PROCESSING NOTES ____________________________________________________________________________________________________________________________________ 0001--THIS PROCESSING NOTE DELETED 1/1/97. * * 0002--THESE CODES (82585, 82595) PERTAIN TO PERFORMING THE ANALYSIS FOR THE * ANALYTE AS OPPOSED TO ADMINISTRATION OF THE ANALYTE. * * 0003--THIS PROCEDURE (85029, 85030) IS USUALLY PART OF THE AUTOMATED PROFILES * FOR CBC AND CONSIDERATION SHOULD BE GIVEN TO NOT PAYING SEPARATELY * FOR THESE INDICES. * * 0004--THIS PROCESSING NOTE DELETED 1/1/97. * * 0005--THE CERTIFICATION CATEGORY WILL DEPEND ON THE TYPE OF TEST/OR ORGANISM * IDENTIFIED AND THERE MUST BE AN IDENTIFIER TO INDICATE THE SPECIFIC * TESTING PERFORMED (87082-87085, 89100, 89130, 89132, 86403). * * 0006--THIS IS NOT A LAB TEST AND IS NOT CERTIFIED. * * 0007--THIS PROCESSING NOTE DELETED 1/1/97. * * 0008--THIS PROCESSING NOTE DELETED 1/1/97. * * 0009--THIS PROCESSING NOTE DELETED 1/1/97. * * 0010--THIS PROCESSING NOTE DELETED 1/1/97. * * 0011--THIS PROCESSING NOTE DELETED 1/1/97. * * 0012--THIS PROCESSING NOTE DELETED 1/1/97. * * 0013--THIS DEVICE (E0194) SHOULD NOT BE CONFUSED WITH E0193 POWERED FLOTATION * THERAPY BED (LOW AIR LOSS BED). SEE CIM TRANS. NO. 44, JULY 1990. * * 0014--CLAIMS SUBMITTED WITH THIS CODE (J9218) WITH OR WITHOUT A MULTIPLIER IN * IN THE UNITS FIELD SHOULD BE REVIEWED IN TERMS OF THE POLICY PERTAINING * TO SELF ADMINISTERED DRUGS. * * 0015--REIMBURSEMENT IS INCLUDED IN THE BASIC ALLOWANCE OF ANOTHER PROCEDURE. * * 0016--DEVICE IS SUITABLE FOR VISUALLY IMPAIRED (E0609). * * 0017--SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS * PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, * A4712, A4730-A4870, A4890-A4927. * * 0018--CODE J2545 TO BE REPORTED WITH 94642 WHERE APPROPRIATE. * * 0019--SERVICE REPRESENTED BY D4211 CAN BE CODED USING CPT 41820 * WITH -52 MODIFIER. * * 0020--SERVICES REPRESENTED BY D7410 AND D7420 CAN BE CODED FROM CPT-4 * USING CODES 21015 FF AND 40810 FF. * * 0021--SERVICES REPRESENTED BY D7430-D7461 CAN BE CODED FROM CPT-4 USING * CODES 21029-21045 AND 41820-41827. * * 0022--SERVICE REPRESENTED BY D7610 CAN BE CODED USING CPT 21346 WITH * -52 MODIFIER. * * 0023--SERVICE REPRESENTED BY D7620 CAN BE CODED USING CPT 21345 WITH * -52 MODIFIER. * * 0024--SERVICE REPRESENTED BY D7630 CAN BE CODED USING CPT 21461 OR * CPT 21462 WITH -52 MODIFIER. * * 0025--SERVICE REPRESENTED BY D7620 CAN BE