New Carrier-Priced (C Status) Procedures for 2010

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, 2010 and after, there are 24 new CPT codes that have a status of "C" (carrier-priced) on the 2010 Medicare Physician Fee Schedule Database (MPFSDB) but do not have pricing established.

New 2010 C Status Codes

0182T (TC & 26 modifiers added in 2010) - High dose rate electronic brachytherapy, per fraction

0203T (global, TC and 26 modifiers) - Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone) and sleep time

0204T (global, TC and 26 modifiers) - Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone)

0205T -Intravascular catheter-based coronary vessel or graft spectroscopy (eg, infrared) during diagnostic evaluation and/0r therapeutic intervention including imaging supervision, interpretation, and report, each vessel (list separately in addition to code for primary procedure)

0206T - Algorithmic analysis, remove of electrocardiographic-derived data with computer probability assessment, including report

0207T - Evaculation of meibomian glands, automated, using heat and

0208T -Pure tone audiometry (threshold), automated (includes use of computer-assisted device); air only

0209T - Pure tone audiometry (threshold), automated (includes use of computer-assisted device); air and bone

0210T - Speech audiometry threshold, automated (includes use of computer-assisted device)

0211T -Speech audiometry threshold, automated (includes use of computer-assisted device); with speech recognition

0212T -Comprehensive audiometry threshold evaluation and speech recognition, automated (includes use of computer-assisted device)

0213T - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic, single level

0214T - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second level (list separately in addition to code for primary procedure)

0215T - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; third and any additional level(s) (list separately in addition to code for primary procedure)

0216T - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level

0217T -Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral, second level (list separately in addition to code for primary procedure)

0218T - Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)

0219T - Placement of posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical

0220T - Placement of posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic

0221T - Placement of posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; lumbar

0222T - Placement of posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; each additional vertebral segment (list separately in addition to code for primary procedure)

33981- Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump

33982 - Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass

33983 - Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass

Page Last Updated: Wednesday, 25-Nov-2009 13:49:57 CST