CMS-1676-F 413. TABLE 12: CY 2018 Work RVUs for New, Revised and Potentially Misvalued Codes

Transcription

1 CMS-1676-F 413 TABLE 12: s for New, Revised and Potentially Misvalued s Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP) Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules) Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s) Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae) Muscle, myocutaneous, or fasciocutaneous flap; trunk Muscle, myocutaneous, or fasciocutaneous flap; upper extremity Muscle, myocutaneous, or fasciocutaneous flap; lower extremity Preparation of tumor cavity with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy CMS NEW No NEW No NEW No NEW No NEW No No NEW No NEW No No No No NEW No Mastectomy, simple, complete No Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or NEW No fascial incision Application of rigid total contact leg cast No Strapping; Unna boot No Application of multi-layer compression system; leg (below knee), including ankle and foot No Submucous resection inferior turbinate, partial or complete, any method No Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method No

2 CMS-1676-F 414 CMS Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method No Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any No method; initial Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any No method; subsequent Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery NEW No Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with NEW No removal of tissue from frontal sinus, when performed Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior) No Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior) No Nasal/sinus endoscopy, surgical, with maxillary antrostomy No Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), NEW No including sphenoidotomy Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of NEW No tissue from the sphenoid sinus Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from No maxillary sinus Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue No from frontal sinus, when performed Nasal/sinus endoscopy, surgical, with sphenoidotomy No Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the No sphenoid sinus Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), No transnasal or canine fossa Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation) No Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation) No Nasal/sinus endoscopy, surgical; with dilation of frontal and sphenoid sinus ostia (eg, balloon NEW No dilation) Tracheostomy, planned (separate procedure) No

3 CMS-1676-F Tracheostomy, planned (separate procedure); younger than 2 years Tracheostomy, emergency procedure; transtracheal Tracheostomy, emergency procedure; cricothyroid membrane Tracheostomy, fenestration procedure with skin flaps Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed with therapeutic aspiration of tracheobronchial tree, initial Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy Removal of a total replacement heart system (artificial heart) for heart transplantation Removal and replacement of total replacement heart system (artificial heart) Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device CMS No No No No No No NEW No No NEW No NEW C C No NEW C C No NEW No NEW No

4 CMS-1676-F selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aortouniiliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aortouniiliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aortobiiliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, CMS NEW No NEW No NEW No

5 CMS-1676-F penetrating ulcer) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aortobiiliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation) Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, traumatic disruption) Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone CMS NEW No NEW No NEW No NEW No

6 CMS-1676-F angioplasty/stenting when performed, per vessel treated Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting when performed; initial vessel treated Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting when performed; each additional vessel treated Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger), including ultrasound guidance, when performed, unilateral Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral Open femoral artery exposure for delivery of endovascular prosthesis by groin incision, unilateral Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion by abdominal or retroperitoneal incision, unilateral CMS NEW No NEW No NEW No NEW No NEW No NEW No NEW No No No

7 CMS-1676-F Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral Open brachial artery exposure for delivery of endovascular prosthesis unilateral Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein) Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg Injection of sclerosant; single incompetent vein (other than telangiectasia) Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access sites CMS No No No No No No NEW No NEW No No No NEW No NEW No

8 CMS-1676-F 420 CMS Therapeutic apheresis; for white blood cells No Therapeutic apheresis; for red blood cells No Therapeutic apheresis; for platelets No Therapeutic apheresis; for plasma pheresis No Therapeutic apheresis; with extracorporeal selective adsorption or selective filtration and plasma reinfusion No Photopheresis, extracorporeal No Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age No Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging No No No No No No

9 CMS-1676-F from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report; with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s); with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty CMS No No No No Transcatheter placement of intravascular No

10 CMS-1676-F stent(s), central dialysis segment, performed through dialysis circuit, including all imaging radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention CMS No Diagnostic bone marrow; aspiration(s) No Diagnostic bone marrow; biopsy(ies) No Diagnostic bone marrow; biopsy(ies) and aspiration(s) NEW No Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling peritoneal washings, peritoneal biopsy(s), omentectomy, and diaphragmatic washings, including biopsy(s) when performed NEW No Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal) Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy, or tri-incisional esophagectomy) Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor Lewis) Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy) Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic esophagogastrostomy (ie, laparoscopic thoracoscopic esophagectomy, Ivor Lewis No No No NEW No NEW No

