H99RPHPC NHIC, CORP. PAGE 1 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER A6549 P 9 01/01/2010 GRADIENT COMPRESSION STOCKING/SLEEVE, NOT OTHERWISE SPECIFIED A9500 4 9 01/01/2010 TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER STUDY DOSE C9248 1 F1 01/01/2009 INJECTION, CLEVIDIPINE BUTYRATE, 1 MG NOT FOUND C9358 9 F9 07/01/2008 DERMAL SUBSTITUTE, NATIVE, NON-DENATURED COLLAGEN, FETAL BOVINE ORIGIN NOT FOUND (SURGIMEND COLLAGEN MATRIX), PER 0.5 SQUARE CENTIMETERS C9728 2 F28 01/01/2010 PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY/SURGERY GUIDANCE (EG, NOT FOUND FIDUCIAL MARKERS, DOSIMETER), FOR OTHER THAN THE FOLLOWING SITES (ANY APPROACH): ABDOMEN, PELVIS, PROSTATE, RETROPERITONEUM, THORAX, SINGLE OR MULTIPLE E0249 APR 9A 01/01/2010 PAD FOR WATER CIRCULATING HEAT UNIT, FOR REPLACEMENT ONLY NOT FOUND E0441 P 9 01/01/2010 STATIONARY OXYGEN CONTENTS, GASEOUS, 1 MONTH'S SUPPLY = 1 UNIT NOT FOUND E0442 P 9 01/01/2010 STATIONARY OXYGEN CONTENTS, LIQUID, 1 MONTH'S SUPPLY = 1 UNIT NOT FOUND E0443 P 9 01/01/2010 PORTABLE OXYGEN CONTENTS, GASEOUS, 1 MONTH'S SUPPLY = 1 UNIT NOT FOUND E0444 P 9 01/01/2010 PORTABLE OXYGEN CONTENTS, LIQUID, 1 MONTH'S SUPPLY = 1 UNIT NOT FOUND E0700 APR 9 01/01/2010 SAFETY EQUIPMENT, DEVICE OR ACCESSORY, ANY TYPE NOT FOUND E1035 R 9 01/01/2010 MULTI-POSITIONAL PATIENT TRANSFER SYSTEM, WITH INTEGRATED SEAT, OPERATED BY NOT FOUND CARE GIVER, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 LBS G0151 1 1 01/01/2010 SERVICES OF A PHYSICAL THERAPIST IN HOME HEALTH OR HOSPICE SETTINGS, EACH 15 NOT FOUND MINUTES G0152 1 1 01/01/2010 SERVICES OF AN OCCUPATIONAL THERAPIST IN HOME HEALTH OR HOSPICE SETTINGS, EACH NOT FOUND 15 MINUTES G0153 1 1 01/01/2010 SERVICES OF A SPEECH AND LANGUAGE PATHOLOGIST IN HOME HEALTH OR HOSPICE NOT FOUND SETTINGS, EACH 15 MINUTES G0154 1 1 01/01/2010 SERVICES OF SKILLED NURSE IN HOME HEALTH, OR NURSE IN HOSPICE SETTINGS, EACH 15 NOT FOUND MINUTES G0155 1 1 01/01/2010 SERVICES OF CLINICAL SOCIAL WORKER IN HOME HEALTH OR HOSPICE SETTINGS, EACH 15 NOT FOUND MINUTES G0156 1 1 01/01/2010 SERVICES OF HOME HEALTH/HOSPICE AIDE IN HOME HEALTH OR HOSPICE SETTINGS, EACH NOT FOUND 15 MINUTES J0585 1P F1 01/01/2010 INJECTION, ONABOTULINUMTOXINA, 1 UNIT J0587 1P F1 01/01/2010 INJECTION, RIMABOTULINUMTOXINB, 100 UNITS J7192 1P F1 01/01/2010 FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED L4396 P 9 01/01/2010 STATIC OR DYNAMIC ANKLE FOOT ORTHOSIS, INCLUDING SOFT INTERFACE MATERIAL, NOT FOUND ADJUSTABLE FOR FIT, FOR POSITIONING, MAY BE USED FOR MINIMAL AMBULATION, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT L8030 P 9 01/01/2010 BREAST PROSTHESIS, SILICONE OR EQUAL, WITHOUT INTEGRAL ADHESIVE NOT FOUND L8619 P 9 01/01/2010 COCHLEAR IMPLANT, EXTERNAL SPEECH PROCESSOR AND CONTROLLER, INTEGRATED SYSTEM, NOT FOUND REPLACEMENT L8680 P 9 01/01/2010 IMPLANTABLE NEUROSTIMULATOR ELECTRODE (WITH ANY NUMBER OF CONTACT POINTS), EACH NOT FOUND Q0496 P 9 01/01/2010 BATTERY, OTHER THAN LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY Q2009 1P F1 01/01/2010 INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT 19295 2 F28 01/01/2010 IMAGE GUIDED PLACEMENT, METALLIC LOCALIZATION CLIP, PERCUTANEOUS, DURING BREAST BIOPSY/ASPIRATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 21015 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FACE OR SCALP; LESS THAN 2 CM 21555 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; LESS THAN 3 CM 21556 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM 21557 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF NECK OR ANTERIOR THORAX; LESS THAN 5 CM 21935 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF BACK OR FLANK; LESS THAN 5 CM H99RPHPC NHIC, CORP. PAGE 2 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER 22520 2 F28 01/01/2010 PERCUTANEOUS VERTEBROPLASTY, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; THORACIC 22521 2 F28 01/01/2010 PERCUTANEOUS VERTEBROPLASTY, 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; LUMBAR 23075 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; LESS THAN 3 CM 23076 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM 23077 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF SHOULDER AREA; LESS THAN 5 CM 23200 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; CLAVICLE 