[Federal Register Volume 68, Number 104 (Friday, May 30, 2003)]
[Rules and Regulations]
[Pages 32400-32405]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-11747]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 410, 414, and 485

[CMS-1204-CN]
RIN 0938-AL21


Medicare Program; Revisions to Payment Policies Under the 
Physician Fee Schedule for Calendar Year 2003 and Inclusion of 
Registered Nurses in the Personnel Provision of the Critical Access 
Hospital Emergency Services Requirement for Frontier Areas and Remote 
Locations

AGENCY: Centers for Medicare & Medicaid Services (CMS), 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 31, 2002, entitled, ``Revisions to Payment Policies Under the 
Physician Fee Schedule for Calendar Year 2003 and Inclusion of 
Registered Nurses in the Personnel Provision of the Critical Access 
Hospital Emergency Services Requirement for Frontier Areas and Remote 
Locations''.

EFFECTIVE DATE: This rule is effective March 1, 2003.

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

SUPPLEMENTARY INFORMATION: 

I. Background

    In FR Doc. 02-32503 of December 31, 2002 (67 FR 79966), there were 
a number of technical errors that are identified and corrected in the 
Correction of Errors section below. Additionally there are various 
revisions to Addenda B, C, D and E. The provisions in this correction 
notice are effective as if they had been included in the document 
published December 31, 2002.

Discussion of Addenda B, C, D and E

    1. In Addendum B, we assigned incorrect status indicators for the 
following CPT codes: Page 80111 for CPT code 67221; page 80143 for CPT 
codes 90723, 90740, 90743, 90744, 90746, 90747 and 90748; page 80158 
for CPT codes 99026 and 99027; and page 80166 for HCPCS code J3370. We 
assigned incorrect status indicators and RVUS for the following CPT and 
HCPCS codes: Page 80147 for CPT code 92597; page 80149 for CPT codes 
93315, 99315-TC, 99317 and 93317-TC; page 80156 for 95951 and 95951-TC, 
page 80158 for CPT code 99026 and 99027 and page 80163 for G0125 and 
G0125-TC. We also erroneously assigned RVUs to the following HCPCS 
codes that are not used for Medicare payment: Page 80164 for G0219 and 
G0219-26; page 80165 for G0255 and G0255-26. These corrections are 
reflected in correction number 12 to follow.
    2. We indicated the incorrect global period in Addenda B and C for 
the following CPT codes: Page 80100 for CPT code 58550; pages 80074 and 
80167 for CPT codes 33224; and page 80134 for CPT codes 77789, 77789-26 
and 77789-TC. The corrected global period is in correction number 13 to 
follow.
    3. In Addenda B and C, on pages 80044, 80165 and 80170, we 
erroneously assigned RVUs to a CPT code 0020T which is an emerging 
technology code and also created two new HCPCS codes (G0279 and G0280) 
with payments based on our valuation of this CPT code. However, 
assignment of RVUs for this CPT code is contrary to national policy 
established in the November 1, 2001 (66 FR 55269), final rule which 
stated that we would provide payment for emerging technology codes as 
determined by the carrier. In addition, based on the creation of these 
two G codes, we are not recognizing CPT code 0019T for Medicare 
purposes. Corrections for these services are in correction number 14.
    4. In Addenda B on page 80097, incorrect work and practice expense 
RVUS were assigned to CPT code 53853. In addition, on page 80110 the 
RVUs listed under non-facility total and facility total were incorrect 
for the following codes: 66710, 66720, 66761 66762 and 66770. These 
corrections are reflected in correction number 15.
    5. In Addenda B and C, incorrect practice expense RVUs were 
assigned for the following CPT codes: Page 80044 for CPT codes 10021 
and 10022; page 80060 for CPT 26587; page 80084 for CPT code 42820; 
page 80092 for CPT codes 50080, 50081, 50236, 50240; page 80093 for CPT 
codes 50553, 50555, 50557, 50561, 50684 and 50690; page 80094 for CPT 
codes 50953, 50955, 50957, 50961, 51010, 51605, 51610, 51710, 51726 and 
51726-TC; page 80095 and 80168 for CPT codes 51772, 51772-TC, 51784, 
51784-TC, 51785, 51785-TC, 51792, 51792-TC, 51795, 51795-TC, 51798, 
52000, 52005, 52010, 52204, 52214, 52224, 52265, 52270, 52275, 52276, 
52281, 52282, 52283, 52285, 52310, 52315, 52317, 52330 and 52332; page 
80096 for CPT codes 52647, 53025, 53040, 53080, 53085, 53200, 53265 and 
53270; page 80093 for CPT codes 53850, 53852, 54000, 54001, 54015, 
54055, 54060, 54105, 54111, 54115, 54120, 54125, 54130, 54135, 54160, 
54205, 54300, 54304, 54308, 54312, 54324, 54328, 54332, 54360 and 
54430; page 80098 for CPT codes 54500, 54700, 55100, 55250, 55450, and 
55700; page 80099 for CPT code 55873; page 80100 for CPT code 58340; 
page 80109 for CPT code 65220; page 80110 for CPT code 66740; page 
80110 for CPT codes 66821 and 66984; page 80111 for CPT codes 67820 and 
67825; page 80117 for CPT codes 71275 and 71275-TC; page 80119 for CPT 
codes 72191 and 72191-TC; page 80120 for CPT codes 73206 and 73206-TC; 
page 80121 for CPT codes 73706 and 73706-TC; page 80122 for CPT codes 
74175 and 74175-TC; page 80130 for CPT codes 76519 and 76519-TC; page 
80141 for CPT code 88141; page 80145 for CPT codes 91122, 91122-TC, 
92014, 92081, 92081-TC, 92083, 92083-TC, 92135 , 92135-TC, 92235; page 
80146 for CPT codes 92235-TC, 92250 and 92250-TC; page 80148 for CPT 
code 93012; page 80153 for CPT codes 94014 and 94015; page 80163 for 
HCPCS codes G0124 and G0141; page 80165 and 80170 for HCPCS codes 
G0275, G0278 and G0281; page 80166 and 80170 for HCPCS codes G0283, 
G0289 and P3001. The corrected RVUs are in item number 16.
    6. In Addendum D, on page 80171, the carrier numbers listed for 
Ohio and West Virginia are incorrect. The corrected numbers are 
reflected in number 17 to follow.

