and/or C, the following CPT codes 
are corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   Fully      Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                             Physician  implemented  trasitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
HCPC \2\      MOD       Status       Description        work    nonfacility  nonfacility  facility PE   facility PE      RVUs     nonfacility    facility      facility     facility     Global
                                                      RVUs\3\     PE RVUs      PE RVUs        RVUs         RVUs                      total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   33968  ..........  A          Remove aortic            0.64        0.25         0.25         0.25         0.25          0.27         1.16         1.16          1.16         1.16         000
                                  assist device.
   47560  ..........  A          Laparoscopy w/           4.89         N/A          N/A         1.95         2.48          0.46          N/A          N/A          7.30         7.83         000
                                  cholangio.
   62263  ..........  A          Lysis epidural           6.02        4.61         4.61         2.18         2.18          0.88        11.51        11.51          9.08         9.08         010
                                  adhesions.
   96570  ..........  A          Photodynamic tx,         1.10        0.71         0.71         0.43         0.43          0.28         2.09         2.09          1.81         1.81         ZZZ
                                  30 min.
   96571  ..........  A          Photodynamc tx,          0.55        0.31         0.31         0.21         0.21          0.28         1.14         1.14          1.04         1.04        ZZZ
                                  addl 15 min.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    13. In table of Addendum B, the following CPT codes are corrected 
to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   Fully      Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                             Physician  implemented  trasitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
HCPC \2\      MOD       Status       Description        work    nonfacility  nonfacility  facility PE   facility PE      RVUs     nonfacility    facility      facility     facility     Global
                                                      RVUs\3\     PE RVUs      PE RVUs        RVUs         RVUs                      total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   33975  ..........  A          Implant                 21.00          NA           NA        16.80        16.10          2.86           NA           NA         40.66        39.96         XXX
                                  ventricular
                                  device.
   33976  ..........  A          Implant                 23.00          NA           NA        18.65        19.82          3.91           NA           NA         45.56        46.73        XXX
                                  ventricular
                                  device.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    14. In table of Addendum B, the following CPT codes are corrected 
to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   Fully      Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                             Physician  implemented  trasitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
HCPC \2\      MOD       Status       Description        work    nonfacility  nonfacility  facility PE   facility PE      RVUs     nonfacility    facility      facility     facility     Global
                                                      RVUs\3\     PE RVUs      PE RVUs        RVUs         RVUs                      total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   G0102              A          Prostate ca              0.17        0.51         0.37         0.06         0.09          0.01         0.69         0.55          0.24         0.27         XXX
                                  screening; dre.
   G0104              A          CA screen; flexi         0.96        1.35         1.34         0.33         0.46          0.07         2.38         2.37          1.36         1.49         000
                                  sigmoidscope.
   G0105              A          Colorectal scrn;         3.70        5.99         5.24         1.29         2.86          0.26         9.95         9.20          5.25         6.82         000
                                  hi risk ind.
   59000              A          Amniocentesis.....       1.30        1.54         1.30         0.49         0.77          0.19         3.03         2.79          1.98         2.26         000
   59012              A          Fetal cord               3.45          NA           NA         1.38         2.11          0.51           NA           NA          5.34         6.07         000
                                  punture, prenatal.
   59015              A          Chorion biopsy....       2.20        1.27         1.29         0.85         1.08          0.32         3.79         3.81          3.37         3.60         000
   59020              A          Fetal contract           0.66        0.78         1.06         0.78         1.06          0.21         1.65         1.93          1.65         1.93         000
                                  stress test.
   59020  26          A          Fetal contract           0.66        0.26         0.53         0.26         0.53          0.13         1.05         1.32          1.05         1.32         000
                                  stress test.
   59020  TC          A          Fetal contract           0.00        0.52         0.53         0.52         0.53          0.08         0.60         0.61          0.60         0.61         000
                                  stress test.
   59025              A          Fetal non-stress         0.53        0.43         0.55         0.43         0.55          0.10         1.06         1.18          1.06         1.18         000
                                  test.
   59025  26          A          Fetal non-stress         0.53        0.20         0.31         0.20         0.31          0.08         0.81         0.92          0.81         0.92         000
                                  test.
   59025  TC          A          Fetal non-stress         0.00        0.23         0.24         0.23         0.24          0.02         0.25         0.26          0.25         0.26         000
                                  test.
   59030              A          Fetal scalp blood        1.99          NA           NA         0.77         1.24          0.30           NA           NA          3.06         3.53         000
                                  sample.
   59050              A          Fetal monitor w/         0.89          NA           NA         0.34         0.61          0.12           NA           NA          1.35         1.62         XXX
                                  report.
   59051              A          Fetal monitor/           0.74          NA           NA         0.28         0.58          0.10           NA           NA          1.12         1.12         XXX
                                  interpret only.
   59100              A          Remove uterus           12.35          NA           NA         6.05         5.27          1.80           NA           NA         20.20        19.42         090
                                  lesion.

