[Federal Register Volume 68, Number 250 (Wednesday, December 31, 2003)]
[Rules and Regulations]
[Pages 75442-75453]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-32016]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 410 and 419

[CMS-1471-CN]
RIN 0938-AL19


Medicare Program; Medicare Program; Changes to the Hospital 
Outpatient Prospective Payment System and Calendar Year 2004 Payment 
Rates; Final Rule; Correction

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Correction of final rule with comment period.

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SUMMARY: This document corrects errors in the final rule with comment 
period that appeared in the Federal Register on November 7, 2003, 
entitled ``Medicare Program; Changes to the Hospital Outpatient 
Prospective Payment System

[[Page 75443]]

and Calendar Year 2004 Payment Rates; Final Rule.'' This notice is a 
supplement to the November 7, 2003 final rule and is completely 
separate from any notice that promulgates new policy that results from 
enactment of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003.

EFFECTIVE DATE: January 1, 2004.

FOR FURTHER INFORMATION CONTACT: Dana Burley, (410) 786-0378.

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 03-27791 of November 7, 2003 (68 FR 63398), there were 
several technical errors as well as a number of public comments that 
were received timely, but that we inadvertently failed to address. The 
errors include incorrect or potentially misleading responses, and in 
Addenda A and B, omissions and typographical errors. In addition, we 
are adding information to the addenda that was not available when we 
published the final rule. This additional information does not affect 
payment under the hospital outpatient prospective payment system 
(OPPS). We ordinarily provide a 30-day delay in the effective date of 
the provisions of a notice. Section 553(d) of the Administrative 
Procedure Act (5 U.S.C. 553(d)) ordinarily requires a 30-day delay in 
the effective date of final rules after the date of their publication 
in the Federal Register. This 30-day delay in effective date can be 
waived, however, if an agency finds good cause that the delay is 
impracticable, unnecessary, or contrary to the public interest, and the 
agency incorporates a statement of the finding and its reasons in the 
notice issued. In addition, section 1871(e)(1) of the Social Security 
Act, as amended by section 903(b)(1) of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (DIMA), also requires that a 
substantive change in a regulation shall not become effective before 
the end of the 30-day period that begins on the date that the Secretary 
has issued or published the substantive change. Section 1871(e)(1) of 
the Social Security Act, as amended by section 903(b)(1) of DIMA, 
provides an exception to that requirement if the Secretary finds that 
the waiver of such 30-day period is necessary to comply with statutory 
requirements or that the application of such 30-day period is contrary 
to the public interest. We find good cause to waive the 30-day delay in 
effective date for this correction notice as set forth in section III, 
``Waiver of 30-Day Delay in Effective Date,'' below.

II. Correction of Errors

A. Correction of Inaccurate Information

    On page 63423, first column, fifth sentence, we stated: ``The case 
of APC 0108, we used the external device cost data that was used to set 
the median for the 2003 OPPS because we received no outside data for 
the 2004 OPPS for this APC and because the proposed median of 
$28,685.30 set forth in the proposed rule was considerably higher than 
the final rule data median of $23,944.80, which resulted when 
additional claims were used to calculate the median cost.''
    We subsequently determined that external data that met our 
preferred criteria for use in setting payment rates had been furnished 
as part of a timely, properly submitted comment for APC 0108. 
Therefore, we have revised the median cost and payment rate 
($23,641.27) that was in the final rule for this APC using the data 
submitted in the comment. The new payment rate is $24,699.74. See Table 
1 below for the complete revised values information.
    To correct this error, we remove the fifth sentence in column 1 on 
page 63423 and replace it with the following: ``In the case of APC 
0108, we used external device cost data submitted in a comment on the 
proposed rule to set the median for the 2004 OPPS. The proposed median 
of $28,685.30 set forth in the proposed rule was considerably higher 
than the median calculated for the final rule, $23,944.80, which 
resulted when additional claims were used to calculate the median cost. 
The use of this external data raised the payment rate to a level we 
believe is more appropriate.''

B. Responses to Comments Not Included in the Final Rule

Bone Marrow Harvesting
    Comment: A commenter asserted that the claims data for Physicians' 
Current Procedural Terminology (CPT) codes 38230 (bone marrow 
harvesting), 38240 (bone marrow/stem cell transplantation, allogenic), 
and 38241 (bone marrow/stem cell transplantation, autologous) are 
seriously flawed. For instance, the median cost for CPT code 38230 
(using data for 35 claims) was $74.81. The commenter stated that CPT 
code 38230 involves a 60-90 minute operating room procedure performed 
under general anesthesia, with costs more closely approaching the 
payment rate for APC 0111 (paying $718.67) than APC 0123 (paying 
$288.53), its current APC placement. The commenter expressed similar 
concern over the claims data for CPT codes 38240 and 38241, asserting 
that their placement in APC 0123 results in inadequate payment to cover 
the costs of bone marrow and stem cell transplantation.
    The commenter urged us to move CPT codes 38230, 38240, and 38241 
from APC 0123 (bone marrow harvesting/stem cell transplant, paying 
$288.53) to APC 0111 (blood product exchange, paying $718.67).
    Response: We agree with the commenter that the claims data for CPT 
code 38230 appear to be based on flawed claims. We believe that the 
costs involved in performing CPT code 38230 (bone marrow harvesting) 
are more similar to the costs involved in performing CPT codes 38205 
and 38206 (stem cell harvesting, placed in APC 0111); therefore, we 
will move CPT code 38230 from APC 0123 to APC 0111. We will maintain 
the payment rate for APC 0111 at $718.67 as stated in the November 7, 
2003 final rule, since we believe the claims for CPT code 38230 
represent aberrant data and should not be used to recalculate the 
payment rate for APC 0111.
    In contrast, we do not believe that the claims data for CPT codes 
38240 and 38241 are flawed. The resource utilization of performing bone 
marrow and stem cell transplantations is similar to the resource 
utilization of performing infusion therapy services (which are paid 
$210 in APC 0110), since bone marrow and stem cell transplantations 
involve no incision and no unusual instruments or equipment. Therefore, 
we believe that the APC placement of CPT codes 38240 and 38241 in APC 
0123 sufficiently captures the costs involved in performing these 
services. Although these codes will remain in APC 0123, their payment 
rate in APC 0123 will increase by $47.01 (from $288.53 to $335.54) 
above the rate stated in the November 7, 2003 final rule, as a result 
of moving CPT code 38230 out of APC 0123 and recalculating the median 
for APC 0123 based on CPT codes 38240 and 38241 that remain in APC 
0123.
Cobalt 60-Based Stereotactic Radiosurgery
    Comment: A commenter requested that we combine CPT codes G0242 
(Cobalt 60-based stereotactic radiosurgery plan) and G0243 (Cobalt 60-
based stereotactic radiosurgery delivery). The commenter explained 
that, before 2000, we allowed Cobalt 60-based stereotactic radiosurgery 
to be appropriately billed using CPT code 61793 (stereotactic 
radiosurgery--particle beam, gamma ray or linear accelerator--one or 
more sessions), the same code that non-Medicare payers continue to use 
for this procedure.

[[Page 75444]]

However, our current guidelines for coding this procedure necessitate 
the billing of two codes (planning and delivery), and therefore, 
correct billing of this treatment using the current codes results in a 
multiple procedure claim. The commenter asserted that because we 
calculate medians using only single claims, the APC placement of 
Healthcare Common Procedure Coding System (HCPCS) codes G0242 and G0243 
was based on aberrant single claims.
    The commenter requested that these codes (G0242 and G0243) be 
combined into a single procedure code (that is, CPT code 61793) in 
order for us to accurately capture the costs of this treatment in a 
single claim because both parts of this treatment (planning and 
delivery) are always delivered on the same day in one surgical 
procedure. Based on resource consumption and clinical homogeneity, the 
commenter suggested that we place this single procedure code in one of 
the following APCs: 0222 (paying $12,670), 0226 (paying $7,437), or 
0227 (paying $8,775).
    Response: In addition to the above comment, we received several 
other comments stating that HCPCS code G0242 (Cobalt 60-based 
stereotactic radiosurgery plan) was being used inappropriately for 
linear accelerator-based stereotactic radiosurgery (SRS) planning in 
addition to Cobalt 60-based SRS planning, due to the nonexistence of a 
code to bill for linear accelerator-based SRS planning. Considering the 
current misuse of HCPCS code G0242 and the potential for causing 
greater confusion by combining CPT codes G0242 and G0243, we created a 
planning code for linear accelerator-based SRS (G0338) to distinguish 
this procedure from Cobalt 60-based SRS planning. Since the claims data 
for G0242 represent costs for linear accelerator-based SRS planning 
(due to misuse of the code) in addition to Cobalt 60-based SRS 
planning, we are uncertain of how to combine these data with G0243 
(Cobalt 60-based SRS delivery) to determine an accurate payment rate 
for a combined code for planning and delivery of Cobalt 60-based SRS. 
Therefore, we will solicit input from the APC Panel at its next meeting 
in early 2004.
    In the meantime, we will maintain two separate HCPCS codes (G0242 
and G0243) for the planning and delivery of Cobalt 60-based SRS 
treatment, consistent with the use of two G codes for the planning 
(G0338) and delivery (G0173, G0251, G0339, G0340, as applicable) of 
each type of linear accelerator-based SRS treatment, as described 
below.
    Correct Coding for Various Types of Stereotactic Radiosurgery 
(SRS):
[sbull] Cobalt 60-based, multi-source SRS--
    Planning--G0242 (APC 1516 paying $1,450)
    Delivery--G0243 (APC 1528 paying $5,250)
[sbull] Linear accelerator-based SRS--
    Non-robotic linear accelerator-based SRS (complete session)
    --Planning--G0338 (APC 1516 paying $1,450)
    --Delivery--G0173 (APC 1528 paying $5,250)
    Non-robotic linear accelerator-based SRS (fractionated sessions)
    --Planning--G0338 (APC 1516 paying $1,450)
    --Delivery--G0251 (APC 1513 paying $1,150, per session)
    Image-guided robotic linear accelerator-based SRS (complete session 
or first session of fractionated treatment)--
    --Planning--G0338 (APC 1516 paying $1,450)
    --Delivery--G0339 (APC 1528 paying $5,250)
    Image-guided robotic linear accelerator-based SRS (fractionated 
treatment, 2nd--5th sessions)--
    --Planning--G0338 (APC 1516 paying $1,450)
    --Delivery--G0340 (APC 1525 paying $3,750, per session)
    Comment: A commenter urged us to recognize the cost and clinical 
differences between HCPCS codes G0243 and G0173 by placing them in 
separate APCs.
    Response: We believe that the low volume of single claims for HCPCS 
code G0243 (172 single claims out of 1,033 total claims = 17 percent of 
total claims) does not substantiate movement of this code into a 
procedural APC at this time, and there is no clinical reason for a 
reassignment. Therefore, we will keep HCPCS code G0243 in new 
technology APC 1528 with a payment of $5,250 for CY 2004.
ProstacScint
    Comment: The manufacturer of ProstaScint (indium capromab 
pendetide), a diagnostic agent used for the imaging of prostate cancer, 
indicated that this product's proposed payment rate is significantly 
below the cost that hospitals incur in acquiring ProstaScint. The 
manufacturer stated that reduced payment would restrict hospitals from 
providing ProstaScint studies to Medicare beneficiaries and have a 
significant negative effect on the treatment and outcomes of patients 
at risk for prostate cancer. The commenter submitted a survey of 
hospitals demonstrating their costs of purchasing ProstaScint.
    Response: We agree with the commenter that the use of only hospital 
claims data to set the payment rate for ProstaScint may adversely 
impact beneficiary access. We believe that the external data submitted 
by the manufacturer meets our preferred criteria; therefore, we will 
use the external data to establish an adjusted median cost for this 
product by blending the median cost derived from our dampening 
methodology with the external cost data on a one-to-one ratio.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            External         2004 1:1
               APC                               HCPCS                       Short descriptor           2004 adjusted     acquisition     Blended median
                                                                                                         median cost          cost             cost
--------------------------------------------------------------------------------------------------------------------------------------------------------
1604.............................  A9507...........................  Indium/111 capromab pendetide...         $726.50        $1,610.75        $1,168.63
--------------------------------------------------------------------------------------------------------------------------------------------------------