23210 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; SCAPULA 23220 2 28 01/01/2010 RADICAL RESECTION OF TUMOR, PROXIMAL HUMERUS 24075 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; LESS THAN 3 CM 24076 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM 24077 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF UPPER ARM OR ELBOW AREA; LESS THAN 5 CM 24150 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR, SHAFT OR DISTAL HUMERUS 24152 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR, RADIAL HEAD OR NECK 25075 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBCUTANEOUS; LESS THAN 3 CM 25076 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 3 CM 25077 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOREARM AND/OR WRIST AREA; LESS THAN 3 CM 25170 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR, RADIUS OR ULNA 26115 2 F28 01/01/2010 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; LESS THAN 1.5 CM 26116 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 1.5 CM 26117 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF HAND OR FINGER; LESS THAN 3 CM 26250 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR, METACARPAL 26260 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR, PROXIMAL OR MIDDLE PHALANX OF FINGER 26262 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR, DISTAL PHALANX OF FINGER 27047 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM 27048 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM 27049 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF PELVIS AND HIP AREA; LESS THAN 5 CM 27050 2 F28 01/01/2010 ARTHROTOMY, WITH BIOPSY; SACROILIAC JOINT 27075 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; WING OF ILIUM, 1 PUBIC OR ISCHIAL RAMUS OR SYMPHYSIS PUBIS 27076 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; ILIUM, INCLUDING ACETABULUM, BOTH PUBIC RAMI, OR ISCHIUM AND ACETABULUM 27077 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; INNOMINATE BONE, TOTAL 27078 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; ISCHIAL TUBEROSITY AND GREATER TROCHANTER OF FEMUR 27327 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; LESS THAN 3 CM 27328 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM 27329 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF THIGH OR KNEE AREA; LESS THAN 5 CM H99RPHPC NHIC, CORP. PAGE 3 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER 27365 2 28 01/01/2010 RADICAL RESECTION OF TUMOR, FEMUR OR KNEE 27615 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF LEG OR ANKLE AREA; LESS THAN 5 CM 27618 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBCUTANEOUS; LESS THAN 3 CM 27619 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM 27620 2 F28 01/01/2010 ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY 27640 2 F28 01/01/2010 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY), BONE (EG, OSTEOMYELITIS); TIBIA 27641 2 F28 01/01/2010 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY), BONE (EG, OSTEOMYELITIS); FIBULA 27645 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; TIBIA 27646 2 28 01/01/2010 RADICAL RESECTION OF TUMOR; FIBULA 27647 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR; TALUS OR CALCANEUS 28043 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBCUTANEOUS; LESS THAN 1.5 CM 28045 2 F28 01/01/2010 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 1.5 CM 28046 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOOT OR TOE; LESS THAN 3 CM 28171 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR; TARSAL (EXCEPT TALUS OR CALCANEUS) 28173 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR; METATARSAL 28175 2 F28 01/01/2010 RADICAL RESECTION OF TUMOR; PHALANX OF TOE 30801 2 F28 01/01/2010 ABLATION, SOFT TISSUE OF INFERIOR TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD (EG, ELECTROCAUTERY, RADIOFREQUENCY ABLATION, OR TISSUE VOLUME REDUCTION); SUPERFICIAL 30802 2 F28 01/01/2010 ABLATION, SOFT TISSUE OF INFERIOR TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD (EG, ELECTROCAUTERY, RADIOFREQUENCY ABLATION, OR TISSUE VOLUME REDUCTION); INTRAMURAL (IE, SUBMUCOSAL) 31622 2 F28 01/01/2010 BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; DIAGNOSTIC, WITH CELL WASHING, WHEN PERFORMED (SEPARATE PROCEDURE) 