New Carrier-Priced (C Status) Procedures for 2009
Category III services (codes ending in T) are temporary codes set up to reflect new technology (experimental/investigative). Their main use is for data collection. These codes will be reviewed individually by Medicare and are usually denied as not medically necessary.
For the other C status codes listed below (other than the T-codes) there are no CMS established fees and we will review these on an individual consideration basis. WPS may establish a price for these services. Under normal circumstances, we will not determine pricing for them until they are billed. We may request medical records to assist in the evaluation and pricing of these services, as these are often unlisted procedures. Some of the C status codes are very specific, but have not been priced by CMS. These typically reflect new technology.
Effective for dates of service January 1, 2009 and after, there are 15 new CPT codes which have a status of "C" (carrier-priced) on the 2009 Medicare Physician Fee Schedule Database (MPFSDB) but do not have pricing established.
New 2009 C Status Codes:
0054T - Computer-assisted musculoskeletal surgical navigational orthopedic procedure with image-guidance based on fluoroscopic images
0055T - Computer-assisted musculoskeletal surgical navigational orthopedic procedure with image-guidance based on CT/MRI images
0193T - Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence
0194T - Procalcitonin (PCT)
0195T - Arthrodesis, pre-sacral interbody technique, including instrumentation, imaging (when performed), and discectomy to prepare interspace, lumbar; single interspace
0196T - Arthrodesis, pre-sacral interbody technique, including instrumentation, imaging (when performed), and discectomy to prepare interspace, lumbar; each additional interspace
0197T - Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (EG, 3D positional tracking, gating, 3D surface tracking), each fraction of treatment
0198T - Measurement of ocular blood flow by repetitive intraocular pressure sampling with interpretation and report
65757 - Backbench preparation of corneal endothelial allograft prior to transplantation
90952 - End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face physician visits per month
90953 - End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month
93229 - Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; technical support for connection and patient instructions for use, attended surveillance, analysis and physician prescribed transmission of daily and emergent data reports
93299 - 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
95803 - Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
96379 - Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion
Page Last Updated: Thursday, 18-Mar-2010 05:56:04 CDT
