October Update To The 2006 Medicare Physician Fee Schedule Database (MPFSDB)

The following are the October updates/additions to the 2006 Medicare Physician Fee Schedule Database (MPFSDB). These changes are effective for claims processed on or after January 1, 2006 unless otherwise noted.

Assistant At Surgery Indicator Changes:

· Procedure Codes 15000 the assistant at surgery indicator is changed from 1 (Assistant at surgery can not be paid. Statutory payment restriction applies to this procedure) to 0 (Payment restriction for assistants at surgery applies to this procedure unless supporting documentation is submitted to establish medical necessity).

· Procedure Codes 15001 the assistant at surgery indicator is changed from 2 (Assistant at surgery may not be paid to 0 (Payment restriction for assistants at surgery applies to this procedure unless supporting documentation is submitted to establish medical necessity).

Global Surgery Indicator Changes:

· Procedure Codes 47145, the Global Surgery Indicator is changed from 090 (Major surgery procedure with a 1 day pre-operative period and 90 day post operative period included in fee schedule payment amount to XXX (Global concept does not apply).

Endoscopic Base Code Changes:

· Procedure code 52402, the Endoscopic Base Code = 52000.

Multiple Surgery Indicator Changes:

· Procedure codes G0289 the Multiple Surgery Indicator is changed from 2 (The standard multiple procedure payment does apply) to 0 (Multiply surgery payment adjustment does not apply).

Type of Service Changes:

• Procedure codes 0159T, 0159T-TC, 0159T-26 are now TOS 4 Diagnostic Radiology
• Procedure code 0160T, 0161T are now TOS 6 Therapeutic Radiology

9/07/2006