[[Page 19333]]

 
   59120              A          Treat ectopic           11.49          NA           NA         5.73         7.13          1.67           NA           NA         18.89        20.29         090
                                  pregnancy.
   59121              A          Treat ectopic           11.67          NA           NA         5.84         5.84          1.70           NA           NA         19.21        19.21         090
                                  pregnancy.
   59130              A          Treat ectopic           14.22          NA           NA         6.89         6.68          2.07           NA           NA         23.18        22.97         090
                                  pregnancy.
   59135              A          Treat ectopic           13.88          NA           NA         6.76         8.73          2.01           NA           NA         22.65        24.62         090
                                  pregnancy.
   59136              A          Treat ectopic           13.18          NA           NA         6.49         6.62          1.92           NA           NA         21.59        21.72         090
                                  pregnancy.
   59140              A          Treat ectopic            5.46          NA           NA         3.40         4.23          0.79           NA           NA          9.65        10.48         090
                                  pregnancy.
   59150              A          Treat ectopic            6.89          NA           NA         3.95         4.44          1.00           NA           NA         11.84        12.33         090
                                  pregnancy.
   59151              A          Treat ectopic            7.86          NA           NA         4.01         6.68          1.15           NA           NA         13.02        15.69         090
                                  pregnancy.
   59160              A          D & C after              2.71        3.30         3.24         2.07         2.63          0.39         6.40         6.34          5.17         5.73         010
                                  delivery.
   59200              A          Insert cervical          0.79        1.19         0.89         0.29          0.3          0.11         2.09         1.79          1.19         1.20         000
                                  dilator.
   59300              A          Episiotomy or            2.41        1.56         1.32         0.92         0.73          0.34         4.31         4.07          3.67         3.48         000
                                  vaginal repair.
   59320              A          Revision of cervix       2.48          NA           NA         1.30         1.62          0.36           NA           NA          4.14         4.46         000
   59325              A          Revision of cervix       4.07          NA           NA         1.92         2.53          0.59           NA           NA          6.58         7.19         000
   59350              A          Repair of uterus..       4.95          NA           NA         1.84         2.84          0.73           NA           NA          7.52         8.52         000
   59400              A          Obstetrical care..      23.06          NA           NA        13.44        14.86          3.35           NA           NA         39.85        41.27         MMM
   59409              A          Obstetrical care..      13.50          NA           NA         5.08         7.69          1.97           NA           NA         20.55        23.16         MMM
   59410              A          Obstetrical care..      14.78          NA           NA         6.01          8.6          2.15           NA           NA         22.94        25.53         MMM
   59412              A          Antepartum               1.71        1.16         1.24         0.65         0.99          0.25         3.12         3.20          2.61         2.95         MMM
                                  manipulation.
   59414              A          Deliver placenta..       1.61          NA           NA         1.13         1.19          0.24           NA           NA          2.98         3.04         MMM
   59425              A          Antepartum care          4.81        4.62         3.88         4.62          3.1          0.71        10.14         9.40         10.14         8.62         MMM
                                  only.
   59426              A          Antepartum care          8.28        7.85         6.61         7.81         5.25          1.20        17.33        16.09         17.29        14.73         MMM
                                  only.
   59430              A          Care after               2.13        1.14         0.78         1.14         0.68          0.32         3.59         3.23          3.59         3.13         MMM
                                  delivery.
   59510              A          Cesarean delivery.      26.22          NA           NA        15.40        16.87          3.82           NA           NA         45.44        46.91         MMM
   59514              A          Cesarean delivery       15.97          NA           NA         6.01         8.97          2.32           NA           NA         24.30        27.26         MMM
                                  only.
   59515              A          Cesarean delivery.      17.37          NA           NA         7.56         10.2          2.53           NA           NA         27.46        30.10         MMM
   59525              A          Remover uterus           8.54          NA           NA         3.19         3.66          1.24           NA           NA         12.97        13.44         ZZZ
                                  after cesarean.
   59610              A          Vbac delivery.....      24.62          NA           NA         9.36        12.82          3.58           NA           NA         37.56        41.02         MMM
   59612              A          Vbac delivery only      15.06          NA           NA         5.77         8.03          2.20           NA           NA         23.03        25.29         MMM
   59614              A          Vbac care after         16.34          NA           NA         6.29         8.74          2.38           NA           NA         25.01        27.46         MMM
                                  delivery.
   59618              A          Attempted Vbac          27.78          NA           NA        10.51        14.43          4.05           NA           NA         42.34        46.26         MMM
                                  delivery.
   59620              A          Attempted Vbac          17.53          NA           NA         6.67         9.30          2.55           NA           NA         26.75        29.38         MMM
                                  delivery only.
   59622              A          Attempted Vbac          18.93          NA           NA         7.27        10.05          2.76           NA           NA         28.96        31.74         MMM
                                  after care.
   59812              A          Treatment of             3.25        4.21         4.07         2.23         3.06          0.48         7.94         7.80          5.96         6.79         090
                                  miscarriage.
