February 2006 Medicare Bulletin - North Carolina Insert

Posted February 3, 2006

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Table of Contents

• 2006 North Carolina Ambulance Fee Schedule
• 2006 North Carolina Clinical Fee Schedule
• North Carolina Health Professionals Shortage Areas (HPSAs)
• North Carolina Mental Health Professional Shortage Areas (HPSAs)
• Rituxan LCD Revision
• Transthoracic Echocardiography (TTE) LCD Revision

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2006 North Carolina Clinical Fee Schedule

2006 North Carolina Clinical Fee Schedule

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2006 North Carolina Ambulance Fee Schedule

PROCEDURE	URBAN RATE	RURAL RATE
A0425	6.05	6.11
A0426	218.60	220.76
A0427	346.11	349.54
A0428	182.16	183.97
A0429	291.46	294.35
A0430	2489.17	3733.76
A0431	2894.03	4341.04
A0432	318.79	321.94
A0433	500.95	505.91
A0434	592.03	597.90
A0435	7.18	10.77
A0436	19.14	28.71
A0998	Invalid for	Medicare

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Transthoracic Echocardiography (TTE) LCD Revision

The North Carolina LCD for Transthoracic Echocardiography (TTE) L6657 has been revised. ICD-9 V15.89 was added to all CPT codes for coverage indications. Please refer to the current NC policy table to review the policy in its entirety.

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Rituxan LCD Revision

The North Carolina LCD for Rituxan, L18591 has been revised for Indication for first line therapy in combination for CLL. Please refer to the current NC policy table to review the policy in its entirety.

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North Carolina Mental Health Professional Shortage Areas (HPSAs)

Designated Geographic Areas

COUNTY AREA NAME/PARTS RURAL/URBAN Beaufort Tideland Beaufort Rural Bertie Roanoke-Chowan Bertie Rural Bladen Southeast Regional MHCA Blanden Rural Brunswick Brunswick Rural Caldwell Caldwell Urban Camden Albermarle Camden Rural Cherokee2 Smokey Mountain MHCA Cherokee Rural Chowan Albermarle Chowan Smokey Mountain Rural Clay2 Smokey Mountain MHCA Clay Rural Columbus Southeast Regional Columbus Rural Currituck Albermarle Currituck Rural Dare Albermarle Dare Rural Duplin Duplin-Sampson Duplin Rural Gates Roanoke-Chowan Gates Rural Graham Smokye Mountain MHCA Graham Rural Halifax Halifax MHCA Halifax Rural Haywood2 Smokey Mountain MHCA Haywood Rural Hertford Roanoke-Chowan Hertford Rural Hyde Tideland Hyde Rural Jackson2 Smokey Mountain MHCA Jackson Rural Macon2 Smokey Mountain MHCA Macon Rural Madison1 Madison   Martin Tideland Martin Rural Northampton Roanoke-Chowan Nothampton Rural Pasquotank Albermarie Pasquotank Rural Perquimans Albermarle Perquimans Rural Robeson Southeast Regional Robeson Rural Sampson Duplin-Sampson Sampson Rural Scotland Southeast Regional Scotland Rural Surry Surry-Yadkin Surry Smokey Mountain Rural Swain2 Smokey Mountain MHCA Swain Rural Tyrrell Tideland Tyrell Rural Washington Tideland Washington Rural Yadkin Surry-Yadkin Yadkin Rural

 ¹ Classified as a Mental Health HPSA, Effective February 2, 2005

² Classified as a Mental Health HPSA, Effective June 30, 2005

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North Carolina Health Professional Shortage Areas (HPSAs)

Designated Geographic Areas

COUNTY AREA NAME/PARTS RURAL/URBAN Alexander All Urban Anson All Rural Beaufort Bayboro - Aurora Richland Twp. Belhaven - Swan Quarter Bath Twp., Pantego Twp Rural Bertie All Rural Bladen1 All Rural Caldwell Western Caldwell - Globe Twp., Johns River Twp., Mulberry Twp., Patterson Twp., Wilson Creek Twp., Rural Carteret5 Eastern Cateret - Atlantic Twp., Cedar Island Twp., Davis Twp., Harkers Islands Twp., Marshallberg Twp., Merrimon Twp., Portsmouth Twp., Sea Level Twp., Smyrna Twp., Stacy Twp., Strait Twp. Rural Caswell All Rural Cherokee3 Andrews Area, Valley Town Twp. Rural Clay All Rural Columbus All Rural Currituck All Urban Dare Hatteras - Ocracoke SA Hatteras Twp., Kinnakeet Twp. Rural Edgecombe All Urban Franklin All Urban Gates All Rural Graham All Rural Greene2 All Rural Guilford Inner City Greensboro - Census Tracts 101, 107.02, 108.01, 110, 111.01, 112, 113, 114, 115 Urban       Hoke All Rural Hyde Belhaven-Swan Quarter Currituck Twp., Fairfield Twp., Lake Landing Twp., Lake Mattamuskeet Unorg., Swan Quarter Twp. Hatteras-Ocracoke Ocracoke Twp. Rural Lenoir East Kinston - Census Tracts 101-105, 107 Urban Macon1 Franklin - Burningtown Twp., Cartoogechaye Twp., Cowee Twp., Ellijay Twp., Flats Twp., Franklin Twp., Millshoal Twp., Nantahala Twp., Smiths Bridge Twp. Rural Mecklenburg Central Charlotte - Census Tracts 1, 4, 5, 6, 7, 8, 36, 37, 38.98, 39.01, 39.02, 41, 42, 45, 46, 47, 48, 49, 50, 51, 51.01, 52 Urban Montgomery1 All Rural Northampton All Rural       Pamlico Bayboro - Aurora Pamlico Rural Pender All Rural Person All Rural Randolph All Urban Robeson All Rural Stokes Danbury - Census Tracts 701, 702, and 703 Urban Tyrrell All Rural Warren All Rural Washington All Rural

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.

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