Loading...
Skip to content
Medicare Part [Change]
CMS Link
CMS Link
Providers in AR, CO, LA, MS, NM, OK, TX, Indian Health & Veteran Affairs

Upcoming Focus of Provider Specific Reviews

Medical Review Part B, Jurisdiction H

The following topics are provider specific and if chosen for review, the provider shall receive individual notification of selection.

Effective date of Listed Topics: 09/22/2017

Code

Description

11765

Excision of nail fold toe

64479

Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or ct); cervical or thoracic, single level

64483

Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or ct); lumbar or sacral, single level

64635

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, single facet joint

64636

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure)

77014

Computed tomography guidance for placement of radiation therapy fields

77332

Treatment devices, design and construction; simple (simple block, simple bolus)

77334

Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)

77373

Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions

77427

Radiation treatment management, 5 treatments

93351

Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional

93880

Duplex scan of extracranial arteries; complete bilateral study

93970

Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study

95886

Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for primary procedure)

95913

Nerve conduction studies; 13 or more studies

95951

Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined electroencephalographic (eeg) and video recording and interpretation (eg, for presurgical localization), each 24 hours

99204-99205*

Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components

99213-99215*

Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of the 3 key components

99222-99223*

Initial hospital care, per day, for the evaluation and management of a patient, which requires 3 key components

99232-99233*

Subsequent hospital care, per day for the evaluation and management of a patient, which require at least 2 of the 3 key components

99291

Critical care, evaluation and management of critically ill or critically injured patients, first 30-74 minutes.

99292

Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)

99307-99310*

Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of the 3 key components

G0479

Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service

G0483

Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed

G6015

Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session

J0585

Injection, onabotulinumtoxina, 1 unit

J0641

Injection, levoleucovorin calcium, 0.5 mg

J0178

Injection, aflibercept, 1 mg

J1561

Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg

J7324

Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose

J9035

Injection, bevacizumab, 10 mg

J9041

Injection, bortezomib, 0.1 mg

Note: Items marked with asterisks (*) Key Components - See E/M Scoresheet


Was this page helpful?
Last modified:  10/27/2017