11 CMS-1676-F 423 CMS esophagectomy) Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical NEW No pharyngogastrostomy or esophagogastrostomy (ie, thoracoscopic, laparoscopic and cervical incision esophagectomy, McKeown esophagectomy, tri-incisional esophagectomy) Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, nonimaging No Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, No cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when NEW No performed Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including No cystourethroscopy, when performed Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy No Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed No Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; No with enterocele repair Laparoscopy, surgical, total hysterectomy; with or without salpingo-oophorectomy, unilateral or bilateral, with resection of malignancy (tumor NEW No debulking), with omentectomy Injection, anesthetic agent; suprascapular nerve No Percutaneous implantation of neurostimulator electrode array; cranial nerve No Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve) No Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve No Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve No Nerve repair; with nerve allograft, each nerve, first strand (cable) NEW No Nerve repair; with nerve allograft, each NEW No

12 CMS-1676-F 424 CMS additional strand Correction of trichiasis; epilation, by forceps only No Computed tomography, soft tissue neck; without contrast material No Computed tomography, soft tissue neck; with contrast material(s) No Computed tomography, soft tissue neck; without contrast material followed by contrast No material(s) and further sections Magnetic resonance angiography, head; without contrast material(s) No Magnetic resonance angiography, head; with contrast material(s) No Magnetic resonance angiography, head; without contrast material(s), followed by contrast No material(s) and further sequences Magnetic resonance angiography, neck; without contrast material(s) No Magnetic resonance angiography, neck; with contrast material(s) No Magnetic resonance angiography, neck; without contrast material(s), followed by contrast No material(s) and further sequences Radiologic examination, chest; single view NEW No Radiologic examination, chest; 2 views NEW No Radiologic examination, chest; 3 views NEW No Radiologic examination, chest; 4 or more views NEW No Radiologic examination, ribs, unilateral; 2 views Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views No No Radiologic examination, ribs, bilateral; 3 views No Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views No Computed tomography, thorax; without contrast material Computed tomography, thorax; with contrast material(s) Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by No No No No No No

13 CMS-1676-F 425 CMS contrast material(s) and further sequences Radiologic examination, wrist; 2 views No Radiologic examination, wrist; complete, minimum of 3 views No Radiologic examination, hand; 2 views No Radiologic examination, hand; minimum of 3 views No Radiologic examination, finger(s), minimum of 2 views No Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) No Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest No No No Radiologic examination, abdomen; 1 view NEW No Radiologic examination, abdomen; 2 views NEW No Radiologic examination, abdomen; 3 or more views NEW No Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) No Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) No Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences No Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing Angiography, extremity, unilateral, radiological supervision and interpretation Angiography, extremity, bilateral, radiological supervision and interpretation Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter Ophthalmic ultrasound, diagnostic; quantitative A-scan only Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative No No No No No No

14 CMS-1676-F 426 CMS A-scan) Ophthalmic biometry by ultrasound echography, A-scan No Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens No power calculation Ultrasound, extremity, nonvascular, real-time with image documentation; complete No Ultrasound, extremity, nonvascular, real-time with image documentation; limited, anatomic No specific Therapeutic radiology treatment planning; simple No Therapeutic radiology treatment planning; intermediate No Therapeutic radiology treatment planning; complex No Bone and/or joint imaging; limited area No Bone and/or joint imaging; multiple areas No Bone and/or joint imaging; whole body No Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computerassisted technology Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values No No No No No No No No

15 CMS-1676-F with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implantable defibrillator system Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantable defibrillator system Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous implantable defibrillator system Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable loop recorder system Peri-procedural device evaluation (in person) and programming of device system parameters CMS No No No No No No No

16 CMS-1676-F before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including analysis of heart rhythm derived data elements Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable loop recorder system, including heart rhythm derived data analysis Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and CMS No No No No No No No