Arthroscopy
    Comment: One commenter requested that we assign CPT code 29827 to 
APC 0042 (Level II Arthroscopy). The code was new for 2003 and was 
assigned to APC 0041 (Level I Arthroscopy). The commenter provided 
information to support the assertion that the procedure described by 
CPT code 29827 is very similar to that described by CPT code 29826 with 
regard to operating room time required, equipment requirements, and 
complexity. However, procedures coded as CPT code 29826 are assigned to 
APC 0042.
    Response: Our medical staff evaluated this request and decided that 
they would like the advice of the APC Panel before making a 
determination. In their analysis of the assignments for CPT codes 29826 
and 29827, they determined that it would be appropriate to solicit 
input from the APC Panel regarding the clinical coherence of both APCs 
0041 and 0042. The APC Panel will meet in early 2004, and we plan to 
include these APCs on the agenda for its

[[Page 75445]]

consideration. The date for the APC Panel meeting and registration 
information will be published in the Federal Register and on the CMS 
OPPS Web site at least 60 days before the meeting date.
Photoselective Vaporization of the Prostate
    Comment: Several commenters urged us to increase payment for CPT 
codes 52647 and 52648 (photoselective vaporization of the prostate 
(PVP)). They expressed concern that other less effective procedures 
requiring less skill have a significantly higher proposed payment rate. 
Commenters stated that the proposed payment rate for PVP under APC 0163 
does not cover the costs of providing access to this new technology.
    Response: Based on our claims data, we believe that CPT codes 52647 
and 52648 are appropriately placed in APC 0163 for CY 2004, but the 
commenters may want to consider applying for a new CPT/HCPCS code for 
this procedure so that it is identifiable separately from other 
procedures. Alternatively, PVP may be a candidate for consideration 
under the OPPS new technology process. We refer interested parties to 
our Web site www.cms.hhs.gov/providers/hopps/ for further information 
on the new technology application and evaluation process.
Inpatient-Only List
    Comment: We received a comment requesting that we remove several 
codes from the inpatient-only list. The codes are: 44901 (Incision and 
drainage of appendiceal abscess; percutaneous); 49021 (Drainage of 
peritoneal abscess or localized peritonitis, exclusive of appendiceal 
abscess; percutaneous); 49041 (Drainage of subdiaphragmatic or 
subphrenic abscess; percutaneous); and 49061 (Drainage of 
retroperitoneal abscess; percutaneous). The commenters based their 
request on the fact that codes they believe are similar to 44901, 
49021, 49041, and 49061 are not on the inpatient-only list. Codes that 
they used as examples included 32201 (Pneumonostomy; with percutaneous 
drainage of abscess or cyst); and 50021 (Drainage of perirenal or renal 
abscess; percutaneous).
    Response: The information provided by the commenter did not provide 
an adequate basis for our medical staff to make a decision. Instead, 
our physicians will solicit input from additional specialty groups that 
provide care to the patients undergoing these procedures. We will also 
present this issue to the APC Panel for consideration at its next 
meeting in early 2004.
Neutron Radiotherapy
    Comment: We received a comment requesting that we create a new 
``G'' code for neutron radiotherapy so that these procedures can be 
assigned to a new APC. At this time, the procedures are coded using a 
CPT code that includes other procedures that the commenter does not 
believe are related to neutron radiotherapy. The commenter believes the 
combination of procedures in the CPT code is inappropriate.
    Response: We evaluated this request and continue to believe that 
the current coding is appropriate. We do not believe that creation of a 
new ``G'' code is warranted in this case because there is a CPT code 
that specifically describes this procedure.
Magnetic Resonance Imaging and Magnetic Resonance Angiography
    Comment: We received a comment requesting that we assign magnetic 
resonance imaging and magnetic resonance angiography to separate APCs. 
These procedures are currently assigned to APCs 0336 and 0337.
    Response: We evaluated this request and continue to believe that 
the current assignments are appropriate and result in accurate payment 
for the procedures.
Fetal Echocardiogram
    Comment: We received one comment requesting that we reassign codes 
for fetal echocardiograms (CPT 76825 through 76827) to APC 0269. The 
codes are currently assigned to APCs 0671 and 0697.
    Response: We believe that the APC assignments for these CPT codes 
continue to be appropriate. We used most of the submitted claims for 
calculating medians for these codes. We believe the resource use and 
clinical coherence in the current APCs are appropriate.
New Orphan Drug
    Comment: We received a comment requesting that arsenic trioxide 
(Trisenox) be considered as a single-indication orphan drug for 
Medicare OPPS. The drug has orphan status from the FDA for treatment of 
multiple myeloma, myelodysplastic syndrome, chronic myeloid leukemia, 
and chronic lymphocystic anemia.
    Response: After careful evaluation, we agree that arsenic trioxide 
does meet our criteria for special payment as a single indication 
orphan drug. As we stated in our final rule (68 FR 63453), we are 
setting payment under the 2004 OPPS for single indication orphan drugs 
at 88 percent of the average wholesale price listed for these drugs in 
the April 1, 2003 single drug pricer unless we are presented with 
verifiable information that shows that our payment rate does not 
reflect the price that is widely available to the hospital market. For 
2004, the payment rate for Trisenox will be $34.32 per unit.

C. Revisions and Corrections to Addenda A and B

    As a result of a HCPCS coding change, the relative weight, payment 
rate, and minimum unadjusted copayment for APC 0012 as published on 
page 63478, are incorrect. Code 11057 moved from APC 0012 to APC 0013, 
and we failed to update the APCs in time for the final rule. The 
correct values for APC 0012 are: relative weight, 0.7612; payment rate, 
$41.53; and minimum unadjusted copayment amount, $8.31. The correct 
values for APC 0013 are relative weight, 1.1302; payment rate, $61.66; 
and the minimum unadjusted copayment is unchanged. These values are 
listed in bold type in Table 1 below.
    As a result of our use of external data, APC 0108 has new values in 
Addendum A on page 63479. The correct relative weight is 452.6995, the 
payment rate increases to $24,669.74, and the minimum unadjusted 
copayment becomes $4,939.95. These values are listed in bold type in 
Table 1 below.
    In response to a comment, we moved HCPCS code 43752 from APC 0272 
to APC 0121. This move resulted in new Addendum A values for both of 
these APCs. The incorrect values on page 63479 for APC 0121 are 
corrected as follows: relative weight, 2.1114; payment rate, $115.2; 
and minimum unadjusted copayment amount, $23.04.
    On page 63481, the incorrect values for APC 0272 are corrected as 
follows: relative weight, 1.4184; payment rate, $77.39; and minimum 
unadjusted copayment, $15.48.
    In response to a comment that we overlooked, we moved CPT code 
38230 from APC 0123 to APC 0111. This resulted in new values for APC 
0123 in Addendum A. The values on page 63479 are corrected as follows: 
relative weight, 6.1499; payment rate, $335.54; and minimum unadjusted 
copayment amount, $67.11. There are no changes to the values for APC 
0111. These values are listed in bold type in Table 1 below.
    On page 63482, the values for APC 0321 are incorrect due to a 
change in the status indicator for HCPCS code 90901. The status 
indicator was changed to ``A'' and, therefore, does not contribute to 
the calculation of the APC median. We correct the values for APC 0321 
by