[[Page 32401]]

    7. We are revising the title of Addendum E that appeared on the top 
of every column from page 80172 through page 80174, to read as follows: 
``Updated List of CPT1/HCPCS Codes Used to Define Certain 
Designated Health Services Under the Physician Self-Referral 
Prohibition (Section 1877 of the Act).'' We are also correcting a 
number of typographical errors. On page 80172, in the second column, 
the last word in the second subheading concerning HCPCS level 2 codes 
for physical therapy/occupational therapy/speech-language pathology 
services is corrected to read ``services''. On page 80173, in the third 
column, the description of CPT codes 93320 and 93321 is corrected to 
include a dash between CPT codes 93303 and 93308. On page 80174, in the 
first column, the description of CPT code 93325 is corrected to include 
a dash between 93303 and 93308. Also on page 80174, in the third 
column, under the first subheading, the description of CPT code 90657 
is corrected to read ``Flu vaccine, 6-35 mo, im.''
    Also in Addendum E, we erroneously included or excluded certain 
codes. On page 80172, in the first column, we erroneously included 
HCPCS codes P2031 and P7001 as clinical laboratory services. We are 
removing these codes and their descriptors, because they are not 
payable by Medicare and therefore are not designated health services. 
On page 80172, in the second column, we inadvertently omitted CPT code 
92597. This code is now covered as a speech-pathology service under 
Medicare and, thus, is being added as a designated health service. Also 
on page 80172, in the second column, we included CPT 0019T as a 
physical therapy service. Consistent with changes made elsewhere in 
this correction notice, we are removing CPT code 0019T and its 
descriptor because it is no longer valid for Medicare purposes. On page 
80174, in the third column under the first subheading, we incorrectly 
included CPT code 90748 and HCPCS codes Q3021, Q3022, and Q3023 as 
vaccines to which the physician self-referral prohibition does not 
apply if certain conditions are satisfied. We are removing CPT code 
90748 and its descriptor because it is no longer valid for Medicare 
purposes. We are removing HCPCS codes Q3021, Q3022 and Q3023 and their 
descriptors, as these codes have been discontinued. Because CPT codes 
90740, 90743, 90744, 90746 and 90747 were reactivated to replace HCPCS 
codes Q3021-23, we are adding in numeric order CPT codes 90740, 90743, 
90744, 90746 and 90747 and their descriptors in place of the removed Q 
codes.
    Lastly, we note that on page 80172 in the third column, we included 
HCPCS code G0281 as a physical therapy service. In accordance with the 
Medicare Program Memorandum Transmittal B-03-001 issued on January 17, 
2003, Medicare coverage for this service will not begin until April 1, 
2003. Although this effective date differs from the March 1, 2003, 
effective date for the rest of the codes that appear in Addendum E, we 
have left the code on the list because it is a designated health 
service subject to the physician self-referral prohibition. Because 
payment cannot be made before April 1, 2003, there are no self-referral 
implications until that date.
    The corrections to Addendum E are shown in correction numbers 18 
and 19 to follow.

