[Federal Register Volume 73, Number 251 (Wednesday, December 31, 2008)]
[Rules and Regulations]
[Pages 80302-80305]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-31027]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 409, 410, 411, 413, 414, 415, 423, 424, 485, 486, 
and 489

[CMS-1403-CN2]
RIN 0938-AP18


Medicare Program; Payment Policies Under the Physician Fee 
Schedule and Other Revisions to Part B for CY 2009; E-Prescribing 
Exemption for Computer Generated Facsimile Transmissions; Corrections

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

ACTION: Correction of final rule with comment period.

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SUMMARY: This document corrects several technical and typographical 
errors in the final rule with comment period that appeared in the 
November 19, 2008 Federal Register entitled ``Medicare Program; Payment 
Policies Under the Physician Fee Schedule and Other Revisions to Part B 
for CY 2009; E-Prescribing Exemption for Computer-Generated Facsimile 
Transmissions; and Payment for Certain Durable Medical Equipment, 
Prosthetics, Orthotics, and Supplies (DMEPOS); Final Rule'' (73 FR 
69726).

DATES: Effective Date: This correction notice is effective January 1, 
2009.

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

SUPPLEMENTARY INFORMATION: 

[[Page 80303]]

I. Background

    In FR Doc. E8-26213 of November 19, 2008 (73 FR 69726) (hereinafter 
referred to as the CY 2009 PFS final rule with comment period), there 
were a number of technical and typographical errors that are identified 
and corrected in the Correction of Errors section of this notice. The 
provisions of this notice are effective as if they had been included in 
the CY 2009 PFS final rule with comment period. Accordingly, the 
corrections are effective January 1, 2009.

II. Summary of Errors

A. Errors in the Preamble

    On pages 69738 and 69739, we are correcting a typographical error 
in the discussion concerning submission of information for supply and 
equipment items. In addition, in Table 2, we are correcting the 
reference to a code number that appears in that table, as well as 
typographical errors that appear in the footnotes for Tables 2 and 3. 
We are also correcting the reference to two code numbers that appear in 
Table 5.
    On pages 69764, 69765, 69801, 69856, 69867, 69868, and 69869, we 
are correcting typographical errors.
    On page 69857, we are deleting a sentence which refers incorrectly 
to a revision to the regulation.
    On page 69866, we are adding a footnote that was referenced but 
inadvertently not included.
    On page 69899, we are adding CPT 78414 to our summary of deleted 
codes. This code does not involve imaging and, therefore, should not be 
included in the category of ``Radiology and Certain Other Imaging 
Services.''
    On page 69900, Table 30, we are adding two codes to the list of 
deletions. Under the heading of ``Clinical Laboratory Services,'' we 
are adding HCPCS code G0394 and its short descriptor because this code 
will be terminated December 31, 2008. Under the heading of ``Radiology 
and Certain Other Imaging Services,'' we are adding in numerical order 
CPT code 78414 and its short descriptor.

B. Errors in the Regulations Text

    The regulations text contained minor typographical and technical 
errors; therefore, we are not summarizing the individual errors in this 
section.

C. Errors in the Addenda

    On pages 69956, 70007, 70024, 70051, 70088, and 70122 of Addendum 
B, Relative Value Units and Related Information Used in Determining 
Medicare Payments for 2009, the PE RVUs listed for CPT codes 20697, 
37205, 37206, 47525 and 76775-26 are corrected. In addition the global 
periods for the CPT codes 47525, 63650, 63685, 63688, and 93352 are 
corrected.
    On pages 70147, 70148, 70149 and 70151 of Addendum C, Codes with 
Interim RVUs, the PE RVUS listed for CPT code 26097 are corrected and 
the global period for CPT codes 47525, 63650, 63685, 63688, and 93352 
are corrected.
    On page 70215, Addendum J, we are deleting HCPCS code G0394 and its 
short descriptor.
    On page 70226, Addendum J, we are deleting CPT 78414 and its short 
descriptor.