CODED USING CPT 21455 WITH -52 * MODIFIER. * * 0026--SERVICE REPRESENTED BY D7650 CAN BE CODED USING CPT 21360 WITH * -52 MODIFIER OR 21365 WITH -52 MODIFIER. * * 0027--SERVICE REPRESENTED BY D7660 CAN BE CODED USING 21355 WITH -52 MODIFIER. * * 0028--SERVICE REPRESENTED BY D7670 CAN BE CODED USING CPT 21422 WITH * -52 MODIFIER. * * 0029--SERVICE REPRESENTED BY D7680 CAN BE CODED USING CPT 21433 WITH * -52 MODIFIER OR 21435 WITH -52 MODIFIER. * * 0030--SERVICE REPRESENTED BY D7920 CAN BE REPORTED USING A MORE SPECIFIC * CPT CODE. * * 0031--SERVICE REPRESENTED BY D7949 CAN BE CODED USING CPT 21151, OR * CODES 21154-21160. * * 0032--SERVICE REPRESENTED BY D7970 CAN BE CODED USING CPT 41828 WITH * -52 MODIFIER. * * 0033--THIS PROCESSING NOTE DELETED 1/1/96. * * 0034--SERVICE REPRESENTED BY D9220 CAN BE CODED FROM CPT-4 USING 00170-00192. * * 0035--SERVICE REPRESENTED BY D9310 CAN BE CODED USING CPT CODES 90600-90643. * * 0036--SERVICE REPRESENTED BY D9410 CAN BE CODED USING CPT CODES 90100-90170. * * 0037--SERVICE REPRESENTED BY D9420 CAN BE CODED USING CPT CODES 90200-90282. * * 0038--SERVICE REPRESENTED BY D9430 CAN BE CODED USING CPT CODES 90000-90080. * * 0039--SEE MEDICARE INTERMEDIARY MANUAL, PART 3 CLAIMS PROCESS SECTION 3628.F * FOR PAYMENT GUIDELINES (P9610, P9615, G0001). * * 0040--SEE MEDICARE INTERMEDIARY MANUAL 3628.E FOR PAYMENT GUIDELINES * (P9610, P9615, G0001). * * 0041--SEE MEDICARE INTERMEDIARY MANUAL SECTION 3112.4 (Q0081, Q0083, * Q0084, Q0085). * * 0042--SERVICES REPRESENTED BY 92392 SHOULD BE RECODED WITH SPECIFIC SYSTEMS * FROM A-N V2600-V2615. * * 0043--SERVICES REPRESENTED BY 92395 SHOULD BE RECODED WITH SPECIFIC LENS * TYPE FROM A-N V2100-V2499. * * 0044--SERVICES REPRESENTED BY 92396 SHOULD BE RECODED WITH SPECIFIC LENS * TYPE FROM V2500-V2599. * * 0045--SEE INTERMEDIARY MANUAL 3628.1A FOR PAYMENT INSTRUCTIONS. (P3000,P3001 * G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148). PROGRAM * MEMORANDUM AB-98-71.60. * * 0046--THIS MODIFIER (Q2) IS AUTHORIZED FOR USE BY THE HCFA OFFICE OF RESEARCH * AND DEMONSTRATIONS ONLY; FOR CLAIMS SUBMITTED TO ORD FOR PAYMENT IN * CONNECTION WITH DEMONSTRATION PROJECTS. * * 0047--THIS PROCESSING NOTE DELETED 1/1/97. * * 0048--SEE MEDICARE INTERMEDIARY MANUAL, SECTION 3112.7D1.E (Q0082). * * 0049--SEE MEDICARE INTERMEDIARY MANUAL, SECTION 3148 (CPT 97001, 97002). * * 0050--THIS CODE MUST INCLUDE NON-CORING NEEDLES, PRESSURE MONITOR WITH * STOPCOCK AND TEMPLATES. CARRIERS SHOULD NOT ALLOW SEPARATE PAYMENT * FOR THIS CODE AND FOR A4212. * * 0051--SPECIAL PAYMENT RULES APPLY. SEE MCM SECTION 15022.F (A4644, * A4645, A4646). * * 0052--PAYMENT BUNDLED INTO PROCEDURE CODE (A4262, A4647, 99141, 99142). * * 0053--THIS MODIFIER CODE CROSSWALKS TO A0999 UNLISTED AMBULANCE SERVICE. * * 0054--CODE Q0144 ESTABLISHED AS A NATIONAL CODE FOR MEDICAID USE. * * 0055--NONCOVERED BY MEDICARE STATUTE, 1862a1a (G0061). * * 0056--PAYMENT FOR THIS SERVICE IS INCLUDED IN THE APPROPRIATE E/M SERVICE * (99371, 99374, 99377, 99379, 99380). * * 0057--SEE CPT (YY,ZZ). * * 0058--THIS PROCEDURE (A2000) CROSSWALKS TO CPT. * * 0059--SEE COVERAGE ISSUES MANUAL, SECTION 50-26 (D0120, D0415, D0425). * * 0060--SEE MCM 2136 (D2385) XXXXXXX. * * 0061--IN 1997, PAYMENT FOR R0076 IS BUNDLED INTO THE PAYMENT FOR THE * REPORTED EKG SERVICE. IN 1998, PER BALANCED BUDGET ACT OF 1997, * SEPARATE PAYMENT FOR R0076 IS MANDATED. * * 0062--CPT 32491 - PAYMENT RESTRICTED TO CERTAIN BENEFICIARIES ENROLLED IN * THE HCFA/NHLBI STUDY. * * 0063--GO100 - SEE PROGRAM MEMO AB-97-9.60 TO INTERMEDIARIES/CARRIERS * * 0064--COVERAGE AND PAYMENT BASED ON BALANCED BUDGET ACT OF 1997 (G0101 - * SEC 4102; G0104, G0105, G0106, G0107, G0120, G0121, G0122 - SEC 4104). * * 0065--THESE CODES CAN BE REPORTED ONLY FOR THOSE MEDICARE BENEFICIARIES * ENROLLED IN THE NATIONAL EMPHYSEMA TREATMENT TRIALS, DEMONSTRATION #30. * * 0066--EFFECTIVE 1/1/98, 76076 AND 76078 ARE BENEFITS UNDER THE BALANCED * BUDGET ACT OF 1997, SECTION 4106. * * 0067--BENEFIT PER BALANCED BUDGET ACT OF 1997 SECTION 4101 (76092). * * 0068--CODES 76070, 76075, 78350, 82523 WERE REINSTATED IN 1998. BENEFIT UNDER * BALANCED BUDGET ACT OF 1997 SECTION 4106. SEE G0131 AND G0132. * * 0069--FOR ASSISTANT SURGEON SERVICES MODIFIERS 80, 81, 82, AK, AL, AM, * AN, AS, AU, AV, AW, AY, QB, QU SEE MCM SECTION 15044. * * 0070--G0128 MAY BE BILLED BY A COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY * ONLY. G0128 ESTABLISHED TO IMPLEMENT BBA (97) SECTION 4541(a)(2). * * 0071--G0108, G0109, SEE PROGRAM MEMORANDUM AB-99-30, MAY 1999, PROGRAM * MEMORANDUM AB-98-36. * * 0072--COMPRESSION LEVELS FOR PRODUCTS IDENTIFIED BY THESE CODES (L8100 - L8200) * HAVE BEEN VALIDATED BY A ASTM/NAHM SANCTIONED INDEPENDENT TEST FACILITY. * * 0073--SEE SECTION 4206(a)(b) OF THE BALANCED BUDGET ACT (BBA) OF 1997. * PROGRAM MEMORANDOM B-99-2, JANUARY 1999. * * 0074--PER