[Federal Register Volume 69, Number 122 (Friday, June 25, 2004)]
[Rules and Regulations]
[Pages 35527-35528]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-14271]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405 and 414

[CMS-1372-CN2]
RIN 0938-AM97


Medicare Program; Changes to Medicare Payment for Drugs and 
Physician Fee Schedule Payments for Calendar Year 2004: Correction

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

ACTION: Correction of interim final rule with comment period.

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SUMMARY: This document corrects technical errors that appeared in the 
final rule with comment period published in the Federal Register on 
January 7, 2004 entitled ``Changes to Medicare Payment for Drugs and 
Physician Fee Schedule Payments for Calendar Year 2004.''

DATES: Effective Date: This correction is effective January 1, 2004.

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

SUPPLEMENTARY INFORMATION:

I. Background

    In FR Doc. 03-32323 of January 7, 2004 (69 FR 1084), there were a 
number of technical errors that we are identifying and correcting in 
section II--Correction of Errors. Additionally, there are various 
revisions to Addenda B and C. (The provisions in this correction notice 
are effective as if they were included in the document published 
January 7, 2004.)

Discussion of Addenda B and C

    1. There was an inadvertent omission of two supplies (Polaroid film 
and gonisol) from the Practice Expense Advisory Committee (PEAC) 
recommendations for CPT codes 76511,76511-TC, 76512, 76512-TC, 
76513,76513-TC, 76516, 76516-TC, 76519,76519-TC, 76529 and 76529-TC 
which impacts the practice expense RVUs for these codes on page 1205 of 
Addendum B. In addition, the supply inputs in the CPEP database for CPT 
code 94240 contained incorrect quantities for two supplies (oxygen and 
helium), resulting in incorrect practice expense RVUs on page 1229 of 
Addendum B for this code and for CPT code 94240-TC. The practice 
expense RVUs for CPT 95144 on page 1230 were also incorrect as they 
reflected the wrong antigen and price. The corrected RVUs are shown in 
section II.2.
    2. In Addendum B, we assigned incorrect status indicators on page 
1154 for CPT code 36416 and on page 1165 for CPT code 47133. These 
corrections are reflected in section II.2.
    3. In Addendum B, we assigned incorrect practice expense RVUs to 
CPT codes 61863 and 61867 on page 1179, and to CPT codes 88358, 88358-
26 and 88358-TC on page 1218. The correct RVUs are reflected in section 
II.2.
    4. In Addendum B, on page 1241, an incorrect short descriptor was 
referenced for HCPCS code G0321, and the RVUs for G0321 and G0322 were 
transposed. The correct short descriptor and RVUs are shown in section 
II.2.
    5. We inadvertently omitted the following CPT codes from Addendum 
B: page 1218 for CPT codes 89220, 89230, and 89240. These corrections 
are reflected in section II.3.
    6. On pages 1146 and 1243 in Addenda B and C, respectively, we 
assigned the incorrect work RVUs to CPT 31629. We also failed to assign 
practice expense RVUs in the non-facility setting for this code. The 
corrected RVUs are shown in section II.4.
    7. On page 1215 of Addenda B, the practice expense RVUs for CPT 
codes 78804 and 78804-TC are revised to reflect the appropriate 
crosswalk. The correction can be found in section II.4.

II. Correction of Errors

0
In FR Doc. 03-32323 of January 7, 2004 (69 FR 1084), make the following 
corrections--
0
1. On page 1094, column one, second sentence, revise as follows to 
correct the specialty code referenced for urology: ``Based on the 2002 
data, we found that the specialties of gynecology/oncology (specialty 
code 98), rheumatology (specialty code 66), and urology (specialty code 
34) received more than 40 percent of total Part B revenues from 
drugs.''

0
2. In the Table of Addendum B, the following CPT codes are corrected to 
read as follows:

[[Page 35528]]