[[Page 75446]]

replacing the values on page 63482 with the following: relative weight, 
1.4817; payment rate, $80.84; and minimum unadjusted copayment amount, 
$16.17. These values are listed in bold type in Table 1 below.
    The status indicator for HCPCS code 96105 was changed to ``A'' and, 
therefore, should not contribute to the calculation of the APC median. 
The values for APC 0373 on page 63482 are incorrect because the code 
(96105) was used under its previous status indicator ``X'' and was 
therefore included in the media calculation. We replace the values in 
Addendum A on page 63482 with the following correct values: relative 
weight, 2.3288; payment rate, $127.06; and minimum unadjusted copayment 
amount, $25.41. These values are listed in bold type in Table 1 below.
    The relative weight, copayment and payment rates are incorrect for 
APC 0384 as published on page 63482. Two HCPCS codes (43268 and 43269) 
were moved from APC 0151 into APC 0384, and those changes were not 
reflected in the published Addendum A. We replace the values for APC 
0384 with the following: relative weight, 36.54; payment rate, 
$1,993.66; national unadjusted copayment, $433.01; and minimum 
unadjusted copayment, $398.73. The values for APC 0151 do not change. 
These values are listed in bold type in Table 1 below.
    APC 0413 was listed in Addendum A on page 63483 in error. No codes 
are assigned to this APC, so it no longer exists. We remove APC 0413.
    We correct Addenda A and B by adding the relative weight for APC 
0734 on page 63484 in Addendum A and for CPT/HCPCS codes C1774 and 
Q0137 on pages 63610 and 36350, respectively, in Addendum B. The 
relative weight is 0.0594 for both of these codes.
    The values for APC 1604 are incorrect as published on page 63486. 
Additional data were available but inadvertently were not used in the 
median calculation for this APC. The new values reflect use of the 
additional data. We correct the values for APC 1604 as follows: 
relative weight, 20.2752; payment rate, $1,106.24; and minimum 
unadjusted copayment, $221.25. These values are listed in bold type in 
Table 1 below.
    On page 63487, the payment rate for APC 9012 is corrected to 
reflect its new status as a single-indication orphan drug. We correct 
the payment rate to $34.32 and the minimum unadjusted copayment to 
$6.86.
    On page 63488, the descriptor for APC 9116 is incorrect. We correct 
it to read ``Inj. Ertapenem sodium, per 500 mg.''
    For the following CPT/HCPCS codes on the pages identified, 
beginning on page 63488 and concluding on page 63644, we listed 
outdated descriptors. We correct the descriptor on page 63488 for code 
0002T; page 63496 for code 15852; page 63548 for code 55870; page 63619 
for code E0141; page 63622 for codes E0973 and E0974; page 63623 for 
code E0978; page 63624 for code E1226; page 63627 for codes G0210, 
G0213, G0214, G0215, G0230, G0246, G0247, G0248; page 63630 for code 
J1563; page 63631 for codes J2260 and J2324; page 63633 for code J8700; 
page 63636 for code K0560; page 63637 for codes K0600, K0607, K0614, 
K0615, K0616, and K0617; page 63643 for codes L4350, L4360, and L4386; 
and on page 63644 for codes L5646 and L5648. See Table 2--Corrections 
to Addendum B of the November 7, 2003, Final Rule for corrections to 
Addendum B for the codes identified above.
    On page 63627, CPT/HCPCS G0244 is listed with an incorrect relative 
weight, payment rate, and copayment amount. We correct the current 
relative weight, payment rate, and copayment, by inserting 6.6961, 
$365.35, and $73.07, respectively. See Table 2 below for the corrected 
values.
    On page 63634, CPT/HCPCS J9017 is listed with an incorrect relative 
weight, payment rate, and copayment. J9017 is an orphan drug and is 
reimbursed at 88 percent of AWP. We correct the addendum by replacing 
current values with a payment rate of $34.32 and minimum unadjusted 
copayment of $6.86.
    On page 63590, we incorrectly assigned status indicator A to CPT/
HCPCS 90918 through 90925. These codes are replaced by G0320 through 
G0327. Therefore, codes 90918 through 90925 are assigned status 
indicator E. On page 63590, for CPT/HCPCS 90918, 90919, 90920, 90921, 
90922, 90924, and 90925, we remove the status indicator A and insert 
status indicator E. See Table 2--Corrections to Addendum B of the 
November 7, 2003, Final Rule for corrections to Addendum B for the 
codes identified above.
    The following CPT/HCPCS codes were omitted from Addendum B of the 
November 7, 2003, final rule: 99375, status indicator E, home health 
care supervision, effective 1/1/03; 99378, status indicator E, hospice 
care supervision, effective 1/1/03; G0308, status indicator A, 
condition NI, ESRD related svc 4+mo<2yrs; G0309, status indicator A, 
condition NI, ESRD related svc 2-3mo<2rs; G0310, status indicator A, 
condition NI, ESRD related svc 1vst<2yr; G0311, status indicator A, 
condition NI, ESRD related svs 4+mo 2-11 yr; G0312, status indicator A, 
condition NI, ESRD related svs 2-3 mo 2-11 yr; G0313, status indicator 
A, condition NI, ESRD related svs 1 mon 2-11 yr; G0314, status 
indicator A, condition NI, ESRD related svs 4+mo 12-19; G0315, status 
indicator A, condition NI, ESRD related svs 2-3 mo 12-19; G0316, status 
indicator A, condition NI, ESRD related svs 1 vst 12-19y; G0317, status 
indicator A, condition NI, ESRD related svs 4+mo 20+yrs; G0318, status 
indicator A, condition NI, ESRD related svs 2-3 mo 20+y; G0319, status 
indicator A, condition NI, ESRD related svs 1 visit 20+y; G0320, status 
indicator A, condition NI, ESRD related svs home under 2; G0321, status 
indicator A, condition NI, ESRD related svs home mo<2ys; G0322, status 
indicator A, condition NI, ESRD related svs home mo12-19; G0328, status 
indicator A, condition NI, fecal blood scrn immunoassay; all effective 
1/1/04; and P9603, status indicator A, One-way allow prorated miles, 
effective 1/1/92. See Table 2--Corrections to Addendum B of the 
November 7, 2003, Final Rule for corrections to Addendum B for the 
codes identified above.
    On page 63608, we incorrectly assigned status indicator B and 
condition NI to CPT/HCPCS A9527, I-131 tositumomab therapeutic. New 
code A9534, with the same descriptor, replaces A9527, effective 1/1/04. 
A9527 is removed effective 1/1/04, with no grace period. On page 63608, 
for CPT/HCPCS A9527, we remove the status indicator of B and insert a 
status indicator of D. We remove the condition NI and insert a 
condition of DNG. See Table 2--Corrections to Addendum B of the 
November 7, 2003, Final Rule for corrections to Addendum B for the code 
identified above.
    For the CPT/HCPCS codes on the pages identified, beginning on page 
63490 and concluding on page 63653, we incorrectly listed status 
indicator E instead of status indicator B. We correct the status 
indicator on page 63490 for codes 0054T, 0055T, 0056T, 0057T, 0060T, 
and 0061T; page 63598 for codes 99002 and 99140; page 63604 for codes 
A4671, A4672, and A4673; page 63605 for codes A4674 and A4728; page 
63624 for code E1634; page 63633 for J7330; page 63641 for L3350; and 
page 63653 for code V2761. See Table 2--Corrections to Addendum B of 
the November 7, 2003, Final Rule for corrections to Addendum B for the 
codes identified above.
    For the following CPT/HCPCS codes on the pages identified, 
beginning on page 63490 and concluding on page 63619, we incorrectly 
listed condition

[[Page 75447]]

DG (deleted with grace). These codes are not deleted for 2004, and the 
condition should be blank. We correct the condition on page 63490 for 
codes 00546, 00548, 00550, 00560, 00562, 00563, and 00566; and page 
63539 for codes 47135, 47136, 47300, and 47350; and page 63619 for 
E0165. See Table 2--Corrections to Addendum B of the November 7, 2003, 
Final Rule for corrections to Addendum B for the codes identified 
above.
    On page 63569, CPT/HCPCS 76977 was inadvertently assigned an 
incorrect status indicator. We remove status indicator S and insert 
status indicator X. The payment rates are correct as is. See Table 2--
Corrections to Addendum B of the November 7, 2003, Final Rule for 
corrections to Addendum B for the code identified above.
    On page 63590, CPT/HCPCS 92019 was assigned an incorrect status 
indicator. We remove status indicator S and insert status indicator T. 
The payment rates are correct as is. See Table 2--Corrections to 
Addendum B of the November 7, 2003, Final Rule for corrections to 
Addendum B for the code identified above.
    On page 63608, CPT/HCPCS A9700 was incorrectly assigned an APC, 
relative weight, payment rate, and copayment. A9700 is not payable 
under OPPS, and no payment should be made for this service. We remove 
the APC, relative weight, payment rate, and minimum unadjusted 
copayment. See Table 2--Corrections to Addendum B of the November 7, 
2003, Final Rule for corrections to Addendum B for the code identified 
above.
    On page 63588, CPT/HCPCS codes 90296 and 90581 are incorrectly 
assigned a status indicator, APC, relative weight, payment rate, and 
copayment. Effective 1/1/04, codes 90296 and 90581 are packaged 
services and therefore are assigned status indicator N. For codes 90296 
and 90581, we remove status indicator K, APC, payment rate, and minimum 
unadjusted copayment, and insert status indicator N. See Table 2--
Corrections to Addendum B of the November 7, 2003, Final Rule for 
corrections to Addendum B for the codes identified above.
    On page 63623, CPT/HCPCS code E1065 omits condition DG. This code 
is deleted with grace period effective January 1, 2004. We correct this 
by inserting DG in the condition column.
    Many codes were incorrectly listed with status indicator A that 
should be listed with the new status indicator Y, indicating that the 
code is not paid under OPPS, but should be billed to the Durable 
Medical Equipment Regional Carrier (DMERC). They are listed in Tables 
3-5. In addition, codes A4232, A4632, E0188, E0189, E0218, E0602, 
E0740, E0760, E0765, K0610, K0611, K0612, and K0613 were incorrectly 
listed with status indicator E, but should be listed with status 
indicator Y. Codes E0967, E0969, E0977, E0980, E0994, E0997, E0998, 
E0999, E1001, E1035, E1065, and E1227 were incorrectly listed with 
status indicator B, but should be listed with status indicator Y. For 
all these codes, we remove the current status indicator and insert 
status indicator Y. See Tables 3-5 for a list of codes for which the 
status indicator has changed from A, E, or B to Y.
    On page 63471 of the November 7, 2002 Final Rule, we specify that 
HCPCS codes for drugs, biologicals, and radiopharmaceuticals that are 
new for 2004 yet have no predecessor will be assigned packaged status 
for 2004.
    On pages 63608 and 63652, HCPCS codes A9526 and Q4078, 
respectively, were incorrectly assigned a status indicator, APC, 
relative weight, payment rate, and copayment. Effective 1/1/04, codes 
A9526 and Q4078 are packaged services and therefore are assigned status 
indicator N. For these codes, we remove status indicator K, APC, 
payment rate, and minimum unadjusted copayment, and insert status 
indicator N.
    On page 63415 of the November 7, 2003 Final Rule, we state that we 
plan to delete HCPCS C1088 effective 1/1/04. Addendum B does not list 
this code as deleted. For HCPCS C1088, we remove status indicator T, 
APC, payment rate, and minimum unadjusted copayment, and insert status 
indicator D and condition DNG (deleted with no grace period).