II. Correction of Errors

Correction of Errors

    In FR Doc. 02-32503 of December 31, 2002 (67 FR 79966), make the 
following corrections:
    1. On page 79966, in column three, in the Comment date section, the 
seventh sentence is revised as follows to correct the referenced table 
number: ``* * * identified in Table 9, the interim work. * * *''
    2. On page 79969, in column two in section E, ``Delay in Effective 
Date'', the last sentence is revised as follows to correct the 
effective date: ``* * * March 1, 2003 * * *''
    3. In Table 6, on page 80004 for CPT code 51798, replace the value 
listed under the column labeled ``2003 Work RVU'' with ``0.00'' to 
agree with discussion on page 80009.
    4. On page 80007, fifth paragraph remove the following language ``* 
* * 21740 Reconstructive repair of pectus excavatum or carinatum; open 
and * * *'' and add ``and ``21743 Reconstructive repair of pectus 
excavatum or carinatum; minimally invasive approach (Nuss procedure), 
with thoracoscopy'' at the end of the paragraph.
    5. On page 80013, in column two, under the discussion of G0279, 
G0280 and CPT code 0020T, we incorrectly discuss assignment of RVUs for 
this CPT code contrary to national policy established in the November 
1, 2001 (66 FR 55269) final rule. (Based on this we also assigned RVUs 
to G0279 and G0280). Replace existing language beginning at the last 
paragraph in column two (``We are creating and establishing a'' * * * 
through the sentence prior to the discussion of Electrical Stimulation 
for Wound Care in the third column (* * * ``total treatments or weekly 
intervals.'') with the following:
    ``We are creating two new G codes describing extracorporeal shock 
wave therapy for the musculoskeletal system. Because we have created 
these two G codes, we will not recognize CPT code 0019T. Creation of 
these G codes does not imply that the services will be covered by 
Medicare. We believe these services are similar to other physical 
therapy modalities, and when covered, will be paid under the therapy 
fee schedule and be carrier priced.''
    6. On page 80016, in the second paragraph of the second column, the 
phrase ``for January 1, 2003'' is revised to read ``March 1, 2003.''
    7. On page 80017, Table 9--``Additions and Deletions to the 
Physician Self-Referral Codes'' is amended as follows:
    a. Under the title, the subheading ``HCPCS'' is corrected to read 
``HCPCS/CPT 1'' and the subheading ``CPT 1/
Descriptor'' is corrected to read ``Descriptor''.
    b. Under the subheading ``Additions,'' CPT code 0019T and HCPCS 
codes Q3021, Q3022 and Q3023 and their descriptors are removed and the 
following CPT codes and their descriptors are added in numeric order:

90740 Hepb vacc, ill pat 3 dose im
90743 Hep b vacc, adol, 2 dose, im
92597 Oral speech device eval

    c. Under the subheading ``Deletions,'' CPT codes 90744, 90746 and 
90747 and their corresponding descriptors are removed and CPT code 
90748 and its descriptor ``Hep b/hib vaccine, im'' is added in numeric 
order.
    8. On page 80018, Table 9 is amended as follows:
    a. Under the title, the subheading ``HCPCS'' is corrected to read 
``HCPCS/CPT 1'' and the subheading ``CPT 1/
Descriptor'' is corrected to read ``Descriptor''.
    b. HCPCS codes P2031 ``Hair analysis'' and P7001 ``Culture 
bacterial urine'' are added in alphanumeric order.
    c. In the footnote to Table 9, the words ``copyrighted in the'' are 
corrected to read ``copyright''.
    9. On page 80018, the first column after Table 9 is amended as 
follows:
    a. The first sentence is revised to read: The ``Additions'' section 
of Table 9 generally reflects changes to the lists of designated health 
services to conform them to the most recent publications of CPT and 
HCPCS codes.''
    b. In the second sentence of the first paragraph: the first 2 words 
of the sentence are removed and replaced with, ``One''; and, ``0019T,'' 
is removed.

[[Page 32402]]