--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                           Non-                  Mal-       Non-
  CPT \1\ HCPCS          MOD             Status            Description       Physician   facility   Facility   practice   facility   Facility    Global
                                                                             work RVUs   PE RVUs    PE RVUs      RVUs      total      total
--------------------------------------------------------------------------------------------------------------------------------------------------------
36416...........  ................  B...............  Capillary blood draw.       0.00       0.00       0.00       0.00       0.00       0.00        XXX
47133...........  ................  X...............  Removal of donor            0.00       0.00       0.00       0.00       0.00       0.00        XXX
                                                       liver.
61863...........  ................  A...............  Implant                    18.97         NA      11.80       4.79         NA      35.56        XXX
                                                       neuroelectrode.
61867...........  ................  A...............  Implant                    31.29         NA      18.08       4.79         NA      54.16         90
                                                       neuroelectrode.
76511...........  ................  A...............  Echo exam of eye.....       0.94       1.83         NA       0.09       2.86         NA        XXX
76511...........  TC..............  A...............  Echo exam of eye.....       0.00       1.43         NA       0.07       1.50         NA        XXX
76512...........  ................  A...............  Echo exam of eye.....       0.66       1.75         NA       0.11       2.52         NA        XXX
76512...........  TC..............  A...............  Echo exam of eye.....       0.00       1.45         NA       0.10       1.55         NA        XXX
76513...........  ................  A...............  Echo exam of eye,           0.66       1.84         NA       0.11       2.61         NA        XXX
                                                       water bath.
76513...........  TC..............  A...............  Echo exam of eye,           0.00       1.54         NA       0.10       1.64         NA        XXX
                                                       water bath.
76516...........  ................  A...............  Echo exam of eye.....       0.54       1.45         NA       0.08       2.07         NA        XXX
76516...........  TC..............  A...............  Echo exam of eye.....       0.00       1.20         NA       0.07       1.27         NA        XXX
76519...........  ................  A...............  Echo exam of eye.....       0.54       1.54         NA       0.08       2.16         NA        XXX
76519...........  TC..............  A...............  Echo exam of eye.....       0.00       1.29         NA       0.07       1.36         NA        XXX
76529...........  ................  A...............  Echo exam of eye.....       0.57       1.40         NA       0.10       2.07         NA        XXX
76529...........  TC..............  A...............  Echo exam of eye.....       0.00       1.15         NA       0.08       1.23         NA        XXX
88358...........  ................  A...............  Analysis, tumor......       0.95       0.56         NA       0.19       1.70         NA        XXX
88358...........  26..............  A...............  Analysis, tumor......       0.95       0.42         NA       0.12       1.49         NA        XXX
88358...........  TC..............  A...............  Analysis, tumor......       0.00       0.14         NA       0.07       0.21         NA        XXX
94240...........  ................  A...............  Residual lung               0.26       0.70         NA       0.06       1.02         NA        XXX
                                                       capacity.
94240...........  TC..............  A...............  Residual lung               0.00       0.62         NA       0.05       0.67         NA        XXX
                                                       capacity.
95144...........  ................  A...............  Antigen therapy             0.06       0.19       0.02       0.01       0.26       0.09        000
                                                       services.
G0321...........  ................  A...............  ESRD related svs home       8.11       3.92       3.92       0.29      12.32      12.32        XXX
                                                       mo 2-11y.
G0322...........  ................  A...............  ESRD relate svs home        6.90       3.67       3.67       0.23      10.80      10.80       XXX
                                                       mo 2-19.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ All CPT codes copyright 2003 American Medical Association.


0
3. In the Table of Addendum B, the following CPT codes are added to 
read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                           Non-                  Mal-       Non-
     CPT \1\ HCPCS2          MOD     Status            Description           Physician   facility   Facility   practice   facility   Facility    Global
                                                                             work RVUs   PE RVUs    PE RVUs      RVUs      total      total
--------------------------------------------------------------------------------------------------------------------------------------------------------
89220...................  ........        A   Sputum specimen collection...       0.00       0.40         NA       0.02       0.42         NA        XXX
89230...................  ........        A   Collect sweat for test.......       0.00       0.44         NA       0.02       0.46         NA        XXX
89240...................  ........         C  Pathology lab procedure......       0.00       0.00       0.00       0.00       0.00       0.00       XXX
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ All CPT codes copyright 2003 American Medical Association.


0
4. In the Table of Addenda B and C, the following CPT codes are 
corrected to read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                           Non-                  Mal-       Non-
     CPT \1\ HCPCS2          MOD     Status            Description           Physician   facility   Facility   practice   facility   Facility    Global
                                                                             work RVUs   PE RVUs    PE RVUs      RVUs      total      total
--------------------------------------------------------------------------------------------------------------------------------------------------------
31629...................  ........        A   Bronchoscopy/needle bx, each.       4.09      12.79       1.45       0.16      17.04       5.70        000
78804...................  ........        A   Tumor imaging, whole body....       1.07      11.47         NA       0.34      12.88         NA        XXX
78804...................        TC        A   Tumor imaging, whole body....       0.00      11.10         NA       0.30      11.40         NA       XXX
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ All CPT codes copyright 2003 American Medical Association.

III. Waiver of Proposed Rulemaking

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register to provide a period for public comment before the 
provisions of a notice take effect. We can waive this procedure, 
however, if we find good cause that notice and comment procedure is 
impracticable, unnecessary, or contrary to the public interest and 
incorporate a statement of the finding and the reasons for it into the 
notice issued.
    In this case, we believe that it is unnecessary to subject the 
corrections identified above to public comment. These errors were the 
result of inadvertent omissions and typographical errors in Addenda B 
and C. Our corrections of the pricing errors and addition of pricing 
information in the addenda do not substantively change any policy nor 
affect the established payment methodology. For this reason, we find it 
unnecessary to provide the opportunity for comment on the technical 
corrections made in this notice. Therefore, we find good cause to waive 
notice and comment procedures.

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

    Dated: June 2, 2004.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. 04-14271 Filed 6-24-04; 8:45 am]
BILLING CODE 4120-01-P