BBA 1997, SECTION 44105, EXPANDED COVERAGE OF SUPPLIES FOR DIABETIC * BENEFICIARIES. * * 0075--PER BBA 1997, SECTION 4541, OUTPATIENT REHABILITATION THERAPY PAYMENT * LIMITATION APPLIES. * * 0076--THE EXISTING LEVEL II CODES ARE J1460 THROUGH J1560. * * 0077--CR#259, AB-97-23 DATED 12-97 IMPLEMENTATION OF 1998 CLINICAL DIAGNOSTIC * LABORATORY FEE SCHEDULE AND MAPPING FOR 1998 LABORATORY CODING CHANGES. * * 0078--PROGRAM MEMORANDUM AB-99-51, JULY 1999. * * 0079--ESTABLISHED PER BBA `97, SEC 4103. * * 0080--SEE CR#855, TRANSMITTAL NO. AB-99-22, DATED APRIL 1999. * * 0081--WHEN ACUITY IS MEASURED AS PART OF A GENERAL OPHTHALMOLOGICAL SERVICE * OR OF AN E/M SERVICE OF THE EYE, IT IS A DIAGNOSTIC EXAMINATION AND NOT * A SCREENING TEST, AND PAYMENT IS THEREFORE INCLUDED IN THE PAYMENT FOR * THE E/M SERVICE. * * 0082--G0151-G0156 MAY BE BILLED ONLY FOR HOME HEALTH CARE SERVICES PROVIDED * UNDER A PLAN OF CARE. SEE CR#588. * * 0083--MODIFIER G8 FOR USE WITH THE FOLLOWING SIX ANESTHESIA CODES; 00100, * 00300, 00400, 00160, 00532 AND 00920. * * 0084--MODIFIER G7 FOR USE WITH CPT CODES FOR MEDICAL ABORTIONS: 59840, 59841, * 59850, 59851, 59852, 59855, 59856, 59857 AND 59866. * * 0085--CODE Q0186 ESTABLISHED PER THE AUTHORITY PROVIDED UNDER SECTION 4531 OF * THE BALANCED BUDGET ACT OF 1997. * * 0086--Q1001, Q1002, Q1003, Q1004, AND Q1005 MUST BE BILLED WITH ONE OF THE * FOLLOWING PROCEDURE CODES - 66983, 66984, 66985 OR 66986 BY ASC. * * 0087--SERVICES REPRESENTED BY G0129 IS DEFINED IN SSA 1861(ff)(2)(B) BBA 1997 * SECTION 4523 (d)(3) AMENDS SSA 1833(a)(2). * * 0088--"S" CODES ARE UNIQUE TEMPORARY CODES ESTABLISHED BY BCBSA AND HIAA FOR * PRIVATE PAYOR USE. THEY ARE NOT VALID NOR PAYABLE BY MEDICARE. * * 0089--REFER TO AB-99-52 SUSPENDING NON-COVERAGE PER CIM 35-98. * * 0090--THIS SERVICE IS BUNDLED WITH THE VISIT SERVICE. * * 0091--AS OF 10/1/1999, THIS VACCINE HAS NOT RECEIVED FDA APPROVAL. * * 0092--SEE NPRN FOR THE MEDICARE PHYSICIANS' FEE SCHEDULE FOR 2000, PUBLISHED * IN THE FEDERAL REGISTER ON JULY 22, 1999. * * 0093--"C" CODES ARE UNIQUE TEMPORARY PRICING CODES THAT WERE INITIALLY * ESTABLISHED BY CMS FOR THE HOSPITAL OUTPATIENT PROSPECTIVE PAYMENT * SYSTEM (OPPS). THE "C" CODES ARE USED ON MEDICARE OPPS CLAIMS BUT * MAY ALSO BE RECOGNIZED ON CLAIMS FROM OTHER PROVIDERS OR BY OTHER * PAYMENT SYSTEMS. * * 0094--CODES G0173 AND G0174 REPLACE CPT 61793 ON THE OPPS PAYMENT METHODOLOGY. * CODES MAY NOT