    c. In the third sentence of the first paragraph, the phrase ``while 
CPT codes 0019T and 0020T are therapy codes'' is revised to read, 
``while CPT code 0020T is a therapy code.''
    d. In the second paragraph that continues into column two, the 
beginning of the third sentence through the parenthetical phrase 
``(Q3021, Q3022 and Q3023)'' is revised to read, ``Table 9 also 
reflects the addition of 2 vaccine codes (CPT 90740 and 90743)''.
    10. On page 80018, the second column is amended as follows:
    a. At the end of the partial paragraph at the top of the column, 
the following sentence is added: ``CPT codes 90740 and 90743 were 
inadvertently omitted from prior years' lists of codes identifying the 
preventive screening tests, immunizations, and vaccines that may 
qualify for this exception.''
    b. The first sentence of the first full paragraph is revised to 
read, ``The ``Deletions'' section of Table 9 generally reflects changes 
necessary to conform the code list to the most recent publications of 
CPT and HCPCS codes.''
    c. The second sentence of the first full paragraph is revised by 
adding the word ``also,'' after the word ``We.''
    11. On page 80018, in the second column, following the first full 
paragraph, a new paragraph is added to read as follows:
    ``We are deleting CPT code 90748 (``Hep b/hib vaccine, im'') and 
HCPCS codes P2031 (``Hair analysis'') and P7001 (``Culture bacteria 
urine''). CPT code 90748 is not valid for Medicare purposes. HCPCS 
codes P2031 and P7001 are not payable by Medicare.''
    12. In Addendum B, the following codes are corrected to read as 
follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                       Physician  Nonfacility   Facility  Malpractice  Nonfacility   Facility
 CPT 1/HCPCS 2        MOD           Status           Description       work RVUs    PE RVUs     PE RVUs       RVUs        total       total      Global
--------------------------------------------------------------------------------------------------------------------------------------------------------
67221..........  ............  R                Ocular photodynamic         4.01        4.63        1.88        0.16         8.80        6.05        000
                                                 ther.
90723..........  ............  I                Dtap-hep b-ipv              0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 vaccine, im.
90740..........  ............  X                Hepb vacc, ill pat 3        0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 dose im.
90743..........  ............  X                Hep b vacc, adol, 2         0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 dose, im.
90744..........  ............  X                Hepb vacc ped/adol 3        0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 dose im.
90746..........  ............  X                Hep b vaccine, adult,       0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 im.
90747..........  ............  X                Hepb vacc, ill pat 4        0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 dose im.
90748..........  ............  I                Hep b/hib vaccine, im       0.00        0.00        0.00        0.00         0.00        0.00        XXX
92597..........  ............  A                Oral speech device          0.86        1.63        0.41        0.04         2.53        1.31        XXX
                                                 eval.
93315..........  ............  C                Echo transescophageal       0.00        0.00        0.00        0.00         0.00        0.00        XXX
93315..........  TC..........  C                Echo transescophageal       0.00        0.00        0.00        0.00         0.00        0.00        XXX
93317..........  ............  C                Echo transescophageal       0.00        0.00        0.00        0.00         0.00        0.00        XXX
93317..........  TC..........  C                Echo transescophageal       0.00        0.00        0.00        0.00         0.00        0.00        XXX
95951..........  ............  C                EEG monitoring/             0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 videorecord.
95951..........  TC..........  C                EEG monitoring/             0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 videorecord.
99026..........  ............  N                In-hospital on call         0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 service.
99027..........  ............  N                Out-of-hosp on call         0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 service.
G0125..........  ............  C                PET image pulmonary         0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 nodule.
G0125..........  TC..........  C                PET image pulmonary         0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 nodule.
G0219..........  ............  N                PET imgwholbod melano       0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 nonco.
G0219..........  26..........  N                PET imgwholbod melano       0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 nonco.
G0255..........  ............  N                Current percep              0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 threshold tst.
G0255..........  26..........  N                Current percep              0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 threshold tst.
J3370..........  ............  E                Vancomycin hci              0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 injection.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    13. In Addenda B and C, the following codes are corrected to read 
as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                       Physician  Nonfacility   Facility  Malpractice  Nonfacility   Facility
 CPT 1/HCPCS 2        MOD           Status           Description       work RVUs    PE RVUs     PE RVUs       RVUs        total       total      Global
--------------------------------------------------------------------------------------------------------------------------------------------------------
33224..........  ............  ...............  Insert pacing lead &        9.05          NA        3.92        0.36           NA       13.33        000
                                                 connect.
58550..........  ............  ...............  Laparo-asst vag            14.19          NA        7.21        1.44           NA       22.84        090
                                                 hysterectomy.
77789..........  ............  ...............  Apply surface               1.12        0.84          NA        0.05         2.01          NA        000
                                                 radiation.
77789..........  26..........  ...............  Apply surface               1.12        0.39        0.39        0.03         1.54        1.54        000
                                                 radiation.
77789..........  TC..........  ...............  Apply surface               0.00        0.45          NA        0.02         0.47          NA        000
                                                 radiation.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    14. In Addenda B and C, the following codes are corrected to read 
as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                       Physician  Nonfacility   Facility  Malpractice  Nonfacility   Facility
 CPT 1/HCPCS 2        MOD           Status           Description       work RVUs    PE RVUs     PE RVUs       RVUs        total       total      Global
--------------------------------------------------------------------------------------------------------------------------------------------------------
0019T..........  ............  I                Extracorp shock wave        0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 tx, ms.

[[Page 32403]]