31641 2 F28 01/01/2010 BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH DESTRUCTION OF TUMOR OR RELIEF OF STENOSIS BY ANY METHOD OTHER THAN EXCISION (EG, LASER THERAPY, CRYOTHERAPY) 31643 2 F28 01/01/2010 BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF CATHETER(S) FOR INTRACAVITARY RADIOELEMENT APPLICATION 31645 2 F28 01/01/2010 BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, INITIAL (EG, DRAINAGE OF LUNG ABSCESS) 31646 2 F28 01/01/2010 BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, SUBSEQUENT 31656 2 F28 01/01/2010 BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH INJECTION OF CONTRAST MATERIAL FOR SEGMENTAL BRONCHOGRAPHY (FIBERSCOPE ONLY) 32560 2 28 01/01/2010 INSTILLATION, VIA CHEST TUBE/CATHETER, AGENT FOR PLEURODESIS (EG, TALC FOR RECURRENT OR PERSISTENT PNEUMOTHORAX) 33216 2 F28 01/01/2010 INSERTION OF A SINGLE TRANSVENOUS ELECTRODE, PERMANENT PACEMAKER OR CARDIOVERTER-DEFIBRILLATOR 33217 2 F28 01/01/2010 INSERTION OF 2 TRANSVENOUS ELECTRODES, PERMANENT PACEMAKER OR CARDIOVERTER-DEFIBRILLATOR 33223 2 F28 01/01/2010 REVISION OF SKIN POCKET FOR CARDIOVERTER-DEFIBRILLATOR 36481 2 28 01/01/2010 PERCUTANEOUS PORTAL VEIN CATHETERIZATION BY ANY METHOD 37183 2 28 01/01/2010 REVISION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) (TIPS) (INCLUDES VENOUS ACCESS, HEPATIC AND PORTAL VEIN CATHETERIZATION, PORTOGRAPHY WITH H99RPHPC NHIC, CORP. PAGE 4 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER HEMODYNAMIC EVALUATION, INTRAHEPATIC TRACT RECANULIZATION/DILATATION, STENT PLACEMENT AND ALL ASSOCIATED IMAGING GUIDANCE AND DOCUMENTATION) 37760 2 F28 01/01/2010 LIGATION OF PERFORATOR VEINS, SUBFASCIAL, RADICAL (LINTON TYPE), INCLUDING SKIN GRAFT, WHEN PERFORMED, OPEN,1 LEG 42894 2 28 01/01/2010 RESECTION OF PHARYNGEAL WALL REQUIRING CLOSURE WITH MYOCUTANEOUS OR FASCIOCUTANEOUS FLAP OR FREE MUSCLE, SKIN, OR FASCIAL FLAP WITH MICROVASCULAR ANASTAMOSIS 43761 2 F28 01/01/2010 REPOSITIONING OF A NASO- OR ORO-GASTRIC FEEDING TUBE, THROUGH THE DUODENUM FOR ENTERIC NUTRITION 46200 2 F28 01/01/2010 FISSURECTOMY, INCLUDING SPHINCTEROTOMY, WHEN PERFORMED 46220 2 F28 01/01/2010 EXCISION OF SINGLE EXTERNAL PAPILLA OR TAG, ANUS 46221 2 F28 01/01/2010 HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S) 46230 2 F28 01/01/2010 CODE IS OUT OF NUMERICAL SEQUENCE. SEE 46200-46288 46250 2 F28 01/01/2010 HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE COLUMNS/GROUPS 46255 2 F28 01/01/2010 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; 46258 2 F28 01/01/2010 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; WITH FISTULECTOMY, INCLUDING FISSURECTOMY, WHEN PERFORMED 46260 2 F28 01/01/2010 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS; 46262 2 F28 01/01/2010 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS; WITH FISTULECTOMY, INCLUDING FISSURECTOMY, WHEN PERFORMED 46275 2 F28 01/01/2010 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); INTERSPHINCTERIC 46280 2 F28 01/01/2010 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); TRANSSPHINCTERIC, SUPRASPHINCTERIC, EXTRASPHINCTERIC OR MULTIPLE, INCLUDING PLACEMENT OF SETON, WHEN PERFORMED 46320 2 F28 01/01/2010 EXCISION OF THROMBOSED HEMORRHOID, EXTERNAL 46945 2 F28 01/01/2010 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; SINGLE HEMORRHOID COLUMN/GROUP 46946 2 F28 01/01/2010 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; SINGLE HEMORRHOID COLUMN/GROUP 2 OR MORE HEMORRHOID COLUMNS/GROUPS 47382 2 F28 01/01/2010 ABLATION, 1 OR MORE LIVER TUMOR(S), PERCUTANEOUS, RADIOFREQUENCY 47525 2 F28 01/01/2010 CHANGE OF PERCUTANEOUS BILIARY DRAINAGE CATHETER 50200 2 F28 01/01/2010 RENAL BIOPSY; PERCUTANEOUS, BY TROCAR OR NEEDLE 51726 2 F28 01/01/2010 COMPLEX CYSTOMETROGRAM (IE, CALIBRATED ELECTRONIC EQUIPMENT); TC 26 51736 2 28F 01/01/2010 SIMPLE UROFLOWMETRY (UFR) (EG, STOP-WATCH FLOW RATE, MECHANICAL UROFLOWMETER) TC 26 51797 2 28F 01/01/2010 51797 VOIDING PRESSURE STUDIES, INTRA-ABDOMINAL (IE, RECTAL, GASTRIC, TC 26 INTRAPERITONEAL) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 52282 2 F28 01/01/2010 CYSTOURETHROSCOPY, WITH INSERTION OF PERMANENT URETHRAL STENT 55873 2 F28 01/01/2010 CRYOSURGICAL ABLATION OF THE PROSTATE (INCLUDES ULTRASONIC GUIDANCE AND MONITORING) 55876 2 F28 01/01/2010 PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE (EG, FIDUCIAL MARKERS, DOSIMETER), PERCUTANEOUS, PROSTATE, SINGLE OR MULTIPLE 59897 2 28 01/01/2010 UNLISTED FETAL INVASIVE PROCEDURE, INCLUDING ULTRASOUND GUIDANCE, WHEN PERFORMED 72291 4 4 01/01/2010 RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY, TC 26 VERTEBRAL AUGMENTATION, OR SACRAL AUGMENTATION (SACROPLASTY), INCLUDING CAVITY CREATION, PER VERTEBRAL BODY OR SACRUM; UNDER FLUOROSCOPIC GUIDANCE 72292 4 4 01/01/2010 RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY, TC 26 VERTEBRAL AUGMENTATION, OR SACRAL AUGMENTATION (SACROPLASTY), INCLUDING CAVITY CREATION, PER VERTEBRAL BODY OR SACRUM; UNDER CT GUIDANCE 77003 4 4 01/01/2010 FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP FOR SPINE OR TC 26 PARASPINOUS DIAGNOSTIC OR THERAPEUTIC INJECTION PROCEDURES (EPIDURAL, TRANSFORAMINAL EPIDURAL, SUBARACHNOID, OR SACROILIAC JOINT), INCLUDING NEUROLYTIC AGENT DESTRUCTION 77371 4 F6 01/01/2010 RADIATION TREATMENT DELIVERY, STEREOTACTIC RADIOSURGERY (SRS), COMPLETE COURSE OF TREATMENT OF CRANIAL LESION(S) CONSISTING OF 1 SESSION; MULTI-SOURCE COBALT 60 BASED H99RPHPC NHIC, CORP. PAGE 5 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER 80055 5 5 01/01/2010 OBSTETRIC PANEL 82306 5 5 01/01/2010 VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED 82652 5 5 01/01/2010 DIHYDROTESTOSTERONE (DHT) 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED 82784 5 5 01/01/2010 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH 82785 5 5 01/01/2010 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE 82787 5 5 01/01/2010 GAMMAGLOBULIN (IMMUNOGLOBULIN); IMMUNOGLOBULIN SUBCLASSES (EG, IGG1, 2, 3, OR 4), EACH 83516 5 5 01/01/2010 IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD 83518 5 5 01/01/2010 IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE OR SEMIQUANTITATIVE, SINGLE STEP METHOD (EG, REAGENT STRIP) 83519 5 5 01/01/2010 IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATIVE, BY RADIOIMMUNOASSAY (EG, RIA) 83520 5 5 01/01/2010 IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATIVE, NOT OTHERWISE SPECIFIED 83986 5 5 01/01/2010 PH; BODY FLUID, NOT OTHERWISE SPECIFIED 86592 5 5 01/01/2010 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART) 86593 5 5 01/01/2010 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUANTITATIVE 87149 5 5 01/01/2010 CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID (DNA OR RNA) PROBE, DIRECT PROBE TECHNIQUE, PER CULTURE OR ISOLATE, EACH ORGANISM PROBED 88312 5 5 01/01/2010 SPECIAL STAINS; GROUP I FOR MICROORGANISMS (EG, GRIDLEY, ACID FAST, METHENAMINE TC 26 SILVER), INCLUDING INTERPRETATION AND REPORT, EACH 88313 5 5 01/01/2010 SPECIAL STAINS; GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT TC 26 IMMUNOCYTOCHEMISTRY AND IMMUNOPEROXIDASE STAINS, INCLUDING INTERPRETATION AND REPORT, EACH 88314 5 5 01/01/2010 SPECIAL STAINS; HISTOCHEMICAL STAINING WITH FROZEN SECTION(S), INCLUDING TC 26 INTERPRETATION AND REPORT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 90378 1 F1 01/01/2010 RESPIRATORY SYNCYTIAL VIRUS, MONOCLONAL ANTIBODY, RECOMBINANT, FOR INTRAMUSCULAR USE, 50 MG, EACH 90663 V V 09/28/2009 INFLUENZA VIRUS VACCINE, PANDEMIC FORMULATION, H1N1 90669 V V 01/01/2010 PNEUMOCOCCAL CONJUGATE VACCINE, 7 VALENT, FOR INTRAMUSCULAR USE 90738 1 1 01/01/2010 JAPANESE ENCEPHALITIS VIRUS VACCINE, INACTIVATED, FOR INTRAMUSCULAR USE 93279 1 1 01/01/2010 PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE TC 26 IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; SINGLE LEAD PACEMAKER SYSTEM 93280 1 1 01/01/2010 PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE TC 26 IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; DUAL LEAD PACEMAKER SYSTEM 93281 1 1 01/01/2010 PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE TC 26 IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; MULTIPLE LEAD PACEMAKER SYSTEM 93282 1 1 01/01/2010 PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE TC 26 IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; SINGLE LEAD IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM 93283 1 1 01/01/2010 PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE TC 26 IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; DUAL LEAD IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM 93284 1 1 01/01/2010 PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE TC 26 H99RPHPC NHIC, CORP. PAGE 6 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; MULTIPLE LEAD IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM 93285 1 1 01/01/2010 PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE TC 26 IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; IMPLANTABLE LOOP RECORDER SYSTEM 93286 1 1 01/01/2010 PERI-PROCEDURAL DEVICE EVALUATION (IN PERSON) AND PROGRAMMING OF DEVICE SYSTEM TC 26 PARAMETERS BEFORE OR AFTER A SURGERY, PROCEDURE, OR TEST WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; SINGLE, DUAL, OR MULTIPLE LEAD PACEMAKER SYSTEM 93287 1 1 01/01/2010 PERI-PROCEDURAL DEVICE EVALUATION (IN PERSON) AND PROGRAMMING OF DEVICE SYSTEM TC 26 PARAMETERS BEFORE OR AFTER A SURGERY, PROCEDURE, OR TEST WITH PHYSICIAN ANALYSIS, REVIEW AND REPORT; SINGLE, DUAL, OR MULTIPLE LEAD IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM 93701 5 5 01/01/2010 BIOIMPEDANCE-DERIVED PHYSIOLOGIC CARDIOVASCULAR ANALYSIS 95806 5 5 01/01/2010 SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING OF, HEART RATE, OXYGEN TC 26 SATURATION, RESPIRATORY AIRFLOW, AND RESPIRATORY EFFORT (EG, THORACOABDOMINAL MOVEMENT) 96570 2 1 01/01/2010 PHOTODYNAMIC THERAPY BY ENDOSCOPIC APPLICATION OF LIGHT TO ABLATE ABNORMAL TISSUE VIA ACTIVATION OF PHOTOSENSITIVE DRUG(S); FIRST 30 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR ENDOSCOPY OR BRONCHOSCOPY PROCEDURES OF LUNG AND GASTROINTESTINAL TRACT) 96571 2 1 01/01/2010 PHOTODYNAMIC THERAPY BY ENDOSCOPIC APPLICATION OF LIGHT TO ABLATE ABNORMAL TISSUE VIA ACTIVATION OF PHOTOSENSITIVE DRUG(S); EACH ADDITIONAL 15 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR ENDOSCOPY OR BRONCHOSCOPY PROCEDURES OF LUNG AND GASTROINTESTINAL TRACT) 99304 1 1 01/01/2010 INITIAL NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED OR COMPREHENSIVE HISTORY; A DETAILED OR COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAKING THAT IS STRAIGHTFORWARD OR OF LOW COMPLEXITY. 99305 1 1 01/01/2010 INITIAL NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAKING OF MODERATE COMPLEXITY. 99306 1 1 01/01/2010 INITIAL NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAKING OF HIGH COMPLEXITY. 99307 1 1 01/01/2010 SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: A PROBLEM FOCUSED INTERVAL HISTORY; A PROBLEM FOCUSED EXAMINATION; STRAIGHTFORWARD MEDICAL DECISION MAKING. 99308 1 1 01/01/2010 SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED INTERVAL HISTORY; AN EXPANDED PROBLEM FOCUSED EXAMINATION; MEDICAL DECISION MAKING OF LOW COMPLEXITY. 99309 1 1 01/01/2010 SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: A DETAILED INTERVAL HISTORY; A DETAILED EXAMINATION; MEDICAL DECISION MAKING OF MODERATE COMPLEXITY. 99310 1 1 01/01/2010 SUBSEQUENT NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: A COMPREHENSIVE INTERVAL HISTORY; A COMPREHENSIVE EXAMINATION; MEDICAL DECISION MAKING OF HIGH COMPLEXITY. 99318 1 1 01/01/2010 EVALUATION AND MANAGEMENT OF A PATIENT INVOLVING AN ANNUAL NURSING FACILITY ASSESSMENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED INTERVAL HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAKING THAT IS OF LOW TO H99RPHPC NHIC, CORP. PAGE 7 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER MODERATE COMPLEXITY. 99358 1 1 01/01/2010 PROLONGED EVALUATION AND MANAGEMENT SERVICE BEFORE AND/ OR AFTER DIRECT (FACE-TO-FACE) PATIENT CARE; FIRST HOUR 99359 1 1 01/01/2010 PROLONGED EVALUATION AND MANAGEMENT SERVICE BEFORE AND/ OR AFTER DIRECT (FACE-TO-FACE) PATIENT CARE; EACH ADDITIONAL 30 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PROLONGED PHYSICIAN SERVICE) 0519F 1 1 01/01/2010 PLANNED CHEMOTHERAPY REGIMEN, INCLUDING AT A MINIMUM: DRUG(S) PRESCRIBED, DOSE, NOT FOUND AND DURATION, DOCUMENTED PRIOR TO INITIATION OF A NEW TREATMENT REGIMEN (ONC)1 0520F 1 1 01/01/2010 RADIATION DOSE LIMITS TO NORMAL TISSUES ESTABLISHED PRIOR TO THE INITIATION OF NOT FOUND A COURSE OF 3D CONFORMAL RADIATION FOR A MINIMUM OF 2 TISSUE/ORGAN (ONC)1 0521F 1 1 01/01/2010 PLAN OF CARE TO ADDRESS PAIN DOCUMENTED (COA)2 (ONC)1 NOT FOUND 0528F 1 1 01/01/2010 RECOMMENDED FOLLOW-UP INTERVAL FOR REPEAT COLONOSCOPY OF AT LEAST 10 YEARS NOT FOUND DOCUMENTED IN COLONOSCOPY REPORT (END/POLYP)5 0529F 1 1 01/01/2010 INTERVAL OF 3 OR MORE YEARS SINCE PATIENT'S LAST COLONOSCOPY, DOCUMENTED NOT FOUND (END/POLYP)5 0535F 1 1 01/01/2010 DYSPNEA MANAGEMENT PLAN OF CARE, DOCUMENTED (PALL CR)5 NOT FOUND 0540F 1 1 01/01/2010 GLUCORTICOID MANAGEMENT PLAN DOCUMENTED (RA)5 NOT FOUND 1150F 1 1 01/01/2010 DOCUMENTATION THAT A PATIENT HAS A SUBSTANTIAL RISK OF DEATH WITHIN 1 YEAR NOT FOUND (PALL CR)5 1151F 1 1 01/01/2010 DOCUMENTATION THAT A PATIENT DOES NOT HAVE A SUBSTANTIAL RISK OF DEATH WITHIN NOT FOUND ONE YEAR (PALL CR)5 1152F 1 1 01/01/2010 DOCUMENTATION OF ADVANCED DISEASE DIAGNOSIS, GOALS OF CARE PRIORITIZE COMFORT NOT FOUND (PALL CR)5 1153F 1 1 01/01/2010 DOCUMENTATION OF ADVANCED DISEASE DIAGNOSIS, GOALS OF CARE DO NOT PRIORITIZE NOT FOUND COMFORT (PALL CR)5 1157F 1 1 01/01/2010 ADVANCE CARE PLAN OR SIMILAR LEGAL DOCUMENT PRESENT IN THE MEDICAL RECORD (COA)2 NOT FOUND 1158F 1 1 01/01/2010 ADVANCE CARE PLANNING DISCUSSION DOCUMENTED IN THE MEDICAL RECORD (COA)2 NOT FOUND 1159F 1 1 01/01/2010 MEDICATION LIST DOCUMENTED IN MEDICAL RECORD (COA)2 NOT FOUND 1160F 1 1 01/01/2010 REVIEW OF ALL MEDICATIONS BY A PRESCRIBING PRACTITIONER OR CLINICAL PHARMACIST NOT FOUND (SUCH AS, PRESCRIPTIONS, OTCS, HERBAL THERAPIES AND SUPPLEMENTS) DOCUMENTED IN THE MEDICAL RECORD (COA)2 1170F 1 1 01/01/2010 FUNCTIONAL STATUS ASSESSED (COA)2 (RA)5 NOT FOUND 1180F 1 1 01/01/2010 ALL SPECIFIED THROMBOEMBOLIC RISK FACTORS ASSESSED (AFIB)1 NOT FOUND 1220F 1 1 01/01/2010 PATIENT SCREENED FOR DEPRESSION (SUD)5 NOT FOUND 2050F 1 1 01/01/2010 WOUND CHARACTERISTICS INCLUDING SIZE AND NATURE OF WOUND BASE TISSUE AND AMOUNT NOT FOUND OF DRAINAGE PRIOR TO DEBRIDEMENT DOCUMENTED (CWC)5 3016F 1 1 01/01/2010 PATIENT SCREENED FOR UNHEALTHY ALCOHOL USE USING A SYSTEMATIC SCREENING METHOD NOT FOUND (PV)1 3018F 1 1 01/01/2010 PRE-PROCEDURE RISK ASSESSMENT AND DEPTH OF INSERTION AND QUALITY OF THE BOWEL NOT FOUND PREP AND COMPLETE DESCRIPTION OF POLYP(S) FOUND, INCLUDING LOCATION OF EACH POLYP, SIZE, NUMBER AND GROSS MORPHOLOGY AND RECOMMENDATIONS FOR FOLLOW-UP IN FINAL COLONOSCOPY REPORT DOCUMENTED (END/POLYP)5 3111F 1 1 01/01/2010 CT OR MRI OF THE BRAIN PERFORMED IN THE HOSPITAL WITHIN 24 HOURS OF ARRIVAL OR NOT FOUND PERFORMED IN AN OUTPATIENT IMAGING CENTER, TO CONFIRM INITIAL DIAGNOSIS OF STROKE, TIA OR HEMORRHAGE (STR)5 3112F 1 1 01/01/2010 CT OR MRI OF THE BRAIN PERFORMED GREATER THAN 24 HOURS AFTER ARRIVAL TO THE NOT FOUND HOSPITAL OR PERFORMED IN AN OUTPATIENT IMAGING CENTER FOR PURPOSE OTHER THAN CONFIRMATION OF INITIAL DIAGNOSIS OF STROKE, TIA OR HEMORRHAGE (STR)5 3250F 1 1 01/01/2010 SPECIMEN SITE OTHER THAN ANATOMIC LOCATION OF PRIMARY TUMOR (PATH)1 NOT FOUND 3321F 1 1 01/01/2010 AJCC CANCER STAGE 0 OR IA MELANOMA, DOCUMENTED (ML)5 NOT FOUND 3322F 1 1 01/01/2010 MELANOMA GREATER THAN AJCC STAGE 0 OR IA (ML)5 NOT FOUND 3370F 1 1 01/01/2010 AJCC BREAST CANCER STAGE 0 DOCUMENTED (ONC)1 NOT FOUND 3372F 1 1 01/01/2010 AJCC BREAST CANCER STAGE I: T1MIC, T1A OR T1B (TUMOR SIZE ª 1 CM) DOCUMENTED NOT FOUND (ONC)1 3374F 1 1 01/01/2010 AJCC BREAST CANCER STAGE I: T1C (TUMOR SIZE > 1 CM TO 2 CM) DOCUMENTED (ONC)1 NOT FOUND H99RPHPC NHIC, CORP. PAGE 8 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER 3376F 1 1 01/01/2010 AJCC BREAST CANCER STAGE II DOCUMENTED (ONC)1 NOT FOUND 3378F 1 1 01/01/2010 AJCC BREAST CANCER STAGE III DOCUMENTED (ONC)1 NOT FOUND 3380F 1 1 01/01/2010 AJCC BREAST CANCER STAGE IV DOCUMENTED (ONC)1 NOT FOUND 3382F 1 1 01/01/2010 AJCC COLON CANCER, STAGE 0 DOCUMENTED (ONC)1 NOT FOUND 3384F 1 1 01/01/2010 AJCC COLON CANCER, STAGE I DOCUMENTED (ONC)1 NOT FOUND 3386F 1 1 01/01/2010 AJCC COLON CANCER, STAGE II DOCUMENTED (ONC)1 NOT FOUND 3388F 1 1 01/01/2010 AJCC COLON CANCER, STAGE III DOCUMENTED (ONC)1 NOT FOUND 3390F 1 1 01/01/2010 AJCC COLON CANCER, STAGE IV DOCUMENTED (ONC)1 NOT FOUND 3450F 1 1 01/01/2010 DYSPNEA SCREENED, NO DYSPNEA OR MILD DYSPNEA (PALL CR)5 NOT FOUND 3451F 1 1 01/01/2010 DYSPNEA SCREENED, MODERATE OR SEVERE DYSPNEA (PALL CR)5 NOT FOUND 3452F 1 1 01/01/2010 DYSPNEA NOT SCREENED (PALL CR)5 NOT FOUND 3455F 1 1 01/01/2010 TB SCREENING PERFORMED AND RESULTS INTERPRETED WITHIN SIX MONTHS PRIOR TO NOT FOUND INITIATION OF FIRST-TIME BIOLOGIC DISEASE MODIFYING ANTI-RHEUMATIC DRUG THERAPY FOR RA (RA)5 3470F 1 1 01/01/2010 RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY, LOW (RA)5 NOT FOUND 3471F 1 1 01/01/2010 RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY, MODERATE (RA)5 NOT FOUND 3472F 1 1 01/01/2010 RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY, HIGH (RA)5 NOT FOUND 3475F 1 1 01/01/2010 DISEASE PROGNOSIS FOR RHEUMATOID ARTHRITIS ASSESSED, POOR PROGNOSIS DOCUMENTED NOT FOUND (RA)5 3476F 1 1 01/01/2010 DISEASE PROGNOSIS FOR RHEUMATOID ARTHRITIS ASSESSED, GOOD PROGNOSIS DOCUMENTED NOT FOUND (RA)5 3490F 1 1 01/01/2010 HISTORY OF AIDS-DEFINING CONDITION (HIV)5 NOT FOUND 3491F 1 1 01/01/2010 HIV INDETERMINATE (INFANTS OF UNDETERMINED HIV STATUS BORN OF HIV-INFECTED NOT FOUND MOTHERS) (HIV)5 3492F 1 1 01/01/2010 HISTORY OF NADIR CD4+ CELL COUNT 350 CELLS/MM3 (HIV)5 NOT FOUND 3493F 1 1 01/01/2010 NO HISTORY OF NADIR CD4+ CELL COUNT 350 CELLS/MM3 AND NO HISTORY OF NOT FOUND AIDS-DEFINING CONDITION (HIV)5 3494F 1 1 01/01/2010 CD4+ CELL COUNT 200 CELLS/MM3 (HIV)5 NOT FOUND 3495F 1 1 01/01/2010 CD4+ CELL COUNT 200 - 499 CELLS/MM3 (HIV)5 NOT FOUND 3496F 1 1 01/01/2010 CD4+ CELL COUNT ª500 CELLS/MM3 (HIV)5 NOT FOUND 3497F 1 1 01/01/2010 CD4+ CELL PERCENTAGE 15% (HIV)5 NOT FOUND 3498F 1 1 01/01/2010 CD4+ CELL PERCENTAGE ª15% (HIV)5 NOT FOUND 3500F 1 1 01/01/2010 CD4+ CELL COUNT OR CD4+ CELL PERCENTAGE DOCUMENTED AS PERFORMED (HIV)5 NOT FOUND 3502F 1 1 01/01/2010 HIV RNA VIRAL LOAD BELOW LIMITS OF QUANTIFICATION (HIV)5 NOT FOUND 3503F 1 1 01/01/2010 HIV RNA VIRAL LOAD NOT BELOW LIMITS OF QUANTIFICATION (HIV)5 NOT FOUND 3510F 1 1 01/01/2010 DOCUMENTATION THAT TUBERCULOSIS (TB) SCREENING TEST PERFORMED AND RESULTS NOT FOUND INTERPRETED (HIV)5 3511F 1 1 01/01/2010 CHLAMYDIA AND GONORRHEA SCREENINGS DOCUMENTED AS PERFORMED (HIV)5 NOT FOUND 3512F 1 1 01/01/2010 SYPHILIS SCREENING DOCUMENTED AS PERFORMED (HIV)5 NOT FOUND 3513F 1 1 01/01/2010 HEPATITIS B SCREENING DOCUMENTED AS PERFORMED (HIV)5 NOT FOUND 3514F 1 1 01/01/2010 HEPATITIS C SCREENING DOCUMENTED AS PERFORMED (HIV)5 NOT FOUND 3515F 1 1 01/01/2010 PATIENT HAS DOCUMENTED IMMUNITY TO HEPATITIS C (HIV)5 NOT FOUND 3550F 1 1 01/01/2010 LOW RISK FOR THROMBOEMBOLISM (AFIB)1 NOT FOUND 3551F 1 1 01/01/2010 INTERMEDIATE RISK FOR THROMBOEMBOLISM (AFIB)1 NOT FOUND 3552F 1 1 01/01/2010 HIGH RISK FOR THROMBOEMBOLISM (AFIB)1 NOT FOUND 3555F 1 1 01/01/2010 PATIENT HAD INTERNATIONAL NORMALIZED RATIO (INR) MEASUREMENT PERFORMED (AFIB)1 NOT FOUND 3570F 1 1 01/01/2010 FINAL REPORT FOR BONE SCINTIGRAPHY STUDY INCLUDES CORRELATION WITH EXISTING NOT FOUND RELEVANT IMAGING STUDIES (EG, X-RAY, MRI, CT) CORRESPONDING TO THE SAME ANATOMICAL REGION IN QUESTION (NUC_MED)1 3572F 1 1 01/01/2010 PATIENT CONSIDERED TO BE POTENTIALLY AT RISK FOR FRACTURE IN A WEIGHT-BEARING NOT FOUND SITE (NUC_MED)1 3573F 1 1 01/01/2010 PATIENT NOT CONSIDERED TO BE POTENTIALLY AT RISK FOR FRACTURE IN A NOT FOUND WEIGHT-BEARING SITE (NUC_MED)1 4011F 1 1 01/01/2010 ORAL ANTIPLATELET THERAPY PRESCRIBED (CAD)1 NOT FOUND 4047F 1 1 01/01/2010 DOCUMENTATION OF ORDER FOR PROPHYLACTIC ANTIBIOTICS TO BE GIVEN WITHIN ONE HOUR NOT FOUND H99RPHPC NHIC, CORP. PAGE 9 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER (IF FLUOROQUINOLONE OR VANCOMYCIN, TWO HOURS) PRIOR TO SURGICAL INCISION (OR START OF PROCEDURE WHEN NO INCISION IS REQUIRED) (PERI 2)5 4048F 1 1 01/01/2010 DOCUMENTATION THAT ADMINISTRATION OF PROPHYLACTIC PARENTERAL ANTIBIOTIC WAS NOT FOUND INITIATED WITHIN ONE HOUR (IF FLUOROQUINOLONE OR VANCOMYCIN, TWO HOURS) PRIOR TO SURGICAL INCISION (OR START OF PROCEDURE WHEN NO INCISION IS REQUIRED) (PERI 2)5 4148F 1 1 01/01/2010 HEPATITIS A VACCINE INJECTION ADMINISTERED OR PREVIOUSLY RECEIVED (HEP-C)1 NOT FOUND 4149F 1 1 01/01/2010 HEPATITIS B VACCINE INJECTION ADMINISTERED OR PREVIOUSLY RECEIVED (HEP-C)1 NOT FOUND 4158F 1 1 01/01/2010 PATIENT COUNSELED ABOUT RISKS OF ALCOHOL USE (HEP-C)1 NOT FOUND 4180F 1 1 01/01/2010 ADJUVANT CHEMOTHERAPY REFERRED, PRESCRIBED, OR PREVIOUSLY RECEIVED FOR STAGE NOT FOUND III COLON CANCER (ONC)1 4192F 1 1 01/01/2010 PATIENT NOT RECEIVING GLUCOCORTICOID THERAPY (RA)5 NOT FOUND 4193F 1 1 01/01/2010 PATIENT RECEIVING 10 MG DAILY PREDNISONE (OR EQUIVALENT), OR RA ACTIVITY IS NOT FOUND WORSENING, OR GLUCOCORTICOID USE IS FOR LESS THAN 6 MONTHS (RA)5 4194F 1 1 01/01/2010 PATIENT RECEIVING ª10 MG DAILY PREDNISONE (OR