BE USED IN MEDICARE PHYSICIAN FEE SCHEDULE SYSTEM. * * 0095--AS REQUIRED BY BBRA SECTION 201. * * 0096--SERVICE REPRESENTED BY G9106 IS REPORTABLE ONLY BY PARTICIPANTS IN THE * SMOKING CESSATION COUNSELING DEMONSTRATION PROJECT. * * 0097--FOR INSTRUCTIONS RELATED TO THE MEDICARE COORDINATED CARE DEMONSTRATION * (MCCD) SEF CR1050, 1116 AND 1118. * * 0098--G0188 IS THE COMPREHENSIVE CODE FOR ANY COMBINATION OF XRAYS OF HIP, KNEE * AND ANKLE (E.G. 73500, 73510, 73550, 73560, 73590, 73600). * * 0099--SEE NPRM SPING 2000. * * 0100--SERVICE REPRESENTED BY G0180 PERTAINS TO SSA 1814(A)(2)(C) AND * 1835(A)(2)(A). * * 0101--G0175 REPRESENTS A SERVICE PAYABLE BY THE OPPS. IT MAY NOT BE USED IN THE * MEDICARE PHYSICIAN FEE SCHEDULE SYSTEM. * * 0102--SERVICES REPRESENTED BY G0176 AND G0177 MAY BE REPORTED BY HOPD * AND PARTIAL HOSPITALIZATION PROGRAMS ONLY (1861FF). * * 0103--G0172 WAS ESTABLISHED TO BE USED FOR PARTIAL HOSPITALIZATION PROGRAM * REPORTING. EFFECTIVE 1/1/2001, IT HAS BEEN REPLACED BY G0177. (1861(FF)). * * 0104--CODE 92525 IS NOT RECOGNIZED BY MEDICARE. REFER TO CODE G0195. * * 0105--MODIFIER 60 IS NOT USED FOR MEDICARE PURPOSES. * * 0106--FOR MEDICARE CLAIMS - CODE A9270 ONLY FOR USE ON BILLS SUBMITTED * BY DMEPOS SUPPLIERS. * * 0107--PAYMENT IS FOR HOSPITAL OUTPATIENT ONLY. NOT PAYABLE UNDER THE PHYSICIAN * FEE SCHEDULE; IN ACCORDANCE WITH FR DATE 8/9/2002 (HOPPS), PAGE 52105. * * 0108--NOT PAYABLE AS A SEPARATE PROCEDURE; SERVICE CONSIDERED BUNDLED INTO * PRIMARY PROCEDURE. * * 0109--PAYMENT IS FOR HOSPITAL OUTPATIENT ONLY; NOT PAYABLE UNDER THE PHYSICIAN * FEE SCHEDULE. * * 0110--SEE TRANSMITTAL AB-02-065. CIM 50-36 WILL GIVE COVERAGE INDICATIONS. * 78459 SHOULD BE USED FOR DETERMINATION OF MYOCARDIAL VIABILITY AS A * PRIMARY OR INITIAL DIAGNOSTIC STUDY PRIOR TO REVASCULARIZATION. * * 0111--IN ACCORDANCE WITH 42 CFR 411.4 (B). * * 0112--THE BASIS FOR THE PASRR LEVEL I SCREEN IS IN REGULATIONS ONLY AT 42 CFR * 483.128(a). * * 0113--THE BASIS FOR THE PASRR LEVEL II SCREEN IS IN STATUTE AT SECTION * 1919(b)(3)(F) AND SECTION 1919(e)(7) OF THE SOCIAL SECURITY ACT. * * 0114--FOR MEDICARE PURPOSES, MODIFIERS UN-US WOULD BE REPORTED WITH R0075. * * 0115--PHOTODYNAMIC THERAPY (INCLUDES INTRAVENOUS INFUSION) COVERAGE LIMITED * TO AGE RELATED MACULAR DEGENERATION (AMD) WITH OCCULT LESIONS WITH NO * CLASSIC CHOROIDAL NEOVASCULARIZATION. * * 0116--FOR MEDICARE, FOR CAH METHOD II BILLING ONLY. * * 