III. Waiver of 30-Day Delay in Effective Date

    We ordinarily provide a 30-day delay in the effective date of the 
provisions of a notice. Section 553(d) of the Administrative Procedure 
Act (5 U.S.C. 553(d)) ordinarily requires a 30-day delay in the 
effective date of final rules after the date of their publication in 
the Federal Register. This 30-day delay in effective date can be 
waived, however, if an agency finds good cause that the delay is 
impracticable, unnecessary, or contrary to the public interest. In 
addition, section 1871(e)(1) of the Social Security Act, as amended by 
section 903(b)(1) of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (DIMA), also requires that a substantive 
change in a regulation shall not become effective before the end of the 
30-day period that begins on the date that the Secretary has issued or 
published the substantive change. Section 1871(e)(1) of the Social 
Security Act, as amended by section 903(b)(1) of DIMA, provides an 
exception to that requirement if the Secretary finds that the waiver of 
such 30-day period is necessary to comply with statutory requirements 
or that the application of such 30-day period is contrary to the public 
interest. The agency must incorporate a statement of the good cause 
finding and rationale in the published rule.
    In this case, we believe that it is in the public interest to make 
the corrections identified above effective January 1, 2004 without the 
30-day delay in effective date. In most cases, these errors were the 
result of our inadvertent failure to address a number of public 
comments that were received timely, incorrect or potentially misleading 
responses, and omissions and typographical errors in Addenda A and B. 
In addition, we have added information to the addenda that was not 
available when we published the November 7, 2003 final rule. This 
information does not affect payment under the OPPS. A delay in the 
effective date of this notice would result, in most cases, in 
underpayment of hospitals beginning January 1, 2004. If we did not make 
these changes, hospitals would be paid improperly, and beneficiaries' 
access to care may be impeded. Therefore, we find good cause to waive 
the 30-day delay in effective date.

                                     Table 1.--Addendum A Corrections as Corrected by This Federal Register Document
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                             National         Minimum
                APC                         Group title              Status indicator        Relative      Payment rate     unadjusted      unadjusted
                                                                                              weight                         copayment       copayment
--------------------------------------------------------------------------------------------------------------------------------------------------------
0012..............................  Level I Debridement &        T......................          0.7612           41.53           11.18            8.31
                                     Destruction.
0013..............................  Level II Debridement &       T......................          1.1302           61.66           14.20           12.33
                                     Destruction.

[[Page 75448]]

 
0108..............................  Insertion/Replacement/       T......................        452.6995        24699.74  ..............         4939.95
                                     Repair of Cardioverter-
                                     Defibrillator Leads.
0121..............................  Level I Tube changes and     T......................          2.1114          115.20           43.80           23.04
                                     Repositioning.
0123..............................  Bone Marrow Harvesting and   S......................          6.1499          335.54  ..............           67.11
                                     Bone Marrow/Stem Cell
                                     Transplant.
0272..............................  Level I Fluoroscopy........  X......................          1.4184           77.39           38.36           15.48
0321..............................  Biofeedback and Other        S......................          1.4817           80.84           21.78           16.17
                                     Training.
0339..............................  Observation................  S......................          6.6961          365.35  ..............           73.07
0373..............................  Neuropsychological Testing.  X......................          2.3288          127.06  ..............           25.41
0384..............................  GI Procedures with Stents..  T......................         36.5400         1993.66          433.01          398.73
APC 0413 is deleted
0734..............................  Injection, darbepoetin alfa  K......................          0.0594            3.24  ..............            0.65
                                     (for non-ESRD, per 1 mcg.
9012..............................  Arsenic Trioxide...........  K......................  ..............           34.32  ..............           .6.86
1604..............................  IN 111 capromab pendetide,   K......................         20.2752         1106.24  ..............          221.25
                                     per dose.
--------------------------------------------------------------------------------------------------------------------------------------------------------


                                     Table 2.--Addendum B Corrections as Corrected by This Federal Register Document
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                  National     Minimum
     CPT/HCPCS        Status  indicator       Condition              Description             APC        Relative     Payment     unadjusted   unadjusted
                                                                                                         weight        rate      copayment    copayment
--------------------------------------------------------------------------------------------------------------------------------------------------------
0002T..............  C.................  DG................  endo repair abd aa aorto    ...........  ...........  ...........  ...........  ...........
                                                              uni.
00546..............  C.................  ..................  Anesth, lung, chest wall    ...........  ...........  ...........  ...........  ...........
                                                              surg.
00548..............  N.................  ..................  Anesth, trachea, bronchi    ...........  ...........  ...........  ...........  ...........
                                                              surg.
0054T..............  B.................  NI................  Bone surgery using          ...........  ...........  ...........  ...........  ...........
                                                              computer.
00550..............  N.................  ..................  Anesth, sternal             ...........  ...........  ...........  ...........  ...........
                                                              debridement.
0055T..............  B.................  NI................  Bone surgery using          ...........  ...........  ...........  ...........  ...........
                                                              computer.
00560..............  C.................  ..................  Anesth, open heart surgery  ...........  ...........  ...........  ...........  ...........
00562..............  C.................  ..................  Anesth, open heart surgery  ...........  ...........  ...........  ...........  ...........
00563..............  N.................  ..................  Anesth, heart proc w/pump.  ...........  ...........  ...........  ...........  ...........
00566..............  N.................  ..................  Anesth, cabg w/o pump.....  ...........  ...........  ...........  ...........  ...........
0056T..............  B.................  NI................  Bone surgery using          ...........  ...........  ...........  ...........  ...........
                                                              computer.
0057T..............  B.................  NI................  Uppr gi scope w/ thrml      ...........  ...........  ...........  ...........  ...........
                                                              txmnt.
0060T..............  B.................  NI................  Electrical impedance scan.  ...........  ...........  ...........  ...........  ...........
0061T..............  B.................  NI................  Destruction of tumor,       ...........  ...........  ...........  ...........  ...........
                                                              breast.
11001..............  T.................  ..................  Debride infected skin add-         0012       0.7612        41.53        11.18         8.31
                                                              on.
11055..............  T.................  ..................  Trim skin lesion..........         0012       0.7612        41.53        11.18         8.31
11056..............  T.................  ..................  Trim skin lesions, 2 to 4.         0012       0.7612        41.53        11.18         8.31
11057..............  T.................  ..................  Trim skin lesions, over 4.         0013       1.1302        61.66        14.20        12.33
11200..............  T.................  ..................  Removal of skin tags......         0013       1.1302        61.66        14.20        12.33
11300..............  T.................  ..................  Shave skin lesion.........         0012       0.7612        41.53        11.18         8.31
11301..............  T.................  ..................  Shave skin lesion.........         0012       0.7612        41.53        11.18         8.31
11302..............  T.................  ..................  Shave skin lesion.........         0012       0.7612        41.53        11.18         8.31
11305..............  T.................  ..................  Shave skin lesion.........         0013       1.1302        61.66        14.20        12.33
11306..............  T.................  ..................  Shave skin lesion.........         0013       1.1302        61.66        14.20        12.33
11307..............  T.................  ..................  Shave skin lesion.........         0013       1.1302        61.66        14.20        12.33
11308..............  T.................  ..................  Shave skin lesion.........         0013       1.1302        61.66        14.20        12.33
11310..............  T.................  ..................  Shave skin lesion.........         0013       1.1302        61.66        14.20        12.33
11311..............  T.................  ..................  Shave skin lesion.........         0013       1.1302        61.66        14.20        12.33
11312..............  T.................  ..................  Shave skin lesion.........         0013       1.1302        61.66        14.20        12.33
11730..............  T.................  ..................  Removal of nail plate.....         0013       1.1302        61.66        14.20        12.33
11732..............  T.................  ..................  Remove nail plate, add-on.         0012       0.7612        41.53        11.18         8.31
11900..............  T.................  ..................  Injection into skin                0012       0.7612        41.53        11.18         8.31
                                                              lesions.
11901..............  T.................  ..................  Added skin lesions                 0012       0.7612        41.53        11.18         8.31
                                                              injection.
15786..............  T.................  ..................  Abrasion, lesion, single..         0012       0.7612        41.53        11.18         8.31
15787..............  T.................  ..................  Abrasion, lesions, add-on.         0013       1.1302        61.66        14.20        12.33
15788..............  T.................  ..................  Chemical peel, face,               0012       0.7612        41.53        11.18         8.31
                                                              epiderm.
15792..............  T.................  ..................  Chemical peel, nonfacial..         0012       0.7612        41.53        11.18         8.31
15793..............  T.................  ..................  Chemical peel, nonfacial..         0012       0.7612        41.53        11.18         8.31
15852..............  X.................  ..................  Dressing change not for            0340       0.6314        34.45  ...........         6.89
                                                              burn.
16000..............  T.................  ..................  Initial treatment of               0012       0.7612        41.53        11.18         8.31
                                                              burn(s).
16020..............  T.................  ..................  Treatment of burn(s)......         0013       1.1302        61.66        14.20        12.33
16025..............  T.................  ..................  Treatment of burn(s)......         0012       0.7612        41.53        11.18         8.31
17250..............  T.................  ..................  Chemical cautery, tissue..         0013       1.1302        61.66        14.20        12.33
17271..............  T.................  ..................  Destruction of skin                0013       1.1302        61.66        14.20        12.33
                                                              lesions.
17340..............  T.................  ..................  Cryotherapy of skin.......         0012       0.7612        41.53        11.18         8.31
17360..............  T.................  ..................  Skin peel therapy.........         0012       0.7612        41.53        11.18         8.31

[[Page 75449]]