 
0020T..........  ............  C                Extracorp shock wave        0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 tx, ft.
G0279..........  ............  C                Excorp shock tx,            0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 elbow epi.
G0280..........  ............  C                Excorp shock tx,            0.00        0.00        0.00        0.00         0.00        0.00        XXX
                                                 other than.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    15. In Addendum B, the following codes are corrected to read as 
follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                       Physician  Nonfacility   Facility  Malpractice  Nonfacility   Facility
 CPT 1/HCPCS 2        MOD           Status           Description       work RVUs    PE RVUs     PE RVUs       RVUs        total       total      Global
--------------------------------------------------------------------------------------------------------------------------------------------------------
53853..........  ............  A                Prostatic water             5.24       38.96        3.67        0.27        44.47        9.18        090
                                                 thermother.
66710..........  ............  A                Destruction, ciliary        4.78        5.14        3.81        0.18        10.10        8.77        090
                                                 body.
66720..........  ............  A                Destruction, ciliary        4.78        5.45        4.49        0.19        10.42        9.46        090
                                                 body.
66761..........  ............  A                Revision of iris.....       4.07        5.25        3.98        0.16         9.48        8.21        090
66762..........  ............  A                Revision of iris.....       4.58        5.33        3.97        0.18        10.09        8.73        090
66770..........  ............  A                Removal of inner eye        5.18        5.76        4.48        0.20        11.14        9.86        090
                                                 lesion.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    16. In addenda B and C, the following codes are corrected to read 
as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                         Physician  Nonfacility   Facility  Malpractice     Non-     Facility
  CPT 1/HCPCS 2        MOD           Status            Description       work RVUs    PE RVUs     PE RVUs       RVUs      Facility    total      Global
--------------------------------------------------------------------------------------------------------------------------------------------------------
10021...........  ............  A                Fna w/o image.........       1.27        2.37        0.53        0.07        3.71       1.87        XXX
10022...........  ............  A                Fna w/ image..........       1.27        2.66        0.44        0.05        3.98       1.76        XXX
26587...........  ............  A                Reconstruct extra           14.05        6.36        4.76        1.12       21.53      19.93        090
                                                  finger.
42820...........  ............  A                Remove tonsils and           3.91        4.25        4.25        0.28        8.44       8.44        090
                                                  adenoids.
50080...........  ............  A                Removal of kidney           14.71       10.16       10.16        0.86       25.73      25.73        090
                                                  stone.
50081...........  ............  A                Removal of kidney           21.80       12.23       12.23        1.30       35.33      35.33        090
                                                  stone.
50236...........  ............  A                Removal of kidney &         24.86       13.21       13.21        1.50       39.57      39.57        090
                                                  ureter.
50240...........  ............  A                Partial removal of          22.00       12.33       12.33        1.36       35.69      35.69        090
                                                  kidney.
50553...........  ............  A                Kidney endoscopy......       5.99       14.02        2.00        0.35       20.36       8.34        000
50555...........  ............  A                Kidney endoscopy &           6.53       16.01        2.17        0.38       22.92       9.08        000
                                                  biopsy.
50557...........  ............  A                Kidney endoscopy &           6.62       14.80        2.18        0.39       21.81       9.19        000
                                                  treatment.
50561...........  ............  A                Kidney endoscopy &           7.59       14.09        2.51        0.44       22.12      10.54        000
                                                  treatment.
50684...........  ............  A                Injection for ureter x-      0.76       12.61        0.25        0.04       13.41       1.05        000
                                                  ray.
50690...........  ............  A                Injection for ureter x-      1.16       12.77        0.39        0.06       13.99       1.61        000
                                                  ray.
50953...........  ............  A                Endoscopy of ureter...       6.24       13.95        2.06        0.37       20.56       8.67        000
50955...........  ............  A                Endoscopy of ureter...       6.75       17.98        2.26        0.38       25.11       9.39        000
50957...........  ............  A                Ureter endoscopy &           6.79       13.79        2.24        0.40       20.98       9.43        000
                                                  treatment.
50961...........  ............  A                Ureter endoscopy &           6.05       17.61        1.99        0.35       24.01       8.39        000
                                                  treatment.
51010...........  ............  A                Drainage of bladder...       3.53        5.71        2.08        0.23        9.47       5.84        010
51605...........  ............  A                Preparation for              0.64       13.63        0.22        0.04       14.31       0.90        000
                                                  bladder x-ray.
51610...........  ............  A                Injection for bladder        1.05       13.41        0.35        0.05       14.51       1.45        000
                                                  x-ray.
51710...........  ............  A                Change of bladder tube       1.49        3.90        1.30        0.09        5.48       2.88        010
51726...........  ............  A                Complex cystometrogram       1.71        6.97        6.97        0.15        8.83       8.83        000
51726...........  TC..........  A                Complex cystometrogram       0.00        6.39        6.39        0.04        6.43       6.43        000
51772...........  ............  A                Urethra pressure             1.61        6.32        6.32        0.16        8.09       8.09        000
                                                  profile.
51772...........  TC..........  A                Urethra pressure             0.00        5.75        5.75        0.04        5.79       5.79        000
                                                  profile.
51784...........  ............  A                Anal/urinary muscle          1.53        5.25        5.25        0.13        6.91       6.91        000
                                                  study.
51784...........  TC..........  A                Anal/urinary muscle          0.00        4.73        4.73        0.03        4.76       4.76        000
                                                  study.
51785...........  ............  A                Anal/urinary muscle          1.53        5.27        5.27        0.12        6.92       6.92        000
                                                  study.
51785...........  TC..........  A                Anal/urinary muscle          0.00        4.75        4.75        0.03        4.78       4.78        000
                                                  study.
51792...........  ............  A                Urinary reflex study..       1.10        5.44        5.44        0.20        6.74       6.74        000
51792...........  TC..........  A                Urinary reflex study..       0.00        5.01        5.01        0.11        5.12       5.12        000
51795...........  ............  A                Urine voiding pressure       1.53        6.70        6.70        0.18        8.41       8.41        000
                                                  study.
51795...........  TC..........  A                Urine voiding pressure       0.00        6.18        6.18        0.08        6.26       6.26        000
                                                  study.
51798...........  ............  A                Us urine capacity            0.00        0.58          NA        0.07        0.65         NA        XXX
                                                  measure.
52000...........  ............  A                Cystoscopy............       2.01        4.57        0.78        0.12        6.70       2.91        000
52005...........  ............  A                Cystoscopy & ureter          2.37        6.38        0.92        0.15        8.90       3.44        000
                                                  catheter.
52010...........  ............  A                Cystoscopy & duct            3.02        7.77        1.15        0.18       10.97       4.35        000
                                                  catheter.
52204...........  ............  A                Cystoscopy............       2.37        5.44        0.93        0.15        7.96       3.45        000
52214...........  ............  A                Cystoscopy and               3.71        7.24        1.36        0.22       11.17       5.29        000
                                                  treatment.

