CMS Pub. 100-04, ch. 13, § 70.2

A/B MACs (B) do not make separate payment for services rendered by the radiation

oncologists or in conjunction with radiation therapy.

11920 Tattooing, intradermal introduction of insoluble opaque pigments to

correct color defects of skin; 6.0 sq. cm or less

11921 6.11 to 20.0 sq. cm

11922 Each additional 20.0 sq. cm

16000 Initial treatment, first-degree burn, when no more than local treatment is

required

16010 Dressings and/or debridement, initial or subsequent; under anesthesia,

small

16015 Under anesthesia, medium or large, or with major debridement

16020 Without anesthesia, office or hospital, small

16025 Without anesthesia, medium (e.g., whole face or whole extremity)

16030 Without anesthesia, large (e.g., more than one extremity)

36425 Venipuncture, cut down age 1 or over

53670 Catheterization, urethra; simple

53675 Complicated (may include difficult removal of balloon catheter)

99211 Office or other outpatient visit, established patient; Level I*

99212 Level II*

99213 Level III*

99214 Level IV

99215 Level V

99238 Hospital discharge day management

99281 Emergency department visit, new or established patient; Level I

99282 Level II

99283 Level III

99284 Level IV

99285 Level V

90780 IV Infusion therapy, administered by physician or under direct supervision

of physician; up to one hour

90781 Each additional hour, up to 8 hours

90847 Family medical psychotherapy (conjoint psychotherapy) by a physician,

with continuing medical diagnostic evaluation, and drug management

when indicated

99050 Services requested after office hours in addition to basic service

99052 Services requested between 10:00 PM and 8:00 AM in addition to basic

service

99054 Services requested on Sundays and holidays in addition to basic service

99058 Office services provided on an emergency basis

99071 Educational supplies, such as books, tapes, and pamphlets, provided by the

physician for the patient’s education at cost to physician

99090 Analysis of information data stored in computers (e.g., ECG, blood

pressures, hematologic data)

99185 Hypothermia; regional

99371 Telephone call by a physician to patient or for consultation or medical

management or for coordinating medical management with other health

care professionals; simple or brief (e.g., to report on tests and/or laboratory

results, to clarify or alter previous instructions, to integrate new

information from other health professionals into the medical treatment

plan, or to adjust therapy)

99372 Intermediate (e.g., to provide advice to an established patient on a new

problem, to initiate therapy that can be handled by telephone, to discuss

test results in detail, to coordinate medical management of a new problem

in an established patient, to discuss and evaluate new information and

details, or to initiate a new plan of care)

99373 Complex or lengthy (e.g., lengthy counseling session with anxious or

distraught patient, detailed or prolonged discussion with family members

regarding seriously ill patient, lengthy communication necessary to

coordinate complex services or several different health professionals

working on different aspects of the total patient care plan)

• Anesthesia (whatever code billed)

• Care of Infected Skin (whatever code billed)

• Checking of Treatment Charts

• Verification of Dosage, As Needed (whatever code billed)

• Continued Patient Evaluation, Examination, Written Progress Notes, As

Needed (whatever code billed)

• Final Physical Examination (whatever code billed)

• Medical Prescription Writing (whatever code billed

• Nutritional Counseling (whatever code billed)

• Pain Management (whatever code billed)

• Review & Revision of Treatment Plan (whatever code billed)

• Routine Medical Management of Unrelated Problem (whatever code billed)

• Special Care of Ostomy (whatever code billed)

• Written Reports, Progress Note (whatever code billed)

• Follow-up Examination and Care for 90 Days After Last Treatment (whatever

code billed)

*NOTE: May be billed with Radiation Treatment Delivery, superficial and/or ortho

voltage, for the purpose of reporting physician services consisting of radiation therapy

planning (including, but not limited to clinical treatment planning, isodose planning,

physics consultation), radiation treatment device construction, and radiation treatment

management when performed on the same date of service as treatment delivery. Billing

with modifier 25 may be necessary if National Correct Coding Initiative (NCCI) edits

apply.