III. Correction of Errors

A. Corrections to the Preamble

    1. On page 69738:
    a. In the 1st column, in the 1st partial paragraph, line 2, the 
phrase ``items for some each of the'' is corrected to read ``items for 
some of the''.
    b. In Table 2, Supply Items Needing Specialty Input for Pricing, in 
column 6, lines 1 and 2, the CPT code ``50395'' is corrected to read 
``50593''.
    c. In the footnote to Table 2, line 5, the phrase ``In these 
instances only'' is corrected to read ``In instances where only''.
    2. On page 69739:
    a. In the footnote to Table 3, line 5, the phrase ``In these 
instances only'' is corrected to read ``In instances where only''.
    b. In the footnote to Table 3, line 15 (item B.), the phrase `` No/
insufficient received.'' is corrected to read ``No/Insufficient 
information received.''
    c. In Table 5, in the 5th column, line 2, the CPT codes ``93693 and 
93696'' are corrected to read ``93293 and 93296''.
    3. On page 69764, in the 3rd column, 1st full paragraph:
    a. Lines 1 and 2, the sentence ``We disagree with the commenter.'' 
is removed.
    b. Line 5, the phrase ``imaging services'' is corrected to read 
``testing services.''
    4. On page 69765, in the 1st column:
    a. In the 1st paragraph, line 2, the phrase ``commenters' concerns 
and we'' is corrected to read ``commenters' concerns, but we.''
    b. In the 5th paragraph, the phrase ``commenters' concerns and we'' 
is corrected to read ``commenters' concerns, but we.''
    5. On page 69801, in the 1st column, in the 2nd full paragraph, 
line 40, the phrase ``PC be an employee or independent'' is corrected 
to read ``PC be an owner, employee, or independent''.
    6. On page 69856, in the 2nd column, in the 1st partial paragraph, 
line 8, the phrase ``beneficiaries who's OSA'' is corrected to read 
``beneficiaries whose OSA''.
    7. On page 69857, in the 1st column, in the 2nd full paragraph, 
lines 7 through 11, the sentence ``In addition, we are adding a new 
paragraph (g), which would create an exception to the prohibition 
contained in (f) if the sleep test is an attended facility-based PSG.'' 
is deleted.
    8. On page 69866, in the 3rd column:
    a. In the 1st partial paragraph, line 12, the footnote annotation 
``2'' is corrected to read ``2A''.
    b. In the footnotes, the following footnote is added in numerical 
order ``\2A\ Dartmouth Atlas of Healthcare. 2005 Medicare reimbursement 
figures derived from Hospital Service Area (HSA).''
    9. On page 69867, in the 2nd column, in the 3rd full paragraph, 
lines 15 and 16, the phrase ``high cost, of a high volume,'' is 
corrected to read ``high cost, high volume,''.
    10. On page 69868:
    a. In the 2nd column, in the 1st partial paragraph, line 16, the 
phrase ``approach to data for Phase 1,'' is corrected to read 
``approach used for Phase 1,''.
    b. In the 2nd column, in the 1st full paragraph, line 6, the phrase 
``high cost, a high volume,'' is corrected to read ``high cost, high 
volume,''.
    c. In the 3rd column, in the 1st paragraph, lines 22 through 23, 
the phrase ``data was available'' is corrected to read ``data were not 
available''.
    11. On page 69869, in the 1st column:
    a. In the 1st partial paragraph, lines 7 through 8, the phrase ``In 
addition, to including'' is corrected to read ``In addition to 
including''.
    b. In the 2nd full paragraph, line 3, the phrase `` of the program 
as'' is corrected to read ``of the program, as''.
    12. On page 69899, in the 3rd column, in the 3rd paragraph, lines 5 
and 6, the phrase ``CPT codes 78000, 78001, and 78003'' is corrected to 
read ``CPT codes 78000, 78001, 78003, and 78414''.
    13. On page 69900, in the 1st column, Table 30: Deletions to the 
Physician Self-Referral List of CPT\1\/HCPCS Codes:
    a. Under the heading of ``Clinical Laboratory Services,'' HCPCS 
code G0394 and its short descriptor are added as the last entry to read 
as follows:

                      Clinical Laboratory Services
------------------------------------------------------------------------
 
------------------------------------------------------------------------
G0394............................  Blood occult test, colorectal.
------------------------------------------------------------------------

    b. Under the heading of ``Radiology and Certain Other Imaging 
Services,'' CPT code 78414 and its short descriptor are added in 
numerical order to read as follows:

