H99RPHPD NHIC, CORP. PAGE 1 11/18/2009 HCPCS DELETES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER A4365 P 9 01/01/2010 ADHESIVE REMOVER WIPES, ANY TYPE, PER 50 A6200 S 9 01/01/2010 COMPOSITE DRESSING, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING A6201 S 9 01/01/2010 COMPOSITE DRESSING, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING A6202 S 9 01/01/2010 COMPOSITE DRESSING, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING A6542 P 9 01/01/2010 GRADIENT COMPRESSION STOCKING, CUSTOM MADE A6543 P 9 01/01/2010 GRADIENT COMPRESSION STOCKING, LYMPHEDEMA A9535 4 4 01/01/2010 INJECTION, METHYLENE BLUE, 1 ML A9605 6 9 01/01/2010 SAMARIUM SM-153 LEXIDRONAMM, THERAPEUTIC, PER 50 MILLICURIES C9245 1 1 01/01/2010 INJECTION, ROMIPLOSTIM, 10 MCG NOT FOUND C9246 1 1 01/01/2010 INJECTION, GADOXETATE DISODIUM, PER ML NOT FOUND C9247 1 1 01/01/2010 IOBENGUANE, I-123, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES NOT FOUND C9249 1 1 01/01/2010 INJECTION, CERTOLIZUMAB PEGOL, 1 MG NOT FOUND C9251 9 1 01/01/2010 INJECTION, C1 ESTERASE INHIBITOR (HUMAN), 10 UNITS NOT FOUND C9252 9 1 01/01/2010 INJECTION, PLERIXAFOR, 1 MG NOT FOUND C9253 9 1 01/01/2010 INJECTION, TEMOZOLOMIDE, 1 MG NOT FOUND E1340 9 9 01/01/2010 REPAIR OR NONROUTINE SERVICE FOR DURABLE MEDICAL EQUIPMENT REQUIRING THE SKILL NOT FOUND OF A TECHNICIAN, LABOR COMPONENT, PER 15 MINUTES E2223 APR 9 01/01/2010 MANUAL WHEELCHAIR ACCESSORY, VALVE, ANY TYPE, REPLACEMENT ONLY, EACH NOT FOUND E2393 APR 9 01/01/2010 POWER WHEELCHAIR ACCESSORY, VALVE FOR PNEUMATIC TIRE TUBE, ANY TYPE, NOT FOUND REPLACEMENT ONLY, EACH E2399 APR 9 01/01/2010 POWER WHEELCHAIR ACCESSORY, NOT OTHERWISE CLASSIFIED INTERFACE, INCLUDING ALL NOT FOUND RELATED ELECTRONICS AND ANY TYPE MOUNTING HARDWARE G0392 2 28 01/01/2010 TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; FOR MAINTENANCE OF HEMODIALYSIS ACCESS, ARTERIOVENOUS FISTULA OR GRAFT; ARTERIAL G0393 2 28 01/01/2010 TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; FOR MAINTENANCE OF HEMODIALYSIS ACCESS, ARTERIOVENOUS FISTULA OR GRAFT; VENOUS G8503 1 1 01/01/2010 DOCUMENTATION THAT PROPHYLACTIC ANTIBIOTIC WAS GIVEN WITHIN ONE HOUR (IF NOT FOUND FLUOROQUINOLONE OR VANCOMYCIN, TWO HOURS) PRIOR TO SURGICAL INCISION (OR START OF PROCEDURE WHEN NO INCISION IS REQUIRED) G8504 1 1 01/01/2010 DOCUMENTATION OF ORDER FOR PROPHYLACTIC ANTIBIOTICS TO BE GIVEN WITHIN ONE HOUR NOT FOUND (IF FLUOROQUINOLONE OR VANCOMYCIN, TWO HOURS) PRIOR TO SURGICAL INCISION (OR START OF PROCEDURE WHEN NO INCISION IS REQUIRED) G8505 1 1 01/01/2010 DOCUMENTATION THAT PROPHYLACTIC ANTIBIOTIC WAS NOT GIVEN WITHIN ONE HOUR (IF NOT FOUND FLUOROQUINOLONE OR VANCOMYCIN, TWO HOURS) PRIOR TO SURGICAL INCISION (OR START OF PROCEDURE WHEN NO INCISION IS REQUIRED), REASON NOT SPECIFIED G8512 1 1 01/01/2010 PAIN SEVERITY QUANTIFIED; PAIN PRESENT NOT FOUND G8513 1 1 01/01/2010 ABI MEASURED AND