0117--SEE G CODES FOR REPORTING. * * 0118--INITIAL PREVENTIVE PHYSICAL EXAM CONSISTS OF MEASUREMENT OF HEIGHT, * WEIGHT AND BLOOD PRESSURE; MUST INCLUDE AN ELECTROCARDIOGRAM OR * THIS CODE IS NOT BILLABLE. * * 0119--SEE NCDM REFERENCE 110.17. * * 0120--SEE BPM (BENEFIT POLICY MANUAL) 7/50.4.3. * * 0121--SECTION 303(e)(2) OF THE MMA IMPLEMENTS A SUPPLYING FEE FOR * IMMUNOSUPPRESSIVE DRUGS, ORAL ANTI-CANCER CHEMOTHERAPEUTIC * DRUGS, AND ANTI-EMETIC DRUGS USED AS PART OF AN ANTI-CANCER * CHEMOTHERAPEUTIC REGIMEN. * * 0122--THE CONCEPT OF "COVERAGE UNDER PROTOCOL (CUP)" REFERS TO A COVERAGE * CONDITION THAT REQUIRES MEDICARE BENEFICIARIES AND PROVIDERS TO * PARTICIPATE IN RESEARCH STUDIES CONCERNING THE ITEM OR SERVICE TO BE * COVERED. * * 0123--PUBLICATION 100.2, CHAPTER 15, SS 502. * * 0124--PUBLICATION 100.2, CHAPTER 15, SS 120. * * 0125--NCD MANUAL 280.1. * * 0126--NCD MANUAL 180.2. * * 0127--PUBLICATION 100.2, CHAPTER 15, 50.1. * * 0128--THIS CODE IS AN ADD ON CODE USED IN ADDITION TO E/M CODE ONLY. * INFORMATION CAN BE FOUND IN 42 CFR PART 410 PAGE 50941. * * 0129--MMA section 303(e). * * 0130--MEDICARE RECOGNIZED CODE 1/1/2006. PRIOR TO THIS DATE, SERVICES BILLED * WITH UNLISTED CODE. * * 0131--PUBLICATION 100.2, CHAPTER 16, SECTION 20 - SERVICES NOT REASONABLE AND * NECESSARY. * * 0132--CARRIER PROCESSING MANUAL, CHAPTER 17. * * 0133--SEE ONLINE MANUAL 100-02.9. * * 0134--SECTION 5112 OF THE DRA. * * 0135--MEDICARE BENEFIT POLICY MANUAL, PUB 100.2, CHAPTER 15, SECTION 110.3 * (100.02,15,110.3). * * 0136--PAID ON THE OPPS FEE SCHEDULE FOR USE WITH REV CODE 068X. * * 0137--PUBLICATION 100-03, CHAPTER 1, SECTION 280.1 (100.03, 1, 280.1). * * 0138--MEDICARE RECOGNIZED ANOTHER CODE FOR PAYMENT. * * 0139--COVERAGE IS LIMITED TO PERSONS WITH DYSPLASTIC NEVUS SYNDROME ONLY; * NO PAYMENT FOR MONITORING OF HIGH RISK PATIENTS WITH A FAMILY HISTORY. * * 0140--CLAIMS PROCESSING MANUAL PUBLICATION 100-04, CHAPTER 13, SECTION 140. * 0141--SEE NATIONAL COVERAGE DETERMINATION MANUAL FOR TRANSCATHETER STENT * PLACEMENT. * 0142--SERVICES ARE CONSIDERED INCLUSIVE OF ANOTHER CODE. PAYMENT FOR SERVICE * IS NOT MADE SEPARATELY. * 0143--INTERNET ONLY MANUAL 100.4, CHAPTER 4, SECTION 61.3. * * 0144--SERVICES CONSIDERED PART OF THE CORRESPONDING E & M VISIT. * * 0145--MEDICARE CLAIMS PROCESSING MANUAL PUB 100-4, CHAPTER 8, SECTION 60.4. * * 0146--NCD MANUAL, SECTION 310.1, 42 CFR 405.205, SUBPART B SECTION 1862(A) OF * THE