[[Page 80304]]



              Radiology and Certain Other Imaging Services
------------------------------------------------------------------------
 
------------------------------------------------------------------------
78414............................  Non-imaging heart function.
------------------------------------------------------------------------

B. Corrections to the Regulation Text

    1. On page 69933, in Sec.  410.33:
    a. In paragraph (g)(16), the phrase ``imaging services'' is 
corrected to read ``testing services''.
    b. In paragraph (g)(17), the phrase ``part of a hospital service 
provided under arrangement with that hospital'' is corrected to read 
``part of a service provided under arrangement as described in section 
1861(w)(1) of the Act''.
    2. On page 69934, in Sec.  411.15, in paragraph (p)(2)(xii), the 
phrase ``paragraphs (k)(15)(i) thorugh (vi) of this section'' is 
corrected to read ``subparagraphs (p)(2)(i) through (vi) of this 
section''.
    3. On page 69936, in Sec.  414.210, in amendatory instruction 
26, the statement ``E. Adding paragraph (e)(3)(iv).'' is added 
in alphabetical order.
    4. On page 69937, in Sec.  414.904, amendatory instruction 
31 is revised to read
    ``Section 414.904 is amended by--
    a. Revising paragraphs (b)(2), (c)(2), and (d)(3).
    b. Adding paragraph (e)(5).
    The revisions and addition read as follows:''.
    5. On page 69938, in Sec.  414.904:
    a. In paragraph (e), the text ``(1) * * *'' is removed.
    b. Paragraph (e)(1)(i) is redesignated to (e)(5).
    c. Paragraph (e)(1)(i)(A) is redesignated to (e)(5)(i).
    d. Paragraph (e)(1)(i)(A)(1) is redesignated to (e)(5)(i)(A).
    e. Paragraph (e)(1)(i)(A)(2) is redesignated to (e)(5)(i)(B).
    f. Paragraph (e)(1)(i)(B) is redesignated to (e)(5)(ii).
    g. Paragraph (e)(1)(i)(B)(1) is redesignated to (e)(5)(ii)(A).
    h. Paragraph (e)(1)(i)(B)(2) is redesignated to (e)(5)(ii)(B).
    6. On page 69940, in Sec.  424.516, in paragraph (e)(1), the phrase 
``ownership, including'' is corrected to read ``ownership or control, 
including''.

C. Corrections to the Addenda

    1. On pages 69956, 70007, 70024, 70051, 70088, and 70122, Addendum 
B: Relative Value Units and Related Information Used in Determining 
Medicare Payments for 2009, the following CPT codes are corrected to 
read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                            Fully imple-  Year 2009                 Year 2009
                                                               Physi- cian   mented non-   transi-    Fully imple-   transi-        Mal-
CPT \1\/ HCPCS    Mod        Status           Description       work RVUs     facility   tional non-     mented       tional      practice      Global
                                                                   \2\        PE  RVUs   facility PE  facility PE  facility PE    RVUs \2\
                                                                                \2\        RVUs \2\     RVUs \2\     RVUs \2\
--------------------------------------------------------------------------------------------------------------------------------------------------------
20697.........  .......  A               Comp ext fixate              0.00        33.08        33.08           NA           NA         0.01          000
                                          strut change.
37205.........  .......  A               Transcath iv stent,          8.27       105.15       105.15         3.35         3.46         0.60          000
                                          percut.
37206.........  .......  A               Transcath iv stent/          4.12        64.26        64.26         1.62         1.58         0.31          ZZZ
                                          perc addl.
47525.........  .......  A               Change bile duct             1.54        10.90        11.98         0.86         1.35         0.33          000
                                          catheter.
63650.........  .......  A               Implant                      7.15           NA           NA         2.71         2.83         0.53          010
                                          neuroelectrodes.
63685.........  .......  A               Insrt/redo spine n           6.00           NA           NA         2.90         3.22         1.05          010
                                          generator.
63688.........  .......  A               Revise/remove                5.25           NA           NA         2.88         3.05         0.89          010
                                          neuroreceiver.
76775.........       26  A               Us exam abdo back            0.58         0.23         0.23         0.23         0.23         0.03          XXX
                                          wall, lim.
93352.........  .......  A               Admin ecg contrast           0.19         0.84         0.84           NA           NA         0.04          ZZZ
                                          agent.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    2. On pages 70147, 70148, 70149 and 70151, Addendum C: Codes with 
Interim RVUs, the following CPT codes are corrected to read as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                            Fully imple-  Year 2009                 Year 2009
                                                               Physi- cian   mented non-   transi-    Fully imple-   transi-        Mal-
CPT \1\/ HCPCS    Mod        Status           Description       work RVUs     facility   tional non-     mented       tional      practice      Global
                                                                   \2\        PE  RVUs   facility PE  facility PE  facility PE    RVUs \2\
                                                                                \2\        RVUs \2\     RVUs \2\     RVUs \2\
--------------------------------------------------------------------------------------------------------------------------------------------------------
20697.........  .......  A               Comp ext fixate              0.00        33.08        33.08           NA           NA         0.01          000
                                          strut change.
47525.........  .......  A               Change bile duct             1.54        10.90        11.98         0.86         1.35         0.33          000
                                          catheter.
63650.........  .......  A               Implant                      7.15           NA           NA         2.71         2.83         0.53          010
                                          neuroelectrodes.
63685.........  .......  A               Insrt/redo spine n           6.00           NA           NA         2.90         3.22         1.05          010
                                          generator.
63688.........  .......  A               Revise/remove                5.25           NA           NA         2.88         3.05         0.89          010
                                          neuroreceiver.
93352.........  .......  A               Admin ecg contrast           0.19         0.84         0.84           NA           NA         0.04          ZZZ
                                          agent.
--------------------------------------------------------------------------------------------------------------------------------------------------------