EQUIVALENT) FOR LONGER THAN 6 NOT FOUND MONTHS, AND IMPROVEMENT OR NO CHANGE IN DISEASE ACTIVITY (RA)5 4195F 1 1 01/01/2010 PATIENT RECEIVING FIRST-TIME BIOLOGIC DISEASE MODIFYING ANTI-RHEUMATIC DRUG NOT FOUND THERAPY FOR RHEUMATOID ARTHRITIS (RA)5 4196F 1 1 01/01/2010 PATIENT NOT RECEIVING FIRST-TIME BIOLOGIC DISEASE MODIFYING ANTI-RHEUMATIC DRUG NOT FOUND THERAPY FOR RHEUMATOID ARTHRITIS (RA)5 4200F 1 1 01/01/2010 EXTERNAL BEAM RADIOTHERAPY AS PRIMARY THERAPY TO PROSTATE WITH OR WITHOUT NODAL NOT FOUND IRRADIATION (PRCA)1 4201F 1 1 01/01/2010 EXTERNAL BEAM RADIOTHERAPY WITH OR WITHOUT NODAL IRRADIATION AS ADJUVANT OR NOT FOUND SALVAGE THERAPY FOR PROSTATE CANCER PATIENT (PRCA)1 4250F 1 1 01/01/2010 ACTIVE WARMING USED INTRAOPERATIVELY FOR THE PURPOSE OF MAINTAINING NOT FOUND NORMOTHERMIA, OR AT LEAST 1 BODY TEMPERATURE EQUAL TO OR GREATER THAN 36 DEGREES CENTIGRADE (OR 96.8 DEGREES FAHRENHEIT) RECORDED WITHIN THE 30 MINUTES IMMEDIATELY BEFORE OR THE 15 MINUTES IMMEDIATELY AFTER ANESTHESIA END TIME (CRIT)1 4260F 1 1 01/01/2010 WOUND SURFACE CULTURE TECHNIQUE USED (CWC)5 NOT FOUND 4261F 1 1 01/01/2010 TECHNIQUE OTHER THAN SURFACE CULTURE OF THE WOUND EXUDATE USED (EG, LEVINE/DEEP NOT FOUND SWAB TECHNIQUE, SEMI-QUANTITATIVE OR QUANTITATIVE SWAB TECHNIQUE) OR WOUND SURFACE CULTURE TECHNIQUE NOT USED (CWC)5 4265F 1 1 01/01/2010 USE OF WET TO DRY DRESSINGS PRESCRIBED OR RECOMMENDED (CWC)5 NOT FOUND 4266F 1 1 01/01/2010 USE OF WET TO DRY DRESSINGS NEITHER PRESCRIBED NOR RECOMMENDED (CWC)5 NOT FOUND 4267F 1 1 01/01/2010 COMPRESSION THERAPY PRESCRIBED (CWC)5 NOT FOUND 4268F 1 1 01/01/2010 PATIENT EDUCATION REGARDING THE NEED FOR LONG TERM COMPRESSION THERAPY NOT FOUND INCLUDING INTERVAL REPLACEMENT OF COMPRESSION STOCKINGS RECEIVED (CWC)5 4269F 1 1 01/01/2010 APPROPRIATE METHOD OF OFFLOADING (PRESSURE RELIEF) PRESCRIBED (CWC)5 NOT FOUND 4274F 1 1 01/01/2010 INFLUENZA IMMUNIZATION ADMINISTERED OR PREVIOUSLY RECEIVED (HIV)5 (P-ESRD)1 NOT FOUND 4275F 1 1 01/01/2010 HEPATITIS B VACCINE INJECTION ADMINISTERED OR PREVIOUSLY RECEIVED (HIV)5 NOT FOUND 4276F 1 1 01/01/2010 POTENT ANTIRETROVIRAL THERAPY PRESCRIBED (HIV)5 NOT FOUND 4290F 1 1 01/01/2010 PATIENT SCREENED FOR INJECTION DRUG USE (HIV)5 NOT FOUND 4293F 1 1 01/01/2010 PATIENT SCREENED FOR HIGH-RISK SEXUAL BEHAVIOR (HIV)5 NOT FOUND 4300F 1 1 01/01/2010 PATIENT RECEIVING WARFARIN THERAPY FOR NONVALVULAR ATRIAL FIBRILLATION OR NOT FOUND ATRIAL FLUTTER (AFIB)1 4301F 1 1 01/01/2010 PATIENT NOT RECEIVING WARFARIN THERAPY FOR NONVALVULAR ATRIAL FIBRILLATION OR NOT FOUND ATRIAL FLUTTER (AFIB)1 4305F 1 1 01/01/2010 PATIENT EDUCATION REGARDING APPROPRIATE FOOT CARE AND DAILY INSPECTION OF THE NOT FOUND FEET RECEIVED (CWC)5 4306F 1 1 01/01/2010 PATIENT COUNSELED REGARDING PSYCHOSOCIAL AND PHARMACOLOGIC TREATMENT OPTIONS NOT FOUND FOR OPIOID ADDICTION (SUD)1 4320F 1 1 01/01/2010 PATIENT COUNSELED REGARDING PSYCHOSOCIAL AND PHARMACOLOGIC TREATMENT OPTIONS NOT FOUND FOR ALCOHOL DEPENDENCE (SUD)5 5020F 1 1 01/01/2010 TREATMENT SUMMARY REPORT COMMUNICATED TO PHYSICIAN(S) MANAGING CONTINUING CARE NOT FOUND H99RPHPC NHIC, CORP. PAGE 10 11/18/2009 HCPCS CHANGES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER AND TO THE PATIENT WITHIN 1 MONTH OF COMPLETING TREATMENT (ONC)1 5100F 1 1 01/01/2010 POTENTIAL RISK FOR FRACTURE COMMUNICATED TO THE REFERRING PHYSICIAN WITHIN 24 NOT FOUND HOURS OF COMPLETION OF THE IMAGING STUDY (NUC_MED)1 6030F 1 1 01/01/2010 ALL ELEMENTS OF MAXIMAL STERILE BARRIER TECHNIQUE FOLLOWED INCLUDING: CAP AND NOT FOUND MASK AND STERILE GOWN AND STERILE GLOVES AND A LARGE STERILE SHEET AND HAND HYGIENE AND 2% CHLORHEXIDINE FOR CUTANEOUS ANTISEPSIS (OR ACCEPTABLE ALTERNATIVE ANTISEPTICS, PER CURRENT GUIDELINE) (CRIT)1 7010F 1 1 01/01/2010 PATIENT INFORMATION ENTERED INTO A RECALL SYSTEM THAT INCLUDES: TARGET DATE FOR NOT FOUND THE NEXT EXAM SPECIFIED AND A PROCESS TO FOLLOW UP WITH PATIENTS REGARDING MISSED OR UNSCHEDULED APPOINTMENTS (ML)5 0197T 6 6 01/01/2010 INTRA-FRACTION LOCALIZATION AND TRACKING OF TARGET OR PATIENT MOTION DURING NOT FOUND DELIVERY OF RADIATION THERAPY (EG, 3D POSITIONAL TRACKING, GATING, 3D SURFACE TRACKING), EACH FRACTION OF TREATMENT 0198T 1 1 01/01/2010 MEASUREMENT OF OCULAR BLOOD FLOW BY REPETITIVE INTRAOCULAR PRESSURE SAMPLING, NOT FOUND WITH INTERPRETATION AND REPORT