   59820              A          Care of                  4.01        4.40         4.24         2.52          3.3          0.59         9.00         8.84          7.12         7.90         090
                                  miscarriage.
   59821              A          Treatment of             4.47        4.87         3.91         2.71         2.83          0.66        10.00         9.04          7.84         7.96         090
                                  miscarriage.
   59830              A          Treat uterus             6.11          NA           NA         3.64         4.28          0.89           NA           NA         10.64        11.28         090
                                  infection.
   59840              R          Abortion..........       3.01        4.64         4.07         2.14         2.82          0.44         8.09         7.52          5.59         6.27         010
   59841              R          Abortion..........       5.24        6.01         5.04         3.35         3.71          0.75        12.00        11.03          9.34         9.70         010
   59850              R          Abortion..........       5.91          NA           NA         2.52         3.43          0.86           NA           NA          9.29        10.20         090
   59851              R          Abortion..........       5.93          NA           NA         2.87         3.76          0.86           NA           NA          9.66        10.55         090
   59852              R          Abortion..........       8.24          NA           NA         4.34         5.16          1.19           NA           NA         13.77        14.59         090
   59855              R          Abortion..........       6.12          NA           NA         3.17         3.83          0.89           NA           NA         10.18        10.84         090
   59856              R          Abortion..........       7.48          NA           NA         3.55         4.55          1.09           NA           NA         12.12        13.12         090
   59857              R          Abortion..........       9.29          NA           NA         4.28         5.52          1.36           NA           NA         14.93        16.17         090
   59866              R          Abortion (mpr)....       4.00          NA           NA         1.55         2.33          0.58           NA           NA          6.13         6.91         000
   59870              A          Evacuate mole of         4.28          NA           NA         2.85         3.01          0.62           NA           NA          7.75         7.91         090
                                  uterus.
   59871              A          Remove cerclage          2.13        1.89         1.91         0.81         1.37          0.32         4.34         4.36          3.26         3.82         000
                                  suture.
   59898              C          Laparo proc, ob          0.00        0.00         0.00         0.00         0.00          0.00         0.00         0.00          0.00         0.00         YYY
                                  care/delivery.
   59899              C          Maternity care           0.00        0.00         0.00         0.00         0.00          0.00         0.00         0.00          0.00         0.00        YYY
                                  procedure.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    15. In table of Addenda B and C, the following CPT code is 
corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  Fully       Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                            Physician  implemented  transitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
  HCPCS      MOD       Status       Description     work RVUs  facility PE   nonfacility  facility PE   facility PE      RVUs     nonfacility   nonfacility    facility     facility     Global
   \2\                                                 \3\         RVUs        PE RVUs        RVUs         RVUs                      total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   20979             N          U.S. bone                0.17        0.25         0.25          0.07         0.07          0.01         0.43         0.43          0.25         0.25        XXX
                                 stimulation.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110--D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    16. In the table of Addendum B, the following CPT codes are 
corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  Fully       Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                            Physician  implemented  transitional  implemented  Transitional  Malpractice  implemented  Transitional  implemented  Transitional
  HCPCS      MOD       Status       Description     work RVUs  nonfacility   nonfacility  facility PE   nonfacility      RVUs     nonfacility   nonfacility    facility     facility     Global
   \2\                                                 \3\       PE RVUs       PE RVUs        RVUs        PE RVUs                    total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   G0106             A          Colon CA screen;         0.99        2.51         2.66          2.51         2.66          0.15         3.65         3.80          3.65         3.80         XXX
                                 barium enema.
   G0106  26         A          Colon CA screen;         0.99        0.27         0.38          0.27         0.38          0.04         1.30         1.41          1.30         1.41         XXX
                                 barium enema.
   G0106  TC         A          Colon CA screen;         0.00        2.24         2.28          2.24         2.28          0.11         2.35         2.39          2.35         2.39         XXX
                                 barium enema.
   G0120  A          A          Colon ca scrn            0.99        2.51         2.66          2.51         2.66          0.15         3.65         3.80          3.65         3.80         XXX
                                 barium enema.
   G0120  26         A          Colon ca scrn            0.99        0.27         0.38          0.27         0.38          0.04         1.30         1.41          1.30         1.41         XXX
                                 barium enema.
   G0120  TC         A          Colon ca scrn            0.00        2.24         2.28          2.24         2.28          0.11         2.35         2.39          2.35         2.39         XXX
                                 barium enema.
   G0170             A          Skin biograft.....       1.50        3.14         3.14          1.10         1.10          0.39         5.03         5.03          2.99         2.99          10
   G0171             A          Skin biograft add-       0.38        0.30         0.30          0.15         0.15          0.39         1.07         1.07          0.92         0.92         ZZZ
                                 on.
   45378  53         A          Diagnostic               0.96        1.35         1.34          0.33         0.46          0.07         2.38         2.37          1.36         1.49        000
                                 colonoscopy.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.