[[Page 32404]]

 
52224...........  ............  A                Cystoscopy and               3.14        6.12        1.18        0.18        9.44       4.50        000
                                                  treatment.
52265...........  ............  A                Cystoscopy and               2.94        5.67        1.14        0.18        8.79       4.26        000
                                                  treatment.
52270...........  ............  A                Cystoscopy & revise          3.37        6.41        1.34        0.20        9.98       4.91        000
                                                  urethra.
52275...........  ............  A                 Cystoscopy & revise         4.70        7.11        1.78        0.28       12.09       6.76        000
                                                  urethra.
52276...........  ............  A                Cystoscopy and               5.00        8.01        1.90        0.30       13.31       7.20        000
                                                  treatment.
52281...........  ............  A                Cystoscopy and               2.80        8.05        1.10        0.17       11.02       4.07        000
                                                  treatment.
52282...........  ............  A                Cystoscopy, implant          6.40       13.08        2.29        0.38       19.86       9.07        000
                                                  stent.
52283...........  ............  A                Cystoscopy and               3.74        5.86        1.41        0.22        9.82       5.37        000
                                                  treatment.
52285...........  ............  A                Cystoscopy and               3.61        6.31        1.37        0.22       10.14       5.20        000
                                                  treatment.
52310...........  ............  A                Cystoscopy and               2.81        4.73        1.05        0.17        7.71       4.03        000
                                                  treatment.
52315...........  ............  A                Cystoscopy and               5.21        5.75        1.88        0.31       11.27       7.40        000
                                                  treatment.
52317...........  ............  A                Remove bladder stone..       6.72        7.82        2.34        0.40       14.94       9.46        000
52330...........  ............  A                Cystoscopy and               5.04       17.40        1.80        0.30       22.74       7.14        000
                                                  treatment.
52332...........  ............  A                Cystoscopy and               2.83       16.40        1.07        0.17       19.40       4.07        000
                                                  treatment.
52647...........  ............  A                Laser surgery of            10.36       42.87        4.57        0.61       53.84      15.54        090
                                                  prostate.
53025...........  ............  A                Incision of urethra...       1.13        3.69        0.45        0.07        4.89       1.65        000
53040...........  ............  A                Drainage of urethra          6.40       11.86        7.17        0.41       18.67      13.98        090
                                                  abscess.
53080...........  ............  A                Drainage of urinary          6.29        7.22        7.22        0.42       13.93      13.93        090
                                                  leakage.
53085...........  ............  A                Drainage of urinary         10.27        8.63        8.63        0.67       19.57      19.57        090
                                                  leakage.
53200...........  ............  A                Biopsy of urethra.....       2.59        4.76        0.95        0.17        7.52       3.71        000
53265...........  ............  A                Treatment of urethra         3.12        5.77        2.28        0.20        9.09       5.60        010
                                                  lesion.
53270...........  ............  A                Removal of urethra           3.09        5.58        2.52        0.21        8.88       5.82        010
                                                  gland.
53850...........  ............  A                Prostatic microwave          9.45       63.30        4.25        0.56       73.31      14.26        090
                                                  thermotx.
53852...........  ............  A                Prostatic rf thermotx.       9.88       52.42        4.43        0.58       62.88      14.89        090
54000...........  ............  A                Slitting of prepuce...       1.54        4.77        1.40        0.10        6.41       3.04        010
54001...........  ............  A                Slitting of prepuce...       2.19        5.36        2.01        0.14        7.69       4.34        010
54015...........  ............  A                Drain penis lesion....       5.32        6.51        3.05        0.33       12.16       8.70        010
54055...........  ............  A                Destruction, penis           1.22        5.59        1.39        0.07        6.88       2.68        010
                                                  lesion(s).
54060...........  ............  A                Excision of penis            1.93        4.89        1.56        0.12        6.94       3.61        010
                                                  lesion(s).
54105...........  ............  A                Biopy of penis........       3.50        5.55        2.07        0.21        9.26       5.78        010
54111...........  ............  A                Treat penis lesion,         13.57        8.38        8.38        0.79       22.74      22.74        090
                                                  graft.
54115...........  ............  A                Treatment of penis           6.15        9.53        6.06        0.39       16.07      12.60        090
                                                  lesion.