DOCUMENTED NOT FOUND G8514 1 1 01/01/2010 CLINICIAN DOCUMENTED THAT PATIENT WAS NOT AN ELIGIBLE CANDIDATE FOR ABI NOT FOUND MEASUREMENT MEASURE G8515 1 1 01/01/2010 ABI MEASUREMENT WAS NOT OBTAINED NOT FOUND G8516 1 1 01/01/2010 PATIENT SCREENED FOR FUTURE FALLS RISK; DOCUMENTATION OF TWO OR MORE FALLS IN NOT FOUND THE PAST YEAR OR ANY FALL WITH INJURY IN THE PAST YEAR G8517 1 1 01/01/2010 PATIENT SCREENED FOR FUTURE FALL RISK; DOCUMENTATION OF NO FALLS IN THE PAST NOT FOUND YEAR OR ONLY ONE FALL WITHOUT INJURY IN THE PAST YEAR G8521 1 1 01/01/2010 ANTIPLATELET THERAPY RECEIVED (ASA ?81-325 MG/DAY¨ AND/OR CLOPIDOGREL ?75 NOT FOUND MG/DAY¨) WITHIN 48 HOURS OF THE INITIATION OF SURGERY AND AT DISCHARGE G8522 1 1 01/01/2010 CLINICIAN DOCUMENTED THAT PATIENT WAS NOT AN ELIGIBLE CANDIDATE FOR NOT FOUND ANTIPLATELET THERAPY G8523 1 1 01/01/2010 ANTIPLATELET THERAPY NOT RECEIVED 48 HOURS PRIOR TO CEA AND AT DISCHARGE, NOT FOUND REASON NOT SPECIFIED G8527 1 1 01/01/2010 DOCUMENTATION OF ORDER FOR CEFAZOLIN OR CEFUROXIME FOR ANTIMICROBIAL PROPHYLAXIS NOT FOUND G8528 1 1 01/01/2010 CLINICIAN DOCUMENTED THAT PATIENT WAS INELIGIBLE FOR PROPHYLACTIC ANTIBIOTIC NOT FOUND H99RPHPD NHIC, CORP. PAGE 2 11/18/2009 HCPCS DELETES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER SELECTION MEASURE G8529 1 1 01/01/2010 ORDER FOR CEFAZOLIN OR CEFUROXIME FOR ANTIMICROBIAL PROPHYLAXIS NOT DOCUMENTED, NOT FOUND REASON NOT SPECIFIED G8533 1 1 01/01/2010 PARTICIPATION BY A PHYSICIAN OR OTHER CLINICIAN IN SYSTEMATIC CLINICAL DATABASE NOT FOUND REGISTRY THAT INCLUDES CONSENSUS-ENDORSED QUALITY MEASURES J0460 1P 1 01/01/2010 INJECTION, ATROPINE SULFATE, UP TO 0.3 MG J0530 1P 1 01/01/2010 INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 600,000 UNITS J0540 1P 1 01/01/2010 INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 1,200,000 UNITS J0550 1P 1 01/01/2010 INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, UP TO 2,400,000 UNITS J0835 1P 1 01/01/2010 INJECTION, COSYNTROPIN, PER 0.25 MG J1565 1P 1 01/01/2010 INJECTION, RESPIRATORY SYNCYTIAL VIRUS IMMUNE GLOBULIN, INTRAVENOUS, 50 MG J7322 1 1 01/01/2010 HYALURONAN OR DERIVATIVE, SYNVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE J9170 1P 1 01/01/2010 INJECTION, DOCETAXEL, 20 MG L0210 P 9 01/01/2010 THORACIC, RIB BELT NOT FOUND L1800 P 9 01/01/2010 KNEE ORTHOSIS, ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND NOT FOUND ADJUSTMENT L1815 P 9 01/01/2010 KNEE ORTHOSIS, ELASTIC OR OTHER ELASTIC TYPE MATERIAL WITH CONDYLAR PAD(S), NOT FOUND PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT L1825 P 9 01/01/2010 KNEE ORTHOSIS, ELASTIC KNEE CAP, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT NOT FOUND L1901 P 9 01/01/2010 ANKLE ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NOT FOUND NEOPRENE, LYCRA) L2770 P 9 01/01/2010 ADDITION TO LOWER EXTREMITY ORTHOSIS, ANY MATERIAL - PER BAR OR JOINT NOT