February 2005 Medicare Bulletin - North Carolina Insert
Posted February 2, 2005
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Table of Contents
- 2005 North Carolina Ambulance Fee Schedule / Prevailing Charges
- Azacitidine for Injectable Suspension (Vidaza TM) (L18986) - LCD
- Cardiac Catheterization (L18290) - LCD Revision
- Flow Cytometry (L5956) - LCD Revision
- North Carolina Health Professionals Shortage Areas (HPSAs)
- North Carolina Mental Health Professional Shortage Areas (HPSAs)
- North Carolina Policy Updates
- Virtual Colonoscopy (CT Colonography) L18987) - LCD
2005 NORTH CAROLINA AMBULANCE FEE SCHEDULE / PREVAILING CHARGES
PROCEDURE |
URBAN RATE |
RURAL RATE |
IIC |
| A0425 | 5.90 | 5.96 | |
| A0426M2 | 208.83 | 210.90 | 133.79 |
| A0426M4 | 208.83 | 210.90 | 119.29 |
| A0427M2 | 330.65 | 333.92 | 205.88 |
| A0427M4 | 330.65 | 333.92 | 122.42 |
| A0428M2 | 174.03 | 175.75 | 120.53 |
| A0428M4 | 174.03 | 175.75 | 119.29 |
| A0429M2 | 278.44 | 281.20 | 137.41 |
| A0429M4 | 278.44 | 281.20 | 119.29 |
| A0430 | 2375.40 | 3563.10 | 2574.82 |
| A0431 | 2761.75 | 4142.62 | 1539.38 |
| A0432 | 304.55 | 307.56 | |
| A0433M2 | 478.57 | 483.31 | 205.88 |
| A0433M4 | 478.57 | 483.31 | 122.42 |
| A0434M2 | 565.58 | 571.18 | 205.88 |
| A0434M4 | 565.58 | 571.18 | 122.42 |
| A0435 | 7.00 | 10.50 | 33.06 |
| A0436 | 18.67 | 28.01 | 33.06 |
| Q3019 | 278.44 | 281.20 | 122.42 |
| Q3020 | 174.03 | 175.75 | 119.29 |
| A0382 | 29.51 | ||
| A0384 | 9.34 | ||
| A0392 | 9.45 | ||
| A0394 | 4.58 | ||
| A0396 | 12.51 | ||
| A0398 | 29.13 | ||
| A0422 | 16.38 |
TopAzacitidine for Injectable Suspension (Vidaza TM) (L18986) - LCD
Azacitidine for Injectable Suspension (Vidaza TM) (L18986) - LCD
Cardiac Catheterization (L18290) - LCD Revision
Cardiac Catheterization (L18290) - LCD Revision
Flow Cytometry (L5956) - LCD Revision
Flow Cytometry (L5956) - LCD Revision
North Carolina Policy Updates
- Monitored Anesthesia Care (MAC) (LMRP 97-06)
CPT code and modifier updates were added to the policy
- Botulinum Toxin (LCD 96-009-04)
Added coverage of hyperhidrosis and sialorrhea, with appropriate ICD-9 codes (705.21, 780.8, and 527.7). Also added CPT 95870 for use with appropraite EMG studies when done with injection of Botulinum Toxin(s).
- Endoluminal Radiofrequency or Laser System Ablation of Varicose Veins (LCD 2003-002)
Replaced CPT code 37799 (UNLISTED PROCEDURE, VASCULAR SURGERY) with the specific CPT codes for radiofrequency (36476, 36476) and laser (36478, 36479).
As the new codes include all imaging guidance and monitoring, inclusion of the statement that medically necessary intraoperative ultrasonic guidance procedures are included as components of the therapy codes and not separately payable.
Removed CPT code 76986 (ULTRASONIC GUIDANCE, INTRAOPERATIVE).
Retired the related LCD article due to assignment of specific CPT codes.
- Colonoscopy (Diagnostic/Screening) (LCD 96- 006)
Added the new CPT codes 45391 (COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION) and 45392 (COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRANSMURAL FINE NEEDLE ASPIRATION/BIOPSY(S)).
- Measurement of Bone Density (LCD 2003-004)
CPT 76077 (new code for 2005) was added. ICD-9 diagnoses 242.00 - 242.91 were added. The verbiage re: fractures requiring a secondary diagnosis was added.
Virtual Colonoscopy (CT Colonography) (L18987) - LCD
Virtual Colonoscopy (CT Colonography) (L18987) - LCD
North Carolina Mental Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
|
North Carolina Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
|
1 No longer classified as a HPSA, effective August 1, 2002.
2 Classifed as a HPSA, effective June 1, 2004.
3 No longer classified as a HPSA, effective December 1, 2004.