ACT. * * 0147--CLAIMS PROCESSING MANUAL PUB 100-04, CHAPTER 17, SECTION 80.9. * * 0148--NCD MANUAL 220.6. * * 0149--THIS DEVICE WAS ONLY APPROVED BY THE FDA TO OBTAIN, MONITOR AND * ANALYZE PRESSURES AT THE TIME AN ENDOVASCULAR PROCEDURE IS * PERFORMED. THE FDA HAS NOT APPROVED THE DEVICE FOR FOLLOW-UP * EVALUATION OF ENDOVASCULAR GRAFT PRESSURES IN THE OUTPATIENT SETTING. * * 0150--SEE NEW 2008 CPT CODES. * * 0151--SERVICES ARE CONSIDERED UNDER G CODES G0396 AND G0397. * 0152--NCD 100-3, 160.12. * 0153--PURSUANT TO SECTION 101 (B) OF THE MEDICARE IMPROVEMENT FOR PATIENTS * AND PROVIDERS ACT OF 2008 (MIPPA) EFFECTIVE JANUARY 1, 2009, WE * EXPANDED COVERAGE FOR THE WELCOME TO MEDICARE BENEFIT; IT IS SUBJECT * TO CERTAIN ELIGIBILITY AND OTHER LIMITATIONS THAT ALLOW PAYMENT FOR AN * INITIAL PREVENTIVE PHYSICAL EXAMINATION (IPPE), NOT LATER THAN 12 * MONTHS AFTER THE DATE THE INDIVIDUAL'S FIRST COVERAGE PERIOD BEGINS * UNDER MEDICARE PART B. * 0154--MEDICARE RECOGNIZES THE FOLLOWING CODES G0412-G0415 FOR THIS SERVICE. * 0155--MEDICARE DOES NOT RECOGNIZE CODES 27215, 27216, 27217 AND 27218 FOR 2009. * 0156--1833(+)(2)(B) OF THE ACT; CY 2008 OPPS/ASC FINAL RULE (DATED NOVEMBER 22, * 2007), P. 66611. * 0157--MEDICARE BENEFIT POLICY MANUAL, PUB 100.02, CHAPTER 15, SECTION 110.2. * 0158--SEE NEW OR ESTABLISHED VISIT CODES. * 0159--THIS DENTAL SERVICE IS NOT PAYABLE OR PROCESSED UNDER THE PHYSICIAN FEE * SCHEDULE. * 0160--THIS SERVICE IS ONLY PAYABLE FOR RESTRICTIVE USE ONLY. * 0161--MEDICARE ALLOWS PAYMENT FOR COLON SCREENING WITH ANOTHER CODE. * 0162--THIS CODE IS NOT PAYABLE UNDER THE MEDICARE PROGRAM. * 0163--MEDICARE RECOGNIZES G9141 AND G9142 FOR THIS SERVICE. * 0164--SEE CHANGE REQUEST 6786. * 0165--PUB 100.3 250.4 (IOM). * 0166--CR6953 RELEASED 6/4/2010, NCD 250.5 (PUB 100-03) AND CPM 32.260 * (PUB 100-04). * 0167--NOT RECOGNIZED BY MEDICARE - USE CODE G0434. * 0168--NATIONAL NON-COVERAGE DECISION, SEE CR 5013. * 0169--SERVICE IS NON-COVERED BY NCD 150.12. * 0170--SEE NCD 20.29. * 0171--MEDICARE DOES NOT RECOGNIZE CODE, SEE CODES Q2035 - Q2039. * 0172--SERVICE IS NON-COVERED BY NCD 40.7. * 0173--SEE CR 7040 AND PUB. 100-3, SECTION 220.2. * 0174--FDA NON-APPROVED MEDICATION, NOT A PAYABLE SERVICE. * 0175--NCD Pub 100-3, 110.22. * 0176--Pub 100-03 NCD Manual, Section 240.2.2. * 0177--SERVICE IS NON-COVERED BY STATUTE 1861(A)1(A). * 0178--SEE NCDM 20.9. * 0179--CY 2013 OPPS/ASC FINAL RULE. * 0180--2013 