54120...........  ............  A                Partial removal of           9.97        7.23        7.23        0.60       17.80      17.80        090
                                                  penis.
54125...........  ............  A                Removal of penis......      13.53        8.43        8.43        0.81       22.77      22.77        090
54130...........  ............  A                Remove penis & nodes..      20.14       10.94       10.94        1.19       32.27      32.27        090
54135...........  ............  A                Remove penis & nodes..      26.36       13.00       13.00        1.58       40.94      40.94        090
54160...........  ............  A                Circumcision..........       2.48        4.97        1.75        0.16        7.61       4.39        010
54205...........  ............  A                Treatment of penis           7.93        6.47        6.47        0.47       14.87      14.87        090
                                                  lesion.
54300...........  ............  A                Revision of penis.....      10.41        8.04        8.04        0.54       18.99      18.99        090
54304...........  ............  A                Revision of penis.....      12.49        9.25        9.25        0.74       22.48      22.48        090
54308...........  ............  A                Reconstruction of           11.83        8.82        8.82        0.70       21.35      21.35        090
                                                  urethra.
54312...........  ............  A                Reconstruction of           13.57        9.87        9.87        0.81       24.25      24.25        090
                                                  urethra.
54324...........  ............  A                Reconstruction of           16.31       11.06       11.06        1.03       28.40      28.40        090
                                                  urethra.
54328...........  ............  A                Revise penis/urethra..      15.65       10.09       10.09        0.92       26.66      26.66        090
54332...........  ............  A                Revise penis/urethra..      17.08       10.56       10.56        1.01       28.65      28.65        090
54360...........  ............  A                Penis plastic surgery.      11.93        7.85        7.85        0.72       20.50      20.50        090
54430...........  ............  A                Revision of penis.....      10.15        7.27        7.27        0.60       18.02      18.02        090
54500...........  ............  A                Biopsy of testis......       1.31        5.46        0.44        0.08        6.85       1.83        000
54700...........  ............  A                Drainage of scrotum...       3.43        7.02        3.06        0.23       10.68       6.72        010
55100...........  ............  A                Drainage of scrotum          2.13        7.87        3.22        0.15       10.15       5.50        010
                                                  abscess.
55250...........  ............  A                Removal of sperm             3.29        7.70        2.92        0.21       11.20       6.42        090
                                                  duct(s).
55450...........  ............  A                Ligation of sperm duct       4.12        5.98        2.43        0.24       10.34       6.79        010
55700...........  ............  A                Biopsy of prostate....       1.57        3.50        0.73        0.10        5.17       2.40        000
55873...........  ............  A                Cryoblate prostate....      19.47        9.46        9.46        1.02       29.95      29.95        090
58340...........  ............  A                Catheter for                 0.88       12.74        0.32        0.08       13.70       1.28        000
                                                  hysterography.
65220...........  ............  A                Remove foreign body          0.71        3.50        0.18        0.05        4.26       0.94        000
                                                  from eye.
66740...........  ............  A                Destruction, ciliary         4.78        4.84        4.84        0.18        9.80       9.80        090
                                                  body.
66821...........  ............  A                After cataract laser         2.35        3.83        3.39        0.10        6.28       5.84        090
                                                  surgery.
66984...........  ............  A                Cataract surg w/iol, 1      10.23          NA        7.65        0.41          NA      18.29        090
                                                  stage.
67820...........  ............  A                Revise eyelashes......       0.89        1.14        0.38        0.04        2.07       1.31        000
67825...........  ............  A                Revise eyelashes......       1.38        1.62        1.03        0.06        3.06       2.47        010
71275...........  ............  A                Ct angiography, chest.       1.92       12.98       12.98        0.38       15.28      15.28        XXX
71275...........  TC..........  A                Ct angiography, chest.       0.00       12.33       12.33        0.32       12.65      12.65        XXX
72191...........  ............  A                Ct angiograph, pelv w/       1.81       12.59       12.59        0.38       14.78      14.78        XXX
                                                  o & w/dye.
72191...........  TC..........  A                Ct angiograph, pelv w/       0.00       11.97       11.97        0.32       12.29      12.29        XXX
                                                  o & w/dye.
73206...........  ............  A                Ct angio upr extrm w/o       1.81       11.54       11.54        0.38       13.73      13.73        XXX
                                                  & w/dye.
73206...........  TC..........  A                Ct angio upr extrm w/o       0.00       10.92       10.92        0.32       11.24      11.24        XXX
                                                  & w/dye.