 
17380..............  T.................  ..................  Hair removal by                    0012       0.7612        41.53        11.18         8.31
                                                              electrolysis.
31502..............  T.................  ..................  Change of windpipe airway.         0121       2.1114       115.20        43.80        23.04
38230..............  S.................  ..................  Bone marrow collection....         0111      13.1719       718.67       200.18       143.73
38240..............  S.................  ..................  Bone marrow/stem                   0123       6.1499       335.54  ...........        67.11
                                                              transplant.
38241..............  S.................  ..................  Bone marrow/stem                   0123       6.1499       335.54  ...........        67.11
                                                              transplant.
43219..............  T.................  ..................  Esophagus endoscopy.......         0384      36.5400      1993.66       433.01       398.73
43256..............  T.................  ..................  Uppr gi endoscopy w stent.         0384      36.5400      1993.66       433.01       398.73
43268..............  T.................  ..................  Endo                               0384      36.5400      1993.66       433.01       398.73
                                                              cholangiopancreatograph.
43269..............  T.................  ..................  Endo                               0384      36.5400      1993.66       433.01       398.73
                                                              cholangiopancreatograph.
43752..............  T.................  ..................  Nasal/orogastric w/stent..         0121       2.1114       115.20        43.80        23.04
43760..............  T.................  ..................  Change gastrostomy tube...         0121       2.1114       115.20        43.80        23.04
43761..............  T.................  ..................  Reposition gastrostomy             0121       2.1114       115.20        43.80        23.04
                                                              tube.
44370..............  T.................  ..................  Small bowel endoscopy/             0384      36.5400      1993.66       433.01       398.73
                                                              stent.
44379..............  T.................  ..................  S bowel endoscope w/stent.         0384      36.5400      1993.66       433.01       398.73
44383..............  T.................  ..................  Ileoscopy w/stent.........         0384      36.5400      1993.66       433.01       398.73
44397..............  T.................  ..................  Colonoscopy w/stent.......         0384      36.5400      1993.66       433.01       398.73
44500..............  T.................  ..................  Intro, gastrointestinal            0121       2.1114       115.20        43.80        23.04
                                                              tube.
45327..............  T.................  ..................  Proctosigmoidoscopy w/             0384      36.5400      1993.66       433.01       398.73
                                                              stent.
45345..............  T.................  ..................  Sigmoidoscopy w/stent.....         0384      36.5400      1993.66       433.01       398.73
45387..............  T.................  ..................  Colonoscopy w/stent.......         0384      36.5400      1993.66       433.01       398.73
46916..............  T.................  ..................  Cryosurgery, anal                  0013       1.1302        61.66        14.20        12.33
                                                              lesion(s).
47135..............  C.................  ..................  Transplantation of liver..  ...........  ...........  ...........  ...........  ...........
47136..............  C.................  ..................  Transplantation of liver..  ...........  ...........  ...........  ...........  ...........
47300..............  C.................  ..................  Surgery for liver lesion..  ...........  ...........  ...........  ...........  ...........
47350..............  C.................  ..................  Repair liver wound........  ...........  ...........  ...........  ...........  ...........
51705..............  T.................  ..................  Change of bladder tube....         0121       2.1114       115.20        43.80        23.04
54050..............  T.................  ..................  Destruction, penis                 0013       1.1302        61.66        14.20        12.33
                                                              lesion(s).
54056..............  T.................  ..................  Cryosurgery, penis                 0012       0.7612        41.53        11.18         8.31
                                                              lesion(s).
55870..............  T.................  ..................  Electroejaculation........         0197       4.8280       263.42  ...........        52.68
62194..............  T.................  ..................  Replace/irrigate catheter.         0121       2.1114       115.20        43.80        23.04
69220..............  T.................  ..................  Clean out mastoid cavity..         0012       0.7612        41.53        11.18         8.31
70370..............  X.................  ..................  Throat x-ray & fluoroscopy         0272       1.4184        77.39        38.36        15.48
70371..............  X.................  ..................  Speech evaluation, complex         0272       1.4184        77.39        38.36        15.48
71023..............  X.................  ..................  Chest x-ray and                    0272       1.4184        77.39        38.36        15.48
                                                              fluoroscopy.
71034..............  X.................  ..................  Chest x-ray and                    0272       1.4184        77.39        38.36        15.48
                                                              fluoroscopy.
71090..............  X.................  ..................  X-ray & pacemaker                  0272       1.4184        77.39        38.36        15.48
                                                              insertion.
74340..............  X.................  ..................  X-ray guide for GI tube...         0272       1.4184        77.39        38.36        15.48
76000..............  X.................  ..................  Fluoroscope examination...         0272       1.4184        77.39        38.36        15.48
76120..............  X.................  ..................  Cine/video x-rays.........         0272       1.4184        77.39        38.36        15.48
76496..............  X.................  ..................  Fluoroscopic procedure....         0272       1.4184        77.39        38.36        15.48
76977..............  X.................  ..................  Us bone density measure...         0340       0.6314        34.45  ...........         6.89
90296..............  N.................  ..................  Diphtheria antitoxin......  ...........  ...........  ...........  ...........  ...........
90581..............  N.................  ..................  Anthrax vaccine, sc.......  ...........  ...........  ...........  ...........  ...........
90911..............  S.................  ..................  Biofeedback peri/uro/              0321       1.4817        80.84        21.78        16.17
                                                              rectal.
90918..............  E.................  ..................  ESRD related services,      ...........  ...........  ...........  ...........  ...........
                                                              month.
90919..............  E.................  ..................  ESRD related services,      ...........  ...........  ...........  ...........  ...........
                                                              month.
90920..............  E.................  ..................  ESRD related services,      ...........  ...........  ...........  ...........  ...........
                                                              month.
90921..............  E.................  ..................  ESRD related services,      ...........  ...........  ...........  ...........  ...........
                                                              month.
90922..............  E.................  ..................  ESRD related services, day  ...........  ...........  ...........  ...........  ...........
90923..............  E.................  ..................  ESRD related services, day  ...........  ...........  ...........  ...........  ...........
90924..............  E.................  ..................  ESRD related services, day  ...........  ...........  ...........  ...........  ...........
90925..............  E.................  ..................  ESRD related services, day  ...........  ...........  ...........  ...........  ...........
92019..............  T.................  ..................  Eye exam & treatment......         0699       2.2303       121.69        47.46        24.34
96100..............  X.................  ..................  Psychological testing.....         0373       2.3288       127.06  ...........        25.41
96110..............  X.................  ..................  Developmental test, lim...         0373       2.3288       127.06  ...........        25.41
96111..............  X.................  ..................  Developmental test, extend         0373       2.3288       127.06  ...........        25.41
96115..............  X.................  ..................  Neurobehavior status exam.         0373       2.3288       127.06  ...........        25.41
96117..............  X.................  ..................  Neuropsych test battery...         0373       2.3288       127.06  ...........        25.41
96920..............  T.................  ..................  Laser tx, skin < 250 sq cm         0012       0.7612        41.53        11.18         8.31
96921..............  T.................  ..................  Laser tx, skin 250-500 sq          0012       0.7612        41.53        11.18         8.31
                                                              cm.
96922..............  T.................  ..................  Laser tx, skin          0013       1.1302        61.66        14.20        12.33
                                                              500 sq cm.
99002..............  B.................  ..................  Device handling...........  ...........  ...........  ...........  ...........  ...........
99140..............  B.................  ..................  Emergency anesthesia......  ...........  ...........  ...........  ...........  ...........
99375..............  E.................  ..................  Home health care            ...........  ...........  ...........  ...........  ...........
                                                              supervision.
99378..............  E.................  ..................  Hospice care supervision..  ...........  ...........  ...........  ...........  ...........
A4671..............  B.................  NI................  Disposable cycler set.....  ...........  ...........  ...........  ...........  ...........
A4672..............  B.................  NI................  Drainage ext line,          ...........  ...........  ...........  ...........  ...........
                                                              dialysis.
A4673..............  B.................  NI................  Ext line w easy lock        ...........  ...........  ...........  ...........  ...........
                                                              connect.
A4674..............  B.................  NI................  Chem/antisept solution,     ...........  ...........  ...........  ...........  ...........
                                                              8oz.
A4728..............  B.................  NI................  Dialysate solution, non-    ...........  ...........  ...........  ...........  ...........
                                                              dex.

[[Page 75450]]