FOUND L3651 P 9 01/01/2010 SHOULDER ORTHOSIS, SINGLE SHOULDER, ELASTIC, PREFABRICATED, INCLUDES FITTING NOT FOUND AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) L3652 P 9 01/01/2010 SHOULDER ORTHOSIS, DOUBLE SHOULDER, ELASTIC, PREFABRICATED, INCLUDES FITTING NOT FOUND AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) L3700 P 9 01/01/2010 ELBOW ORTHOSIS, ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND NOT FOUND ADJUSTMENT L3701 P 9 01/01/2010 ELBOW ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NOT FOUND NEOPRENE, LYCRA) L3909 P 9 01/01/2010 WRIST ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NOT FOUND NEOPRENE, LYCRA) L3911 P 9 01/01/2010 WRIST HAND FINGER ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND NOT FOUND ADJUSTMENT (E.G. NEOPRENE, LYCRA) L6639 P 9 01/01/2010 UPPER EXTREMITY ADDITION, HEAVY DUTY FEATURE, ANY ELBOW NOT FOUND Q2023 1P 1 01/01/2010 INJECTION, FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) (XYNTHA), PER I.U. NOT FOUND Q2024 1P 1 01/01/2010 INJECTION, BEVACIZUMAB, 0.25 MG NOT FOUND Q4080 1P 1 01/01/2010 ILOPROST, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 20 MICROGRAMS S0162 9 9 10/01/2009 INJECTION, EFALIZUMAB, 125 MG S0345 9 9 01/01/2010 ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING RECORDING, MONITORING, RECEIPT OF TRANSMISSIONS, ANALYSIS, AND PHYSICIAN REVIEW AND INTERPRETATION; PER 24-HOUR PERIOD S0346 9 9 01/01/2010 ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING RECORDING, MONITORING, RECEIPT OF TRANSMISSIONS, AND ANALYSIS; PER 24-HOUR PERIOD S0347 9 9 01/01/2010 ELECTROCARDIOGRAPHIC MONITORING UTILIZING A HOME COMPUTERIZED TELEMETRY STATION WITH AUTOMATIC ACTIVATION AND REAL-TIME NOTIFICATION OF MONITORING STATION, 24-HOUR ATTENDED MONITORING, INCLUDING PHYSICIAN REVIEW AND INTERPRETATION; H99RPHPD NHIC, CORP. PAGE 3 11/18/2009 HCPCS DELETES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER 24-HOUR PERIOD S0605 9 9 01/01/2010 DIGITAL RECTAL EXAMINATION, MALE, ANNUAL S8190 9 9 04/01/2009 ELECTRONIC SPIROMETER (OR MICROSPIROMETER) 21 01/01/2009 PROLONGED EVALUATION AND MANAGEMENT SERVICES: WHEN THE FACE-TO-FACE OR FLOOR/UNIT SERVICE(S) PROVIDED IS PROLONGED OR OTHERWISE GREATER THAN THAT USUALLY REQUIRED FOR THE HIGHEST LEVEL OF EVALUATION AND MANAGEMENT SERVICE WITHIN A GIVEN CATEGORY, IT MAY BE IDENTIFIED BY ADDING MODIFIER -21 TO THE EVALUATION AND MANAGEMENT CODE NUMBER OR BY USE OF THE SEPARATE FIVE DIGIT MODIFIER CODE 09921. A REPORT MAY ALSO BE APPROPRIATE. 