[[Page 32405]]

 
73706...........  ............  A                Ct angio lwr extr w/o        1.90       11.57       11.57        0.38       13.85      13.85        XXX
                                                  & w/dye.
73706...........  TC..........  A                Ct angio lwr extr w/o        0.00       10.92       10.92        0.32       11.24      11.24        XXX
                                                  & w/dye.
74175...........  ............  A                Ct angio abdom w/o & w/      1.90       12.62       12.62        0.38       14.90      14.90        XXX
                                                  dye.
74175...........  TC..........  A                Ct angio abdom w/o & w/      0.00       11.97       11.97        0.32       12.29      12.29        XXX
                                                  dye.
76519...........  ............  A                Echo exam of eye......       0.54        1.93          NA        0.07        2.54         NA        XXX
76519...........  TC..........  A                Echo exam of eye......       0.00        1.68          NA        0.06        1.74         NA        XXX
88141...........  ............  A                Cytopath, c/v,               0.42        0.19        0.19        0.01        0.62       0.62        XXX
                                                  interpret.
91122...........  ............  A                Anal pressure record..       1.77        4.55        4.55        0.17        6.49       6.49        000
91122...........  TC..........  A                Anal pressure record..       0.00        3.93        3.93        0.07        4.00       4.00        000
92014...........  ............  A                Eye exam & treatment..       1.10        1.37        0.48        0.02        2.49       1.60        XXX
92081...........  ............  A                Visual field                 0.36        0.89          NA        0.02        1.27         NA        XXX
                                                  examination(s).
92081...........  TC..........  ...............  Visual field                 0.00        0.73          NA        0.01        0.74         NA        XXX
                                                  examination(s).
92083...........  ............  A                Visual field                 0.50        1.37          NA        0.02        1.89         NA        XXX
                                                  examination(s).
92083...........  TC..........  ...............  Visual field                 0.00        1.14          NA        0.01        1.15         NA        XXX
                                                  examination(s).
92135...........  ............  ...............  Opthalmic dx imaging..       0.35        1.32          NA        0.02        1.69         NA        XXX
92135...........  TC..........  ...............  Opthalmic dx imaging..       0.00        1.16          NA        0.01        1.17         NA        XXX
92235...........  ............  ...............  Eye exam with photos..       0.81        2.68          NA        0.07        3.56         NA        XXX
92235...........  TC..........  ...............  Eye exam with photos..       0.00        2.31          NA        0.05        2.36         NA        XXX
92250...........  ............  ...............  Eye exam with photos..       0.44        1.54          NA        0.02        2.00         NA        XXX
92250...........  TC..........  ...............  Eye exam with photos..       0.00        1.35          NA        0.01        1.26         NA        XXX
93012...........  ............  A                Transmission of ecg...       0.00        5.99          NA        0.15        6.14         NA        XXX
94014...........  ............  A                Patient recorded             0.52        0.98          NA        0.03        1.53         NA        XXX
                                                  spirometry.
94015...........  ............  A                Patient recorded             0.00        0.81          NA        0.01        0.82         NA        XXX
                                                  spirometry.
G0124...........  ............  A                Screen c/v thin layer        0.42        0.19        0.19        0.01        0.62       0.62        XXX
                                                  by MD.
G0141...........  ............  A                Scr c/v cyto, autosys        0.42        0.19        0.19        0.01        0.62       0.62        XXX
                                                  and MD.
G0275...........  ............  A                Renal angio, cardiac         0.25        0.10        0.10        0.01        0.36       0.36        ZZZ
                                                  cath.
G0278...........  ............  A                Iliac art angio,             0.25        0.10        0.10        0.01        0.36       0.36        ZZZ
                                                  cardiac cath.
G0281...........  ............  A                Elec stim unattend for       0.18        0.16        0.16        0.01        0.35       0.35        XXX
                                                  press.
G0283...........  ............  A                Elec stim other than         0.18        0.16        0.16        0.01        0.35       0.35        XXX
                                                  wound.
G0289...........  ............  A                Arthro, loose body +         1.48        0.58        0.58        0.27        2.33       2.33        ZZZ
                                                  chondro.
P3001...........  ............  A                Screening pap smear by       0.42        0.19        0.19        0.01        0.62       0.62        XXX
                                                  phys.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    17. In the table of addendum D the following carrier numbers are 
corrected as follows:

                                                   Addendum D
                                                   [Corrected]
----------------------------------------------------------------------------------------------------------------
                 Locality                                                                 Practice
 Carrier no.       no.                      Locality name                      Work       expense    Malpractice
----------------------------------------------------------------------------------------------------------------
00883........           00  OHIO.........................................        0.988        0.944        0.957
00884........           16  WEST VIRGINIA................................        0.963        0.850        1.378
----------------------------------------------------------------------------------------------------------------

Addendum E [Corrected]

    18. In Addendum E, the following CPT codes and their descriptors 
are added:

 
 
 
 PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY
92597.....................................  Oral speech device eval
         PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES
90740.....................................  Hepb vacc, ill pat 3 dose im
90743.....................................  Hep b vacc, adol, 2 dose, im
90744.....................................  Hepb vacc ped/adol 3 dose im
90746.....................................  Hep b vaccine, adult, im
90747.....................................  Hepb vacc, ill pat 4 dose im
 

    19. In Addendum E, the following CPT and HCPCS codes and their 
descriptors are removed:

 
 
 
                      CLINICAL LABORATORY SERVICES
P2031.....................................  Hair analysis
P7001.....................................  Culture bacterial urine
 PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY
0019T.....................................  Extracorp shock wave tx, ms
         PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES
90748.....................................  Hep b/hib vaccine, im
Q3021.....................................  Ped hepatitis b vaccine inj
Q3022.....................................  Hepatitis b vaccine adult ds
Q3023.....................................  Injection hepatitis Bvaccine
 

III. Waiver of Proposed Rulemaking

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register to provide a period for public comment before the 
provisions of a notice take effect. We can waive this procedure, 
however, if we find good cause that notice and comment procedure is 
impracticable, unnecessary, or contrary to the public interest and 
incorporate a statement of the finding and the reasons for it into the 
notice issued.
    We find it unnecessary to undertake notice and comment rulemaking 
because this notice merely provides technical corrections to the 
regulations. Therefore, we find good cause to waive notice and comment 
procedures.

    Dated: April 24, 2003.
Ann Agnew,
Executive Secretary to the Department.
[FR Doc. 03-11747 Filed 5-29-03; 8:45 am]
BILLING CODE 4120-01-P