 
A9507..............  K.................  ..................  Indium/111 capromab                1604      20.2752      1106.24  ...........       221.25
                                                              pendetid.
A9526..............  N.................  NI................  Ammonia N-13, per dose....  ...........  ...........  ...........  ...........  ...........
A9527..............  D.................  DNG...............  I-131 tositumomab           ...........  ...........  ...........  ...........  ...........
                                                              therapeut.
A9700..............  E.................  ..................  Echocardiography Contrast.  ...........  ...........  ...........  ...........  ...........
C1088..............  D.................  DNG...............  Laser Optic Tr Sys........  ...........  ...........  ...........  ...........         0.65
C1774..............  K.................  DG................  Darbepoetin alfa, 1 mcg...         0734       0.0594         3.24  ...........  ...........
E0141..............  Y.................  ..................  Rigid wheeled walker adj/   ...........  ...........  ...........  ...........  ...........
                                                              fix.
E0165..............  A.................  ..................  Commode chair stationry     ...........  ...........  ...........  ...........  ...........
                                                              det.
E0973..............  B.................  ..................  W/Ch access det adj         ...........  ...........  ...........  ...........  ...........
                                                              armrest.
E0974..............  B.................  ..................  W/Ch access anti-rollback.  ...........  ...........  ...........  ...........  ...........
E0978..............  B.................  ..................  W/C acc,saf belt pelv       ...........  ...........  ...........  ...........  ...........
                                                              strap.
E1065..............  B.................  DG................  Wheelchair power            ...........  ...........  ...........  ...........  ...........
                                                              attachment.
E1226..............  B.................  ..................  W/C access fully            ...........  ...........  ...........  ...........  ...........
                                                              reclineback.
E1634..............  B.................  NI................  Peritoneal dialysis clamp.  ...........  ...........  ...........  ...........  ...........
G0210..............  S.................  ..................  PET img wholebody dxlung..  ...........  ...........      1450.00  ...........       290.00
G0213..............  S.................  ..................  PET img wholbody dx.......  ...........  ...........      1450.00  ...........       290.00
G0214..............  S.................  ..................  PET img wholebod init.....  ...........  ...........      1450.00  ...........       290.00
G0215..............  S.................  ..................  PETimg wholebod restag....  ...........  ...........      1450.00  ...........       290.00
G0230..............  S.................  ..................  PET myocard viability post  ...........  ...........      1450.00  ...........       290.00
G0244..............  S.................  ..................  Observ care by facility            0339       6.6961       365.35  ...........        73.07
                                                              topt.
G0246..............  V.................  ..................  Followup eval of foot pt           0600       0.9278        50.62  ...........        10.12
                                                              lop.
G0247..............  T.................  ..................  Routine footcare pt w lops         0009       0.6652        36.29         8.34         7.26
G0248..............  S.................  ..................  Demonstrate use home inr           1503  ...........       150.00  ...........        30.00
                                                              mon.
G0272..............  X.................  DG................  Naso/oro gastric tube pl           0272       1.4184        77.39        38.36        15.48
                                                              MD.
G0299..............  T.................  NF................  Inser/repos single                 0108     452.6995     24699.74  ...........      4939.95
                                                              icd+leads.
G0300..............  T.................  NF................  Insert reposit lead                0108     452.6995     24699.74  ...........      4939.95
                                                              dual+gen.
G0308..............  A.................  NI................  ESRD related svc 4+mo<2yrs  ...........  ...........  ...........  ...........  ...........
G0309..............  A.................  NI................  ESRD related svc 2-         ...........  ...........  ...........  ...........  ...........
                                                              3mo<2yrs.
G0310..............  A.................  NI................  ESRD related svc 1vst<2yr.  ...........  ...........  ...........  ...........  ...........
G0311..............  A.................  NI................  ESRD related svs 4+mo 2-11  ...........  ...........  ...........  ...........  ...........
                                                              yr.
G0312..............  A.................  NI................  ESRD relate svs 2-3 mo 2-   ...........  ...........  ...........  ...........  ...........
                                                              11 y.
G0313..............  A.................  NI................  ESRD related svs 1 mon 2-   ...........  ...........  ...........  ...........  ...........
                                                              11 y.
G0314..............  A.................  NI................  ESRD related svs 4+mo 12-   ...........  ...........  ...........  ...........  ...........
                                                              19.
G0315..............  A.................  NI................  ESRD related svs 2-3 mo 12- ...........  ...........  ...........  ...........  ...........
                                                              19.
G0316..............  A.................  NI................  ESRD related svs 1 vis/ 12- ...........  ...........  ...........  ...........  ...........
                                                              19y.
G0317..............  A.................  NI................  ESRD related svs 4+mo       ...........  ...........  ...........  ...........  ...........
                                                              20+yrs.
G0318..............  A.................  NI................  ESRD related svs 2-3 mo     ...........  ...........  ...........  ...........  ...........
                                                              20+y.
G0319..............  A.................  NI................  ESRD related svs 1 visit    ...........  ...........  ...........  ...........  ...........
                                                              20+y.
G0320..............  A.................  NI................  ESRD related svs home undr  ...........  ...........  ...........  ...........  ...........
                                                              2.
G0321..............  A.................  NI................  ESRD related svs home       ...........  ...........  ...........  ...........  ...........
                                                              mo<2ys.
G0322..............  A.................  NI................  ESRD related svs hom mo12-  ...........  ...........  ...........  ...........  ...........
                                                              19.
G0328..............  A.................  NI................  Fecal blood scrn            ...........  ...........  ...........  ...........  ...........
                                                              immunoassay.
J1563..............  K.................  ..................  IV immune globulin........         0905       0.8057        43.96  ...........         8.79
J2260..............  K.................  ..................  Inj milrinone lactate/5 MG         7007       0.2129        11.62  ...........         2.32
J2324..............  G.................  ..................  Nesiritide................         9114  ...........       151.62  ...........        22.66
J7330..............  B.................  ..................  Cultured chondrocytes       ...........  ...........  ...........  ...........  ...........
                                                              implnt.
J8700..............  K.................  ..................  Temozolomide..............         1086       0.0690         3.76  ...........         0.75
J9017..............  K.................  ..................  Arsenic trioxide..........         9012  ...........        34.32  ...........         6.86
K0560..............  N.................  DG................  MCP joint 2-piece for       ...........  ...........  ...........  ...........  ...........
                                                              implnt.
K0600..............  Y.................  NF................  Functional                  ...........  ...........  ...........  ...........  ...........
                                                              neuromuscularstim.
K0607..............  Y.................  NF................  Repl batt for AED.........  ...........  ...........  ...........  ...........  ...........
K0614..............  Y.................  DG................  Chem/antisept solution,     ...........  ...........  ...........  ...........  ...........
                                                              8oz.
K0615..............  Y.................  DG................  SGD prerec mes 8min <=20min.
K0616..............  Y.................  DG................  SGD prerec mes20min <=40min.
K0617..............  Y.................  DG................  SGD prerec mes   ...........  ...........  ...........  ...........  ...........
                                                              40min.
L3350..............  B.................  ..................  Shoe heel wedge...........  ...........  ...........  ...........  ...........  ...........
L4350..............  A.................  ..................  Ankle control orthosi       ...........  ...........  ...........  ...........  ...........
                                                              prefab.
L4360..............  A.................  ..................  Pneumati walking boot       ...........  ...........  ...........  ...........  ...........
                                                              prefab.
L4386..............  A.................  ..................  Non-pneum walk boot prefab  ...........  ...........  ...........  ...........  ...........
L5646..............  A.................  ..................  Below knee cushion socket.  ...........  ...........  ...........  ...........  ...........
L5648..............  A.................  ..................  Above knee cushion socket.  ...........  ...........  ...........  ...........  ...........
P9603..............  A.................  ..................  One-way allow prorated      ...........  ...........  ...........  ...........  ...........
                                                              miles.
Q0137..............  K.................  NI................  Darbepoetin alfa, non esrd         0734       0.0594         3.24  ...........         0.65
Q4078..............  N.................  DG................  Ammonia N-13, per dose....  ...........  ...........  ...........  ...........  ...........
V2761..............  B.................  NI................  Mirror coating............  ...........  ...........  ...........  ...........  ...........
--------------------------------------------------------------------------------------------------------------------------------------------------------


[[Page 75451]]


    Table 3.-- HCPCS With Status Indicators That Changed From B to Y
------------------------------------------------------------------------
            CPT/ HCPCS                           Description
------------------------------------------------------------------------
E0967.............................  Wheelchair hand rims.
E0969.............................  Wheelchair narrowing device.
E0977.............................  Wheelchair wedge cushion.
E0980.............................  Wheelchair safety vest.
E0994.............................  Wheelchair arm rest.
E0997.............................  Wheelchair caster w/ a fork.
E0998.............................  Wheelchair caster w/o a fork.
E0999.............................  Wheelchr pneumatic tire w/wh.
E1001.............................  Wheelchair wheel.
E1035.............................  Patient transfer system.
E1065.............................  Wheelchair power attachment.
E1227.............................  Wheelchair spec sz spec ht a.
------------------------------------------------------------------------