01632 7 7 01/01/2010 ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, ACROMIOCLAVICULAR JOINT, AND SHOULDER JOINT; RADICAL RESECTION 14300 2 28 01/01/2010 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, MORE THAN 30 SQ CM, UNUSUAL OR COMPLICATED, ANY AREA 23221 2 28 01/01/2010 RADICAL RESECTION OF BONE TUMOR, PROXIMAL HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) 23222 2 28 01/01/2010 RADICAL RESECTION OF BONE TUMOR, PROXIMAL HUMERUS; WITH PROSTHETIC REPLACEMENT 24151 2 28 01/01/2010 RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) 24153 2 28 01/01/2010 RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) 26255 2 28 01/01/2010 RADICAL RESECTION, METACARPAL (EG, TUMOR); WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) 26261 2 28 01/01/2010 RADICAL RESECTION, PROXIMAL OR MIDDLE PHALANX OF FINGER (EG, TUMOR); WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) 27079 2 28 01/01/2010 RADICAL RESECTION OF TUMOR OR INFECTION; ISCHIAL TUBEROSITY AND GREATER TROCHANTER OF FEMUR, WITH SKIN FLAPS 29220 2UW 28 01/01/2010 STRAPPING; LOW BACK 36145 2 28 01/01/2010 INTRODUCTION OF NEEDLE OR INTRACATHETER; ARTERIOVENOUS SHUNT CREATED FOR DIALYSIS (CANNULA, FISTULA, OR GRAFT) 36834 2 28 01/01/2010 PLASTIC REPAIR OF ARTERIOVENOUS ANEURYSM (SEPARATE PROCEDURE) 45170 2 28 01/01/2010 EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH 46210 2 28 01/01/2010 CRYPTECTOMY; SINGLE 46211 2 28 01/01/2010 CRYPTECTOMY; MULTIPLE (SEPARATE PROCEDURE) 46937 2 28 01/01/2010 CRYOSURGERY OF RECTAL TUMOR; BENIGN 46938 2 28 01/01/2010 CRYOSURGERY OF RECTAL TUMOR; MALIGNANT 51772 2 28 01/01/2010 URETHRAL PRESSURE PROFILE STUDIES (UPP) (URETHRAL CLOSURE PRESSURE PROFILE), TC 26 ANY TECHNIQUE 51795 2 28 01/01/2010 VOIDING PRESSURE STUDIES (VP); BLADDER VOIDING PRESSURE, ANY TECHNIQUE TC 26 63660 2 28 01/01/2010 REVISION OR REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S) OR PLATE/PADDLE(S) 64470 2 28 01/01/2010 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; CERVICAL OR THORACIC, SINGLE LEVEL 64472 2 28 01/01/2010 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; CERVICAL OR THORACIC, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 64475 2 28 01/01/2010 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMBAR OR SACRAL, SINGLE LEVEL 64476 2 28 01/01/2010 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 75558 4 4 01/01/2010 CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST TC 26 MATERIAL; WITH FLOW/VELOCITY QUANTIFICATION 75560 4 4 01/01/2010 CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST TC 26 MATERIAL; WITH FLOW/VELOCITY QUANTIFICATION AND STRESS H99RPHPD NHIC, CORP. PAGE 4 11/18/2009 HCPCS DELETES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER 75562 4 4 01/01/2010 CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST TC 26 MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; WITH FLOW/VELOCITY QUANTIFICATION 75564 4 4 01/01/2010 CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND FUNCTION WITHOUT CONTRAST TC 26 MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; WITH FLOW/VELOCITY QUANTIFICATION AND STRESS 75790 4 4 01/01/2010 ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL TC 26 SUPERVISION AND INTERPRETATION 78460 4 4 01/01/2010 MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR STRESS TC 26 (EXERCISE AND/OR PHARMACOLOGIC), WITH OR WITHOUT QUANTIFICATION 78461 4 4 01/01/2010 MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES (PLANAR), AT REST AND/OR STRESS TC 26 (EXERCISE AND/OR PHARMACOLOGIC), AND REDISTRIBUTION AND/OR REST INJECTION, WITH OR WITHOUT QUANTIFICATION 78464 4 4 01/01/2010 MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY (INCLUDING TC 26 ATTENUATION CORRECTION WHEN PERFORMED), AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH OR WITHOUT QUANTIFICATION 78465 4 4 01/01/2010 MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE STUDIES (INCLUDING TC 26 ATTENUATION CORRECTION WHEN PERFORMED), AT REST AND/OR STRESS (EXERCISE AND/OR PHARMACOLOGIC) AND REDISTRIBUTION AND/OR REST INJECTION, WITH OR WITHOUT QUANTIFICATION 78478 4 4 01/01/2010 MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR QUANTITATIVE STUDY TC 26 (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 78480 4 4 01/01/2010 MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST SEPARATELY IN ADDITION TC 26 TO CODE FOR PRIMARY PROCEDURE) 82307 5 5 01/01/2010 CALCIFEROL (VITAMIN D) 86781 5 5 01/01/2010 ANTIBODY; TREPONEMA PALLIDUM, CONFIRMATORY TEST (EG, FTA-ABS) 90379 1 1 01/01/2010 RESPIRATORY SYNCYTIAL VIRUS IMMUNE GLOBULIN (RSV-IGIV), HUMAN, FOR INTRAVENOUS USE 92569 K 5 01/01/2010 ACOUSTIC REFLEX TESTING; DECAY 99185 1 1 01/01/2010 HYPOTHERMIA; REGIONAL 99186 1 1 01/01/2010 HYPOTHERMIA; TOTAL BODY 1127F 1 1 01/01/2010 NEW EPISODE FOR CONDITION (ML)5 NOT FOUND 1128F 1 1 01/01/2010 SUBSEQUENT EPISODE FOR CONDITION (ML)5 NOT FOUND 0062T 2 28 01/01/2010 PERCUTANEOUS INTRADISCAL ANNULOPLASTY, ANY METHOD EXCEPT ELECTROTHERMAL, NOT FOUND UNILATERAL OR BILATERAL INCLUDING FLUOROSCOPIC GUIDANCE; SINGLE LEVEL 0063T 2 28 01/01/2010 PERCUTANEOUS INTRADISCAL ANNULOPLASTY, ANY METHOD EXCEPT ELECTROTHERMAL, NOT FOUND UNILATERAL OR BILATERAL INCLUDING FLUOROSCOPIC GUIDANCE; 1 OR MORE ADDITIONAL LEVELS (LIST SEPARATELY IN ADDITION TO 0062T FOR PRIMARY PROCEDURE) 0064T 5 5 01/01/2010 SPECTROSCOPY, EXPIRED GAS ANALYSIS (EG, NITRIC OXIDE/CARBON DIOXIDE TEST) NOT FOUND 0066T 2 28 01/01/2010 COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY (IE, VIRTUAL COLONOSCOPY); SCREENING NOT FOUND 0067T 4 4 01/01/2010 COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY (IE, VIRTUAL COLONOSCOPY); DIAGNOSTIC NOT FOUND 0068T 4 4 01/01/2010 ACOUSTIC HEART SOUND RECORDING AND COMPUTER ANALYSIS; WITH INTERPRETATION AND NOT FOUND REPORT 0069T 4 4 01/01/2010 ACOUSTIC HEART SOUND RECORDING AND COMPUTER ANALYSIS; ACOUSTIC HEART SOUND NOT FOUND RECORDING AND COMPUTER ANALYSIS ONLY 0070T 4 4 01/01/2010 ACOUSTIC HEART SOUND RECORDING AND COMPUTER ANALYSIS; INTERPRETATION AND REPORT NOT FOUND ONLY 0077T 2 28 01/01/2010 IMPLANTING AND SECURING CEREBRAL THERMAL PERFUSION PROBE, INCLUDING TWIST DRILL NOT FOUND OR BURR HOLE, TO MEASURE ABSOLUTE