17 CMS-1676-F without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other qualified health care professional Interrogation device evaluation(s), (remote) up to 30 days; implantable loop recorder system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular monitor system or implantable loop recorder system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or CMS No No No No No No No No No

18 CMS-1676-F 430 CMS limited study Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, No bicycle exercise and/or pharmacologically induced stress, with interpretation and report; 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; No including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring No purposes Intracardiac electrophysiologic 3-dimensional mapping No Peripheral arterial disease (PAD) rehabilitation, per session N No Patient/caregiver training for initiation of home INR monitoring under the direction of a physician or other qualified health care professional, including face-to-face, use and care of the INR monitor, obtaining blood NEW No sample, instructions for reporting home INR test results, and documentation of patient's/caregiver s ability to perform testing and report results Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab International Normalized Ratio (INR) test NEW No result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s) when performed Exercise test for bronchospasm, including preand post-spirometry and pulse oximetry NEW No Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, NEW No oximetry, and oxygen titration, when performed Cardiopulmonary exercise testing, including measurements of minute ventilation, CO2 production, O2 uptake, and No electrocardiographic recordings Percutaneous tests (scratch, puncture, prick) No

19 CMS-1676-F with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and printout of recording Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; interpretation and report Visual evoked potential (VEP) testing central nervous system except glaucoma, checkerboard or flash, with interpretation and report Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument Intravenous infusion, hydration; initial, 31 minutes to 1 hour Intravenous infusion, hydration; each additional hour Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug Application of on-body injector (includes cannula insertion) for timed subcutaneous injection Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic Chemotherapy administration; intravenous, push technique, single or initial substance/drug CMS No No No No No No No No No No No No No No Chemotherapy administration; intravenous, No

20 CMS-1676-F 432 CMS push technique, each additional substance/drug Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and NEW No illumination/activation of photosensitizing drug(s), per day Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent NEW No mucosa with application and illumination/activation of photosensitizing drug(s), per day Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and No ultraviolet B Application of a modality to 1 or more areas; traction, mechanical No Application of a modality to 1 or more areas; electrical stimulation (unattended) No Application of a modality to 1 or more areas; vasopneumatic devices No Application of a modality to 1 or more areas; paraffin bath No Application of a modality to 1 or more areas; whirlpool No Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes No Application of a modality to 1 or more areas; iontophoresis, each 15 minutes No Application of a modality to 1 or more areas; contrast baths, each 15 minutes No Application of a modality to 1 or more areas; ultrasound, each 15 minutes No Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and No flexibility Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic No sense, posture, and/or proprioception for sitting and/or standing activities Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic No exercises Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing) No Therapeutic interventions that focus on NEW I I Yes

21 CMS-1676-F cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks, direct (one-on-one) patient contact (do not report 97X11 in conjunction with 0364T, 0365T, 0368T, 0369T) (report 97X11 only once per day) Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes Wheelchair management (eg, assessment, fitting, training), each 15 minutes Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes CMS No No No No No No No No NEW No

22 CMS-1676-F Collection and interpretation of physiologic data (eg, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements:cognition-focused evaluation including a pertinent history and examination;medical decision making of moderate or high complexity;functional assessment (eg, Basic and Instrumental Activities of Daily Living), including decisionmaking capacity;use of standardized instruments for staging of dementia (eg, Functional Assessment Staging Test [FAST], Clinical Dementia Rating [CDR]);Medication reconciliation and review for high-risk medications;evaluation for neuropsychiatric and behavioral symptoms, including depression, including use of standardized screening instrument(s);evaluation of safety (eg, home), including motor vehicle operation;identification of caregiver(s), caregiver knowledge, caregiver needs, social supports, and the willingness of caregiver to take on caregiving tasks;development, updating or revision, or review of an Advance Care Plan;Creation of a written care plan, including initial plans to address any neuropsychiatric symptoms, neuro-cognitive symptoms, functional limitations, and referral to community resources as needed (eg, rehabilitation services, adult day programs, support groups) shared with the patient and/or caregiver with initial education and support.typically, 50 minutes are spent face-toface with the patient and/or family or caregiver. Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements:initial assessment or follow-up monitoring, including the use of applicable validated rating CMS B No NEW No NEW No