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3 Skin Replacement Surgery Grafts Harvest of skin for cultured autograft 100 sq cm or less Epidermal autograft, trunk, arms, legs; first 100 sq cm or 1% of children ; each additional 100 sq cm Epidermal autograft, face, scalp, eyelids, mouth, neck, orbits, genitalia, hands, feet, multiple digits; first 100 sqcm ; each additional 100 sq cm Dermal autograft, trunk, arms, legs; first 100 sq cm or 1% of children or less ; each additional 100 sq cm Dermal autograft, face, scalp, eyelids, mouth, neck, orbits, genitalia, hands, feet, multiple digits; first 100 sq cm ; each additional 100 sq cm Tissue cultured autograft, trunk, arms, legs; first 25 sq cm or 1% of children or less ; each additional 1 sq cm to 75 sq cm ; each additional 100 sq cm Tissue cultured autograft, face, scalp, eyelids, mouth, neck, orbits, genitalia, hands, feet, multiple digits; first 25 sq cm ; each additional 1 to 75 sq cm ; each additional 100 sq cm Allograft for temp wound closure, trunk, arms, legs; first 100 sq cm or 1% of children or less ; each additional 100 sq cm Allograft for temp wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, multiple digits; first 100 sq cm ; each additional 100 sq cm

4 15330 Acellular dermal allograft, trunk, arms, legs; first 100 sq cm or 1% of children or less ; each additional 100 sq cm Acellular dermal allograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, multiple digits; first 100 sq cm ; each additional 100 sq cm Tissue cultured allogeneic skin substitute deleted ; each additional 25 sq cm Tissue cultured allogeneic skin substitute, trunk, arms, legs; first 100 sq cm or 1% of children or less ; each additional 100 sq cm Tissue cultured allogeneic skin substitute, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, multiple digits; first 100 sq cm ; each additional 100 sq cm Skin Replacement Surgery - Xenografts Xenograft skin for temp wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, multiple digits; first 100 sq cm or 1% of children or less ; each additional 100 sq cm Acellular xenograft implant; first 100 sq cm or 1% of children or less ; each additional 100 sq cm

5 Orthopedic - Spine Incision and drainage, open of deep abscess, posterior spine, cervical thoracic or cervicothoracic ; lumbar, sacral or lumbosacral Percutaneous vertebral augmentation; thoracic 2254 ; lumbar each additional thoracic or lumbar vertebral body Orthopedic - Foot Extracorporeal shock wave therapy, high energy, performed by physician, requiring anesthesia other than local, including US guidance, involving plantar fascia Respiratory resection of apical lung tumor including chest wall resection, ribs, neurovascular dissection; without chest wall reconstructions ; with chest wall reconstructions Surgery - Cardiovascular Repair of anomalous aortic origin of coronary artery by unroofing or translocation Surgical ventricular restoration, includes prosthetic patch Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass ; with cardiopulmonary bypass Contrast injections for radiologic evaluation of existing central venous access device, inc fluoroscopy

6 Surgery transcatheter procedures (CV) see new notes Primary percutaneous transluminal mechanical thrombectomy, arterial ; initial vessel ; second and all subsequent vessels within same vascular family add-on secondary percutaneous transluminal thrombectomy Primary percutaneous transluminal mechanical thrombectomy, veins ; initial vessel ; repeat treatment on subsequent day during course of thrombolytic therapy Surgery Ligation (CV) Ligation, division and stripping; long (greater) saphenous veins from sapenofemoral junction to the knee or below Surgery Bariatric Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric band ; revision of adjustable gastric band only ; removal of gastric band only ; removal and replacement of gastric band only ; removal of adjustable gastric band and port components

7 Surgery Laparoscopy Laparoscopy, surgical; enterolysis (separate procedure) ; jejunostomy ; ileostomy or jejunostomy, non-tube ; colostomy or skin level cecostomy ; (add on) mobilization (take-down) of splenic flexure in conjunction with partial colectomy ; closure of enterostomy, large or small intestine with resection and anastomosis Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy ; proctectomy, combined abdominoperineal pullthrough procedure with creation of colonic resevoir, with diverting enterostomy, when performed ; proctopexy for prolapse ; proctopexy for prolapse with sigmoid resection ; unlisted laparoscopy procedure, rectum Surgery Anus Repair of ileoanal pouch fistula/sinus, pouch advancement; transperineal approach ; combined transperineal approach and transabdominal approach

8 Surgery Urology Renal pelvis procedures Removal and replacement of internally dwelling ureteral stent via percutaneous approach, inc radiologic supervision and interpretation removal only (no replacement) Removal and replacement of externally accessible transnephric uteral stent req. flouro, inc radiolological supervision and interpretation removal only (no replacement) Ablation one or more renal tumors, percutaneous, unilateral, radiofrequency (as opposed to cryotherapy) Unlisted procedure, bladder Surgery Female Genital System Revision (including removal) of prosthetic vaginal graft, vaginal approach (add on) Endometrial sampling performed in conjunction with colposcopy Surgery Nervous system Balloon angioplasty, intracranial, percutaneous Transcatheter placement of intravascular stents, intracranial, inc ballon angioplasty when performed 61640Balloon dilation of intracranial vasospasm, percutaneous; initial vessel ; each additional vessel ; each additional vessel in each different vascular family Chemodenervation of eccrine glands; both axillae ; other areas

9 Medicine Human papilloma Virus vaccine (FDA pending) Tetanus and diptheria toxoids absorbed Zoster vaccine IV infusion, hydration; initial up to 1 hr ; each additional hour up to IV infusion for therapy, prophylaxis or diagnosis; initial up to 1 hr ; each additional hour up to 8 hours ; additional sequential infusion, up to 1 hour ; concurrent infusion Therapeutic, prophylactic or diagnostic injection; subcutaneous or IM ; inta-arterial ; intravenous push, single or initial substance ; each additional IV push of a new substance Unlisted therapeutic, prophylactic or diagnostic IV or inta-arterial injection or infusion Gastroenterology Duodenal motility study Audiology Eval auditory rehab status; first hour ; each additional 15minutes Auditory rehab; pre-lingual hearing loss ; post-lingual hearing loss

10 Endocrinology Physician interpretation of continuous glucose monitoring (95250) EMG and Nerve Conduction Tests Needle EMG; larynx (do not report 50 modifier, if unilateral only use modifier 52) ; hemidiaphragm electrical stimulation for guidance (ad-on) Needle EMG for guidance (add-on) Central Nervous System testing Chemotherapy significant changes and additions Orthotic management Moderate sedation (new section and all new codes dealing with conscious sedation) watch for procedures indicated with Category II codes 1003F-1008F (history) 2001F 2004F Physical Exam Other Cat II codes 3000F-4018F Category III codes 0089T-0140T (testing codes for new technology)