    3. On page 70215, in Addendum J, the entry for HCPCS code G0394 and 
its short descriptor are removed.
    4. On page 70226, in Addendum J, the entry for CPT code 78414 and 
its short descriptor are removed.

III. Waiver of Proposed Rulemaking and Delay in Effective Date

    We ordinarily publish a notice of proposed rulemaking in the 
Federal Register to provide a period for public comment before the 
provisions of a rule take effect in accordance with section 553(b) of 
the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we 
can waive the notice and comment procedure if the Secretary finds, for 
good cause, that the notice and comment process is impracticable, 
unnecessary, or contrary to the public interest, and incorporates a 
statement of the finding and the reasons for it in the rule.
    Section 553(d) of the APA ordinarily requires a 30-day delay in the 
effective date of final rules after the date of their publication. This 
30-day delay in effective date can be waived, however, if an agency 
finds for good cause that the delay is impracticable, unnecessary, or 
contrary to the public interest, and the agency incorporates a 
statement of the findings and its reasons in the rule issued.

[[Page 80305]]

    This document merely corrects typographical and technical errors 
made in FR Doc. E8-26213, the CY 2009 PFS final rule with comment 
period, which appeared in the November 19, 2009 Federal Register (73 FR 
69726), and is (with limited exceptions not relevant to these 
corrections, but noted in the rule), effective January 1, 2009. The 
provisions of the final rule with comment period have been subjected 
previously to notice and comment procedures. The corrections contained 
in this document are consistent with, and do not make substantive 
changes to, the payment methodologies and policies adopted in the CY 
2009 PFS final rule with comment period. As such, these corrections are 
being made to ensure the CY 2009 PFS final rule with comment period 
accurately reflects the policies adopted in that rule. We find, 
therefore, for good cause that it is unnecessary and would be contrary 
to the public interest to undertake further notice and comment 
procedures to incorporate these corrections into the CY 2009 PFS final 
rule with comment period.
    For the same reasons, we are also waiving the 30-day delay in 
effective date for these corrections. We believe that it is in the 
public interest to ensure that the CY 2009 PFS final rule with comment 
period accurately states our policies as of the date they take effect. 
Therefore, we find that delaying the effective date of these 
corrections beyond the effective date of the final rule with comment 
period would be contrary to the public interest. In so doing, we find 
good cause to waive the 30-day delay in the effective date.

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

    Dated: December 22, 2008.
Ann C. Agnew,
Executive Secretary to the Department.
[FR Doc. E8-31027 Filed 12-30-08; 8:45 am]
BILLING CODE 4120-01-P