[[Page 19334]]

 
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    17. In the table of Addendum B, the following CPT code is corrected 
to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  Fully       Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                            Physician  implemented  transitional  implemented  Transitional  Malpractice  implemented  Transitional  implemented  Transitional
  HCPCS      MOD       Status       Description     work RVUs  nonfacility   nonfacility  facility PE   nonfacility      RVUs     nonfacility   nonfacility    facility     facility     Global
   \2\                                                 \3\       PE RVUs       PE RVUs        RVUs        PE RVUs                    total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   40814             A          Excise/repair            3.42        3.64         3.58          3.64         2.70          0.25         7.31         7.25          7.31         6.37         90
                                 mouth lesion.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

    18. In the table of Addendum B, the following HCPCS codes are 
corrected to read as follows:

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  Fully       Year 2000      Fully       Year 2000                   Fully       Year 2000      Fully       Year 2000
CPT \1\/                                            Physician  implemented  transitional  implemented  transitional  Malpractice  implemented  transitional  implemented  transitional
  HCPCS      MOD       Status       Description        work    nonfacility   nonfacility  facility PE   facility PE      RVUs     nonfacility   nonfacility    facility     facility     Global
   \2\                                               RVUs\3\     PE RVUs       PE RVUs        RVUs         RVUs                      total         total        total         total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
   G0163  .........  A          PET for rec of           1.50       56.21        56.21         56.21        56.21          2.06        59.77        59.77         59.77        59.77         XXX
                                 colorectal ca.
   G0163  26.......  A          PET for rec of           1.50        0.58         0.58          0.58         0.58          0.05         2.13         2.13          2.13         2.13         XXX
                                 colorectal ca.
   G0163  TC.......  A          PET for rec of           0.00       55.63        55.63         55.63        55.63          2.01        57.64        57.64         57.64        57.64         XXX
                                 colorectal ca.
   G0164  .........  A          PET for lymphoma         1.87       56.35        56.35         56.35        56.35          2.06        60.28        60.28         60.28        60.28         XXX
                                 staging.
   G0164  26.......  A          PET for lymphoma         1.87        0.72         0.72          0.72         0.72          0.05         2.64         2.64          2.64         2.64         XXX
                                 staging.
   G0164  TC.......  A          PET for lymphoma         0.00       55.63        55.63         55.63        55.63          2.01        57.64        57.64         57.64        57.64         XXX
                                 staging.
   G0165  .........  A          PET, rec of              1.50       56.21        56.21         56.21        56.21          2.06        59.77        59.77         59.77        59.77         XXX
                                 melanoma/met ca.
   G0165  26.......  A          PET, rec of              1.50        0.58         0.58          0.58         0.58          0.05         2.13         2.13          2.13         2.13         XXX
                                 melanoma/met ca.
   G0165  TC.......  A          PET, rec of              0.00       55.63        55.63         55.63        55.63          2.01        57.64        57.64         57.64        57.64        XXX
                                 melanoma/met ca.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved (D0110-D9999).
\3\ + Indicates RVUs are not used for Medicare payment.
\4\ PE RVUs = Practice Expense Relative Value Units.

(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: March 23, 2000.
Brian P. Burns,
Deputy Assistant Secretary for Information Resources Management.
[FR Doc. 00-8717 Filed 4-10-00; 8:45 am]
BILLING CODE 4120-01-P