PFS; PUB 100-04, 5-10, 12.027I. * 0181--THIS IS A BUNDLED SERVICE. * 0182--THIS CODE IS TO BE USED FOR THE TAVR/TAVI PROCEDURE; PERFORMED WITH CO-SURGEONS. * 0183--NCD 220.6 POSITRON EMISSION TOMOGRAPHY (PET) SCANS, (EFFECTIVE 4/6/2009) (REV. 120; ISSUED 5/6/2010; EFFECTIVE DATE: 4/3/2009; IMPLEMENTATION DATE: 10/30/2009). * 0184--MEDICARE RECOGNIZES CODE G0455 FOR THIS SERVICE. * 0185--THIS SERVICE IS LIMITED TO PAYMENT IN AN ASC. * 0186--SEE CPT BOOK PARENTHETICAL LANGUAGE FOR ADDITIONAL INFO. * 0187--PUB. 100-4, CHAPTER 17. * 0188--PUB. 100-04 CH. 20 S. 30.3. * 0189--IOM 100-3, CH 4, NCD 220.6.20. * 0190--MEDICARE RECOGNIZES ANOTHER CODE FOR THIS SERVICE, SEE CODES G0461 AND G0462. * 0191--IOM 100-3, CHAPTER 4, 220.6.20. * 0192--PL 112-242. * 0193--SEE 150.13 MEDICARE NATIONAL COVERAGE DETERMINATIONS MANUAL CHAPTER 1, PART 2; ALSO CR 8757, TRANSMITTAL 167 DATED MAY 16, 2014. * 0194--PUB. 100-4, CH. 15. * 0195--PUB. 100-4, CH.4, SEC 240. * 0196--PUB. 100-4, CH.21, SEC 10.1.3. * 0197--NCD 240.2. * 0198--NCD 160.19. * 0199--SEE CR 8871, SERVICE IS APPROVED PER NCD COVERAGE; RESTRICTIVE GUIDELINES. * 0200--TECHNICAL TREATMENT AND DELIVERY OF HBOT, PHYSICIAN SUPERVISION CODE 99183. * 0201--MEDICARE RECOGNIZES ANOTHER CODE FOR PAYMENT PURPOSES ON THE CLINICAL LAB FEE SCHEDULE. * 0202--THE PATIENT PROTECTION AND AFFORDABLE CARE ACT MADE IT MANDATORY FOR ALL HEALTHCARE INSURANCE PLANS TO COVER SOME PREVENTIVE SERVICES AND IMMUNIZATIONS AS PART OF ALL BENEFIT PLANS; THIS MODIFIER DOES NOT APPLY TO CMS SCREENING SERVICES AS THEY ARE STATUTORILY ADMINISTERED. * 0203--CODE CREATED TO IDENTIFY RECENTLY DEVELOPED "FOURTH GENERATION" HIV SCREENING TESTS; COVERAGE EFFECTIVE BY NCD. * 0204--NCD 110.18. * 0205--PUB 100-4, CH 17, SEC 20.1.2. * 0206--THIS SERVICE IS PART OF A DEMONSTRATION PROJECT. * 0207--BBA 2015 SEC 603. * 0208--IOM 100-2, CH.15, SEC 100. * 0209--NCD MANUAL 280.0. * 0210--PUB 100-2, CH 15. * 0211--PUB 100-4, CH 17, SEC 80.4. * 0212--CMS-1682-R. * 0213--42 CFR SEC 424.5(a)(6). * 0214--SERVICES FOR RURAL HEALTH CLINIC OR FEDERALLY QUALIFIED HEALTH CENTER (RHC/FQHC) ONLY. * 0215--THE DEDUCTIBLE AND COINSURANCE ARE WAIVED FOR CODE 77067. * 0216--SERVICES AVAILABLE PER NCD DATED MAY 25, 2017. * 0217--SEC 30.7.2 OF THE CLAIMS PROCESSING MANUAL. * 0218--MEDICARE DOES NOT COVER THIS SERVICE INDEPENDENTLY AS A SEPARATE IDENTIFIABLE SERVICE. * 0219--NCD 30.4. * 0220--REFER TO THE NCD MANUAL, SECTION 30.3. *