CEREBRAL TISSUE PERFUSION 0084T 1 1 01/01/2010 INSERTION OF A TEMPORARY PROSTATIC URETHRAL STENT NOT FOUND 0086T 1 1 01/01/2010 LEFT VENTRICULAR FILLING PRESSURE INDIRECT MEASUREMENT BY COMPUTERIZED NOT FOUND CALIBRATION OF THE ARTERIAL WAVEFORM RESPONSE TO VALSALVA MANEUVER 0087T 5 5 01/01/2010 SPERM EVALUATION, HYALURONAN SPERM BINDING TEST NOT FOUND 0144T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITHOUT CONTRAST MATERIAL, INCLUDING IMAGE NOT FOUND POSTPROCESSING AND QUANTITATIVE EVALUATION OF CORONARY CALCIUM H99RPHPD NHIC, CORP. PAGE 5 11/18/2009 HCPCS DELETES PROC CMS PROC CODE TOS TOS DATE DESCRIPTION EXCL MFSDB MODIFIER 0145T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST NOT FOUND IMAGES, IF PERFORMED, CARDIAC GATING AND 3D IMAGE POSTPROCESSING; CARDIAC STRUCTURE AND MORPHOLOGY 0146T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST NOT FOUND IMAGES, IF PERFORMED, CARDIAC GATING AND 3D IMAGE POSTPROCESSING; COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF CORONARY ARTERIES (INCLUDING NATIVE AND ANOMALOUS CORONARY ARTERIES, CORONARY BYPASS GRAFTS), WITHOUT QUANTITATIVE EVALUATION OF CORONARY CALCIUM 0147T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST NOT FOUND IMAGES, IF PERFORMED, CARDIAC GATING AND 3D IMAGE POSTPROCESSING; COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF CORONARY ARTERIES (INCLUDING NATIVE AND ANOMALOUS CORONARY ARTERIES, CORONARY BYPASS GRAFTS), WITH QUANTITATIVE EVALUATION OF CORONARY CALCIUM 0148T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST NOT FOUND IMAGES, IF PERFORMED, CARDIAC GATING AND 3D IMAGE POSTPROCESSING; CARDIAC STRUCTURE AND MORPHOLOGY AND COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF CORONARY ARTERIES (INCLUDING NATIVE AND ANOMALOUS CORONARY ARTERIES, CORONARY BYPASS GRAFTS), WITHOUT QUANTITATIVE EVALUATION OF CORONARY CALCIUM 0149T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST NOT FOUND IMAGES, IF PERFORMED, CARDIAC GATING AND 3D IMAGE POSTPROCESSING; CARDIAC STRUCTURE AND MORPHOLOGY AND COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF CORONARY ARTERIES (INCLUDING NATIVE AND ANOMALOUS CORONARY ARTERIES, CORONARY BYPASS GRAFTS), WITH QUANTITATIVE EVALUATION OF CORONARY CALCIUM 0150T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST NOT FOUND IMAGES, IF PERFORMED, CARDIAC GATING AND 3D IMAGE POSTPROCESSING; CARDIAC STRUCTURE AND MORPHOLOGY IN CONGENITAL HEART DISEASE 0151T 4 4 01/01/2010 COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST NOT FOUND IMAGES, IF PERFORMED, CARDIAC GATING AND 3D IMAGE POSTPROCESSING, FUNCTION EVALUATION (LEFT AND RIGHT VENTRICULAR FUNCTION, EJECTION-FRACTION AND SEGMENTAL WALL MOTION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) 0170T 2 28 01/01/2010 REPAIR OF ANORECTAL FISTULA WITH PLUG (EG, PORCINE SMALL INTESTINE SUBMUCOSA NOT FOUND ?SIS¨) 0194T 5 5 01/01/2010 PROCALCITONIN (PCT) NOT FOUND