    Table 4.--HCPCS With Status Indicators That Changed From A to Y.
------------------------------------------------------------------------
             CPT/HCPCS                           Description
------------------------------------------------------------------------
A4221.............................  Maint drug infus cath per wk.
A4222.............................  Drug infusion pump supplies.
A4230.............................  Infus insulin pump non needle.
A4231.............................  Infusion insulin pump needle.
A4253.............................  Blood glucose/reagent strips.
A4254.............................  Battery for glucose monitor.
A4255.............................  Glucose monitor platforms.
A4256.............................  Calibrator solution/chips.
A4257.............................  Replace Lensshield Cartridge.
A4258.............................  Lancet device each.
A4259.............................  Lancets per box.
A4265.............................  Paraffin.
A4556.............................  Electrodes, pair.
A4557.............................  Lead wires, pair.
A4558.............................  Conductive paste or gel.
A4595.............................  TENS suppl 2 lead per month.
A4608.............................  Transtracheal oxygen cath.
A4609.............................  Trach suction cath clsed sys.
A4610.............................  Trach sctn cath 72h clsedsys.
A4611.............................  Heavy duty battery.
A4612.............................  Battery cables.
A4613.............................  Battery charger.
A4615.............................  Cannula nasal.
A4616.............................  Tubing (oxygen) per foot.
A4617.............................  Mouth piece.
A4618.............................  Breathing circuits.
A4619.............................  Face tent.
A4620.............................  Variable concentration mask.
A4621.............................  Tracheotomy mask or collar.
A4624.............................  Tracheal suction tube.
A4628.............................  Oropharyngeal suction cath.
A4630.............................  Repl bat t.e.n.s. own by pt.
A4631.............................  Wheelchair battery.
A4633.............................  Uvl replacement bulb.
A4635.............................  Underarm crutch pad.
A4636.............................  Handgrip for cane etc.
A4637.............................  Repl tip cane/crutch/walker.
A4639.............................  Infrared ht sys replcmnt pad.
A4640.............................  Alternating pressure pad.
A7000.............................  Disposable canister for pump.
A7001.............................  Nondisposable pump canister.
A7002.............................  Tubing used w suction pump.
A7003.............................  Nebulizer administration set.
A7004.............................  Disposable nebulizer sml vol.
A7005.............................  Nondisposable nebulizer set.
A7006.............................  Filtered nebulizer admin set.
A7007.............................  Lg vol nebulizer disposable.
A7008.............................  Disposable nebulizer prefill.
A7009.............................  Nebulizer reservoir bottle.
A7010.............................  Disposable corrugated tubing.
A7011.............................  Nondispos corrugated tubing.
A7012.............................  Nebulizer water collec devic.
A7013.............................  Disposable compressor filter.
A7014.............................  Compressor nondispos filter.
A7015.............................  Aerosol mask used w nebulize.
A7016.............................  Nebulizer dome & mouthpiece.
A7017.............................  Nebulizer not used w oxygen.
A7018.............................  Water distilled w/nebulizer.
A7019.............................  Saline solution dispenser.
A7020.............................  Sterile H2O or NSS w lgv neb.
A7025.............................  Replace chest compress vest.
A7026.............................  Replace chst cmprss sys hose.
A7030.............................  CPAP full face mask.
A7031.............................  Replacement facemask interfa.
A7032.............................  Replacement nasal cushion.
A7033.............................  Replacement nasal pillows.
A7034.............................  Nasal application device.
A7035.............................  Pos airway press headgear.
A7036.............................  Pos airway press chinstrap.
A7037.............................  Pos airway pressure tubing.
A7038.............................  Pos airway pressure filter.
A7039.............................  Filter, non disposable w pap.
A7044.............................  PAP oral interface.
E0100.............................  Cane adjust/fixed with tip.
E0105.............................  Cane adjust/fixed quad/3 pro.
E0110.............................  Crutch forearm pair.
E0111.............................  Crutch forearm each.
E0112.............................  Crutch underarm pair wood.
E0113.............................  Crutch underarm each wood.
E0114.............................  Crutch underarm pair no wood.
E0116.............................  Crutch underarm each no wood.
E0117.............................  Underarm springassist crutch.
E0130.............................  Walker rigid adjust/fixed ht.
E0135.............................  Walker folding adjust/fixed.
E0141.............................  Rigid wheeled walker adj/fix.
E0142.............................  Walker rigid wheeled with se.
E0143.............................  Walker folding wheeled w/o s.
E0144.............................  Enclosed walker w rear seat.
E0145.............................  Walker whled seat/crutch att.
E0146.............................  Folding walker wheels w seat.
E0147.............................  Walker variable wheel resist.
E0148.............................  Heavyduty walker no wheels.
E0149.............................  Heavy duty wheeled walker.
E0153.............................  Forearm crutch platform atta.
E0154.............................  Walker platform attachment.
E0155.............................  Walker wheel attachment, pair.
E0156.............................  Walker seat attachment.
E0157.............................  Walker crutch attachment.
E0158.............................  Walker leg extenders set of 4.
E0159.............................  Brake for wheeled walker.
E0160.............................  Sitz type bath or equipment.
E0161.............................  Sitz bath/equipment w/faucet.
E0162.............................  Sitz bath chair.
E0163.............................  Commode chair stationry fxd.
E0164.............................  Commode chair mobile fixed a.
E0165.............................  Commode chair stationry det.
E0166.............................  Commode chair mobile detach.
E0167.............................  Commode chair pail or pan.
E0168.............................  Heavyduty/wide commode chair.
E0169.............................  Seatlift incorp commodechair.
E0175.............................  Commode chair foot rest.
E0176.............................  Air pressre pad/cushion nonp.
E0177.............................  Water press pad/cushion nonp.
E0178.............................  Gel pressre pad/cushion nonp.
E0179.............................  Dry pressre pad/cushion nonp.
E0180.............................  Press pad alternating w pump.
E0181.............................  Press pad alternating w/pump.
E0182.............................  Pressure pad alternating pump.
E0184.............................  Dry pressure mattress.
E0185.............................  Gel pressure mattress pad.
E0186.............................  Air pressure mattress.
E0187.............................  Water pressure mattress.
E0191.............................  Protector heel or elbow.
E0192.............................  Pad wheelchr low press/posit.
E0193.............................  Powered air flotation bed.
E0194.............................  Air fluidized bed.
E0196.............................  Gel pressure mattress.
E0197.............................  Air pressure pad for mattress.
E0198.............................  Water pressure pad for mattr.
E0199.............................  Dry pressure pad for mattress.
E0200.............................  Heat lamp without stand.
E0202.............................  Phototherapy light w/photom.
E0205.............................  Heat lamp with stand.
E0210.............................  Electric heat pad standard.
E0215.............................  Electric heat pad moist.
E0217.............................  Water circ heat pad w/pump.
E0220.............................  Hot water bottle.
E0221.............................  Infrared heating pad system.
E0225.............................  Hydrocollator unit.
E0230.............................  Ice cap or collar.
E0235.............................  Paraffin bath unit portable.
E0236.............................  Pump for water circulating p.
E0238.............................  Heat pad non-electric moist.
E0239.............................  Hydrocollator unit portable.
E0249.............................  Pad water circulating heat u.
E0250.............................  Hosp bed fixed ht w/mattress.
E0251.............................  Hosp bed fixed ht w/o mattress.
E0255.............................  Hospital bed var ht w/mattress.
E0256.............................  Hospital bed var ht w/o matt.
E0260.............................  Hosp bed semi-electr w/matt.
E0261.............................  Hosp bed semi-electr w/o matt.
E0265.............................  Hosp bed total electr w/matt.
E0266.............................  Hosp bed total elec w/o matt.
E0271.............................  Mattress innerspring.
E0272.............................  Mattress foam rubber.
E0275.............................  Bed pan standard.
E0276.............................  Bed pan fracture.
E0277.............................  Powered pres-redu air mattrs.
E0280.............................  Bed cradle.
E0290.............................  Hosp bed fx ht w/o rails w/m.
E0291.............................  Hosp bed fx ht w/o rail w/o.
E0292.............................  Hosp bed var ht w/o rail w/o.
E0293.............................  Hosp bed var ht w/o rail w/.
E0294.............................  Hosp bed semi-elect w/ mattrs.
E0295.............................  Hosp bed semi-elect w/o matt.
E0296.............................  Hosp bed total elect w/matt.
E0297.............................  Hosp bed total elect w/o matt.
E0305.............................  Rails bed side half length.
E0310.............................  Rails bed side full length.
E0316.............................  Bed safety enclosure.
E0325.............................  Urinal male jug-type.
E0326.............................  Urinal female jug-type.
E0371.............................  Nonpower mattress overlay.
E0372.............................  Powered air mattress overlay.
E0373.............................  Nonpowered pressure mattress.
E0424.............................  Stationary compressed gas 02.
E0431.............................  Portable gaseous 02.
E0434.............................  Portable liquid 02.
E0439.............................  Stationary liquid 02.
E0441.............................  Oxygen contents, gaseous.
E0442.............................  Oxygen contents, liquid.
E0443.............................  Portable 02 contents, gas.
E0444.............................  Portable 02 contents, liquid.
E0450.............................  Volume vent stationary/porta.
E0454.............................  Pressure ventilator.

[[Page 75452]]

 
E0455.............................  Oxygen tent excl croup/ped t.
E0457.............................  Chest shell.
E0459.............................  Chest wrap.
E0460.............................  Neg press vent portabl/statn.
E0461.............................  Vol vent noninvasive interfa.
E0462.............................  Rocking bed w/ or w/o side r.
E0480.............................  Percussor elect/pneum home m.
E0482.............................  Cough stimulating device.
E0483.............................  Chest compression gen system.
E0484.............................  Non-elec oscillatory pep dvc.
E0500.............................  Ippb all types.
E0550.............................  Humidif extens supple w ippb.
E0555.............................  Humidifier for use w/ regula.
E0560.............................  Humidifier supplemental w/ I.
E0565.............................  Compressor air power source.
E0570.............................  Nebulizer with compression.
E0571.............................  Aerosol compressor for svneb.
E0572.............................  Aerosol compressor adjust pr.
E0574.............................  Ultrasonic generator w svneb.
E0575.............................  Nebulizer ultrasonic.
E0580.............................  Nebulizer for use w/ regulat.
E0585.............................  Nebulizer w/ compressor & he.
E0590.............................  Dispensing fee dme neb drug.
E0600.............................  Suction pump portab hom modl.
E0601.............................  Cont airway pressure device.
E0605.............................  Vaporizer room type.
E0606.............................  Drainage board postural.
E0607.............................  Blood glucose monitor home.
E0610.............................  Pacemaker monitr audible/vis.
E0615.............................  Pacemaker monitr digital/vis.
E0617.............................  Automatic ext defibrillator.
E0620.............................  Cap bld skin piercing laser.
E0621.............................  Patient lift sling or seat.
E0627.............................  Seat lift incorp lift-chair.
E0628.............................  Seat lift for pt furn-electr.
E0629.............................  Seat lift for pt furn-non-el.
E0630.............................  Patient lift hydraulic.
E0635.............................  Patient lift electric.
E0636.............................  PT support & positioning sys.
E0650.............................  Pneuma compresor non-segment.
E0651.............................  Pneum compressor segmental.
E0652.............................  Pneum compres w/cal pressure.
E0655.............................  Pneumatic appliance half arm.
E0660.............................  Pneumatic appliance full leg.
E0665.............................  Pneumatic appliance full arm.
E0666.............................  Pneumatic appliance half leg.
E0667.............................  Seg pneumatic appl full leg.
E0668.............................  Seg pneumatic appl full arm.
E0669.............................  Seg pneumatic appli half leg.
E0671.............................  Pressure pneum appl full leg.
E0672.............................  Pressure pneum appl full arm.
E0673.............................  Pressure pneum appl half leg.
E0691.............................  Uvl pnl 2 sq ft or less.
E0692.............................  Uvl sys panel 4 ft.
E0693.............................  Uvl sys panel 6 ft.
E0694.............................  Uvl md cabinet sys 6 ft.
E0701.............................  Helmet w face guard prefab.
E0720.............................  Tens two lead.
E0730.............................  Tens four lead.
E0731.............................  Conductive garment for tens/.
E0744.............................  Neuromuscular stim for scoli.
E0745.............................  Neuromuscular stim for shock.
E0747.............................  Elec osteogen stim not spine.
E0748.............................  Elec osteogen stim spinal.
E0776.............................  Iv pole.
E0779.............................  Amb infusion pump mechanical.
E0780.............................  Mech amb infusion pump <8hrs.
E0781.............................  External ambulatory infus pu.
E0784.............................  Ext amb infusn pump insulin.
E0791.............................  Parenteral infusion pump sta.
E0840.............................  Tract frame attach headboard.
E0850.............................  Traction stand free standing.
E0855.............................  Cervical traction equipment.
E0860.............................  Tract equip cervical tract.
E0870.............................  Tract frame attach footboard.
E0880.............................  Trac stand free stand extrem.
E0890.............................  Traction frame attach pelvic.
E0900.............................  Trac stand free stand pelvic.
E0910.............................  Trapeze bar attached to bed.
E0920.............................  Fracture frame attached to b.
E0930.............................  Fracture frame free standing.
E0935.............................  Exercise device passive moti.
E0940.............................  Trapeze bar free standing.
E0941.............................  Gravity assisted traction de.
E0942.............................  Cervical head harness/halter.
E0943.............................  Cervical pillow.
E0944.............................  Pelvic belt/harness/boot.
E0945.............................  Belt/harness extremity.
E0946.............................  Fracture frame dual w cross.
E0947.............................  Fracture frame attachmnts pe.
E0948.............................  Fracture frame attachmnts ce.
E0962.............................  Wheelchair 1 inch cushion.
E0963.............................  Wheelchair 2 inch cushion.
E0964.............................  Wheelchair 3 inch cushion.
E0965.............................  Wheelchair 4 inch cushion.
E0968.............................  Wheelchair commode seat.
E1011.............................  Ped wc modify width adjustm.
E1012.............................  Int seat sys planar ped w/c.
E1013.............................  Int seat sys contour ped w/c.
E1014.............................  Reclining back add ped w/c.
E1015.............................  Shock absorber for man w/c.
E1016.............................  Shock absorber for power w/c.
E1017.............................  HD shck absrbr for hd man wc.
E1018.............................  HD shck absrber for hd powwc.
E1020.............................  Residual limb support system.
E1025.............................  Pedwc lat/thor sup nocontour.
E1026.............................  Pedwc contoured lat/thor sup.
E1027.............................  Ped wc lat/ant support.
E1031.............................  Rollabout chair with casters.
E1037.............................  Transport chair, ped size.
E1038.............................  Transport chair, adult size.
E1210.............................  Whlchr moto ful arm leg rest.
E1211.............................  Wheelchair motorized w/ det.
E1225.............................  Wheelchair spec sz semi-recl.
E1228.............................  Wheelchair spec sz spec ht b.
E1230.............................  Power operated vehicle.
E1231.............................  Rigid ped w/c tilt-in-space.
E1232.............................  Folding ped wc tilt-in-space.
E1233.............................  Rig ped wc tltnspc w/o seat.
E1234.............................  Fld ped wc tltnspc w/o seat.
E1235.............................  Rigid ped wc adjustable.
E1236.............................  Folding ped wc adjustable.
E1237.............................  Rgd ped wc adjstabl w/o seat.
E1238.............................  Fld ped wc adjstabl w/o seat.
E1296.............................  Wheelchair special seat heig.
E1297.............................  Wheelchair special seat dept.
E1298.............................  Wheelchair spec seat depth/w.
E1310.............................  Whirlpool non-portable.
E1340.............................  Repair for DME, per 15 min.
E1353.............................  Oxygen supplies regulator.
E1355.............................  Oxygen supplies stand/rack.
E1372.............................  Oxy suppl heater for nebuliz.
E1390.............................  Oxygen concentrator.
E1405.............................  O2/water vapor enrich w/heat.
E1406.............................  O2/water vapor enrich w/o he.
E1700.............................  Jaw motion rehab system.
E1701.............................  Repl cushions for jaw motion.
E1702.............................  Repl measr scales jaw motion.
E1800.............................  Adjust elbow ext/flex device.
E1801.............................  SPS elbow device.
E1802.............................  Adjst forearm pro/sup device.
E1805.............................  Adjust wrist ext/flex device.
E1806.............................  SPS wrist device.
E1810.............................  Adjust knee ext/flex device.
E1811.............................  SPS knee device.
E1815.............................  Adjust ankle ext/flex device.
E1816.............................  SPS ankle device.
E1818.............................  SPS forearm device.
E1820.............................  Soft interface material.
E1821.............................  Replacement interface SPSD.
E1825.............................  Adjust finger ext/flex devc.
E1830.............................  Adjust toe ext/flex device.
E1840.............................  Adj shoulder ext/flex device.
E2000.............................  Gastric suction pump hme mdl.
E2100.............................  Bld glucose monitor w voice.
E2101.............................  Bld glucose monitor w lance.
K0001.............................  Standard wheelchair.
K0002.............................  Stnd hemi (low seat) whlchr.
K0003.............................  Lightweight wheelchair.
K0004.............................  High strength ltwt whlchr.
K0005.............................  Ultralightweight wheelchair.
K0006.............................  Heavy duty wheelchair.
K0007.............................  Extra heavy duty wheelchair.
K0009.............................  Other manual wheelchair/base.
K0010.............................  Stnd wt frame power whlchr.
K0011.............................  Stnd wt pwr whlchr w control.
K0012.............................  Ltwt portbl power whlchr.
K0014.............................  Other power whlchr base.
K0015.............................  Detach non-adjus hght armrst.
K0016.............................  Detach adjust armrst cmplete.
K0017.............................  Detach adjust armrest base.
K0018.............................  Detach adjust armrst upper.
K0019.............................  Arm pad each.
K0020.............................  Fixed adjust armrest pair.
K0022.............................  Reinforced back upholstery.
K0023.............................  Planr back insrt foam w/strp.
K0024.............................  Plnr back insrt foam w/hrdwr.
K0025.............................  Hook-on headrest extension.
K0026.............................  Back upholst lgtwt whlchr.
K0027.............................  Back upholst other whlchr.
K0028.............................  Manual fully reclining back.
K0029.............................  Reinforced seat upholstery.
K0030.............................  Solid plnr seat sngl dnsfoam.
K0031.............................  Safety belt/pelvic strap.
K0032.............................  Seat uphols lgtwt whlchr.
K0033.............................  Seat upholstery other whlchr.
K0035.............................  Heel loop with ankle strap.
K0036.............................  Toe loop each.
K0037.............................  High mount flip-up footrest.
K0038.............................  Leg strap each.
K0039.............................  Leg strap h style each.
K0040.............................  Adjustable angle footplate.
K0041.............................  Large size footplate each.
K0042.............................  Standard size footplate each.
K0043.............................  Ftrst lower extension tube.
K0044.............................  Ftrst upper hanger bracket.
K0045.............................  Footrest complete assembly.
K0046.............................  Elevat legrst low extension.
K0047.............................  Elevat legrst up hangr brack.
K0048.............................  Elevate legrest complete.
K0049.............................  Calf pad each.
K0050.............................  Ratchet assembly.
K0051.............................  Cam relese assem ftrst/lgrst.
K0052.............................  Swingaway detach footrest.
K0053.............................  Elevate footrest articulate.
K0054.............................  Seat wdth 10-12/15/17/20 wc.
K0055.............................  Seat dpth 15/17/18 ltwt wc.

[[Page 75453]]

 
K0056.............................  Seat ht <17 or =21 ltwt
                                     wc.
K0057.............................  Seat wdth 19/20 hvy dty wc.
K0058.............................  Seat dpth 17/18 power wc.
K0059.............................  Plastic coated handrim each.
K0060.............................  Steel handrim each.
K0061.............................  Aluminum handrim each.
K0062.............................  Handrim 8-10 vert/obliq proj.
K0063.............................  Hndrm 12-16 vert/obliq proj.
K0064.............................  Zero pressure tube flat free.
K0065.............................  Spoke protectors.
K0066.............................  Solid tire any size each.
K0067.............................  Pneumatic tire any size each.
K0068.............................  Pneumatic tire tube each.
K0069.............................  Rear whl complete solid tire.
K0070.............................  Rear whl compl pneum tire.
K0071.............................  Front castr compl pneum tire.
K0072.............................  Frnt cstr cmpl sem-pneum tir.
K0073.............................  Caster pin lock each.
K0074.............................  Pneumatic caster tire each.
K0075.............................  Semi-pneumatic caster tire.
K0076.............................  Solid caster tire each.
K0077.............................  Front caster assem complete.
K0078.............................  Pneumatic caster tire tube.
K0079.............................  Wheel lock extension pair.
K0080.............................  Anti-rollback device pair.
K0081.............................  Wheel lock assembly complete.
K0082.............................  22 nf deep cycl acid battery.
K0083.............................  22 nf gel cell battery each.
K0084.............................  Grp 24 deep cycl acid battry.
K0085.............................  Group 24 gel cell battery.
K0086.............................  U-1 lead acid battery each.
K0087.............................  U-1 gel cell battery each.
K0088.............................  Battry chrgr acid/gel cell.
K0089.............................  Battery charger dual mode.
K0090.............................  Rear tire power wheelchair.
K0091.............................  Rear tire tube power whlchr.
K0092.............................  Rear assem cmplt powr whlchr.
K0093.............................  Rear zero pressure tire tube.
K0094.............................  Wheel tire for power base.
K0095.............................  Wheel tire tube each base.
K0096.............................  Wheel assem powr base complt.
K0097.............................  Wheel zero presure tire tube.
K0098.............................  Drive belt power wheelchair.
K0099.............................  Pwr wheelchair front caster.
K0100.............................  Amputee adapter pair.
K0102.............................  Crutch and cane holder.
K0103.............................  Transfer board < 25''.
K0104.............................  Cylinder tank carrier.
K0105.............................  Iv hanger.
K0106.............................  Arm trough each.
K0107.............................  Wheelchair tray.
K0108.............................  W/c component-accessory NOS.
K0114.............................  Whlchr back suprt inr frame.
K0115.............................  Back module orthotic system.
K0116.............................  Back & seat modul orthot sys.
K0195.............................  Elevating whlchair leg rests.
K0268.............................  Humidifier nonheated w PAP.
K0452.............................  Wheelchair bearings.
K0455.............................  Pump uninterrupted infusion.
K0460.............................  WC power add-on joystick.
K0461.............................  WC power add-on tiller cntrl.
K0462.............................  Temporary replacement eqpmnt.
K0531.............................  Heated humidifier used w pap.
K0532.............................  Noninvasive assist wo backup.
K0533.............................  Noninvasive assist w backup.
K0534.............................  Invasive assist w backup.
K0538.............................  Neg pressure wnd thrpy pump.
K0539.............................  Neg pres wnd thrpy dsg set.
K0540.............................  Neg pres wnd thrp canister.
K0541.............................  SGD prerecorded msg <= 8 min.
K0542.............................  SGD prerecorded msg  8
                                     min.
K0543.............................  SGD msg formed by spelling.
K0544.............................  SGD w multi methods msg/accs.
K0545.............................  SGD sftwre prgrm for PC/PDA.
K0546.............................  SGD accessory, mounting systm.
K0547.............................  SGD accessory NOC.
K0549.............................  Hosp bed hvy dty xtra wide.
K0550.............................  Hosp bed xtra hvy dty x wide.
L3964.............................  Seo mobile arm sup att to wc.
L3965.............................  Arm supp att to wc rancho ty.
L3966.............................  Mobile arm supports reclinin.
L3968.............................  Friction dampening arm supp.
L3969.............................  Monosuspension arm/hand supp.
L3970.............................  Elevat proximal arm support.
L3972.............................  Offset/lat rocker arm w/ ela.
L3974.............................  Mobile arm support supinator.
------------------------------------------------------------------------


     Table 5.--HCPCS With Status Indicators That Changed From E to Y
------------------------------------------------------------------------
             CPT/HCPCS                           Description
------------------------------------------------------------------------
A4232.............................  Syringe w/needle insulin 3cc.
A4632.............................  Infus pump rplcemnt battery.
E0188.............................  Synthetic sheepskin pad.
E0189.............................  Lambswool sheepskin pad.
E0218.............................  Water circ cold pad w pump.
E0602.............................  Manual breast pump.
E0740.............................  Incontinence treatment systm.
E0760.............................  Osteogen ultrasound stimltor.
E0765.............................  Nerve stimulator for tx n&v.
K0610.............................  Peritoneal dialysis clamp.
K0611.............................  Disposable cycler set.
K0612.............................  Drainage ext line, dialysis.
K0613.............................  Ext line w/easy lock connect.
K0614.............................  Chem/antisept solution, 8oz.
------------------------------------------------------------------------


(Catalog of Federal Domestic Assistance Program No. 93.773, 
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)


    Dated: December 22, 2003.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 03-32016 Filed 12-24-03; 1:03 pm]
BILLING CODE 4120-01-P