Change Request 4236 - CMS
CMS Manual SystemDepartment of Health &Human Services (DHHS)Pub 100-04 Medicare ClaimsProcessingCenters for Medicare &Medicaid Services (CMS)Transmittal 783Date: DECEMBER 16, 2005Change Request 4236SUBJECT: January 2006 Non-Outpatient Prospective Payment System OutpatientCode Editor (Non-OPPS OCE) Specifications Version 21.1I. SUMMARY OF CHANGES: This instruction informs the Fiscal Intermediaries (FIs)that the January 2006 Non-OPPS OCE has been updated with new additions, changes anddeletions to HCPCS codes and procedure codes.NEW/REVISED MATERIALEFFECTIVE DATE: Various dates as described in the CR and attachmentsIMPLEMENTATION DATE: January 3, 2006Disclaimer for manual changes only: The revision date and transmittal number applyonly to red italicized material. Any other material was previously published andremains unchanged. However, if this revision contains a table of contents, you willreceive the new/revised information only, and not the entire table of contents.II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated)R REVISED, N NEW, D . FUNDING:No additional funding will be provided by CMS; Contractor activities are to becarried out within their FY 2006 operating budgets.IV. ATTACHMENTS:Recurring Update Notification*Unless otherwise specified, the effective date is the date of service.
Attachment – Recurring Update NotificationPub. 100-04Transmittal: 783Date: December 16, 2005Change Request 4236SUBJECT: January 2006 Non-Outpatient Prospective Payment System Outpatient Code Editor(Non-OPPS OCE) Specifications Version 21.1I.GENERAL INFORMATIONA. Background: The Non-OPPS OCE has been updated with new additions, changes, and deletions toHealthcare Common Procedure Coding System/Current Procedural Terminology, Fourth Edition(HCPCS/CPT-4) codes. This OCE is used to process bills from hospitals not paid under OPPS.B. Policy:The following are changes made to version 21.0 of the Non-OPPS OCE with various effective dates: The new HCPCS/CPT codes as listed in Appendix A have been added to the list of valid codes inthe Non-OPPS OCE. The HCPCS/CPT codes as listed in Appendix B have been deleted from the Non-OPPS OCE. The HCPCS/CPT codes as listed in Appendix C have been added to the list of Non-Reportableprocedures in the Non-OPPS OCE. The following codes have been added to the Procedures for Females Only List, effective 1/1/06:Code01965019665729558110DescriptionAnesth, inc/missed ab procAnesth, induced ab procedureChange vaginal graftBx done w/colposcopy add-on The following code has been added to the Procedures for Males Only list , effective 1/1/06:Code0137TDescriptionProstate saturation sampling The following code has been removed from the Non-Covered List (NCL), effective 8/1/00 or whenthe code was placed on the NCL, if more recent:CodeA0888DescriptionNon-covered ambulance mileage The following codes have been removed from the Non-Reportable List, effective 1/1/06:CodeL3000DescriptionFt insert ucb berkeley shell
Foot insert remov molded speFoot insert plastazote or eqFoot insert silicone gel eacFoot lamin/prepreg compositeFt arch suprt premold longitFoot arch supp premold metatFoot arch supp longitud/metaArch suprt att to sho longitArch supp att to shoe metataArch supp att to shoe long/mHallus-valgus nght dynamic sAbduction rotation bar shoeAbduct rotation bar w/o shoeShoe styled positioning devFoot plastic heel stabilizerOxford w supinat/pronat infOxford w/ supinat/pronator cOxford w/ supinator/pronatorHightop w/ supp/pronator infHightop w/ supp/pronator chiHightop w/ supp/pronator junSurgical boot each infantSurgical boot each childSurgical boot each juniorBenesch boot pair infantBenesch boot pair childBenesch boot pair juniorOrthopedic ftwear ladies oxfOrthoped ladies shoes dpth iLadies shoes hightop depth iOrthopedic mens shoes oxfordOrthopedic mens shoes dpth iMens shoes hightop depth inlCustom shoes depth inlayCustom mold shoe remov prostShoe molded to pt silicone sShoe molded plastazote custShoe molded plastazote custOrth foot non-stndard size/wOrth foot non-standard size/Orth foot add charge split sPlastazote sandal eachSho lift taper to metatarsalShoe lift elev heel/sole neoShoe lift elev heel/sole corLifts elevation metal extensShoe lifts tapered to one-haShoe lifts elevation heel /iShoe wedge sachShoe heel wedge
L3630L3640L3649Shoe sole wedge outside soleShoe sole wedge between soleShoe clubfoot wedgeShoe outflare wedgeShoe metatarsal bar wedge roShoe metatarsal bar betweenFull sole/heel wedge btweenSho heel count plast reinforHeel leather reinforcedShoe heel sach cushion typeShoe heel new leather standaShoe heel new rubber standarShoe heel thomas with wedgeShoe heel thomas extend to bShoe heel pad & depress forShoe heel pad removable forOrtho shoe add leather insolOrthopedic shoe add rub inslO shoe add felt w leath inslOrtho shoe add half soleOrtho shoe add full soleO shoe add standard toe tapO shoe add horseshoe toe tapO shoe add instep extensionO shoe add instep velcro cloO shoe convert to sof counteOrtho shoe add march barTrans shoe calip plate existTrans shoe caliper plate newTrans shoe solid stirrup exiTrans shoe solid stirrup newShoe dennis browne splint boOrthopedic shoe modifica NOS
II.BUSINESS REQUIREMENTS“Shall" denotes a mandatory requirement"Should" denotes an optional requirementRequirement RequirementsNumberResponsibility (“X” indicates thecolumns that apply)FI4236.14236.2The Shared System Maintainer shall installNon-OPPS OCE Version 21.1 into theirsystems.FIs shall inform providers of the Non-OPPSOCE changes for Version 21.1 detailed in thisrecurring update notification.RHHICarrierDMERCShared SystemMaintainersFISSOtherM V CC M WS S FXXIII. PROVIDER EDUCATIONRequirement RequirementsNumberResponsibility (“X” indicates thecolumns that apply)FI4236.3XA provider education article related to thisinstruction will be available atwww.cms.hhs.gov/medlearn/matters shortlyafter the CR is released. You will receivenotification of the article release via theestablished "medlearn matters" listserv.Contractors shall post this article, or a directlink to this article, on their Web site and includeinformation about it in a listserv message within1 week of the availability of the providereducation article. In addition, the providereducation article shall be included in your nextregularly scheduled bulletin and incorporatedinto any educational events on this topic.Contractors are free to supplement MedlearnMatters articles with localized information thatwould benefit their provider community inbilling and administering the Medicare programcorrectly.RHHICarrierDMERCShared SystemMaintainersFISSM V CC M WS S FOther
IV. SUPPORTING INFORMATION AND POSSIBLE DESIGN CONSIDERATIONSA.Other Instructions: N/AX-Ref Requirement # InstructionsB.Design Considerations: N/AX-Ref Requirement #Recommendation for Medicare System RequirementsC.Interfaces: OPPS OCE/PRICERD.Contractor Financial Reporting /Workload Impact: N/AE.Dependencies: N/AF.Testing Considerations: N/AV.SCHEDULE, CONTACTS, AND FUNDINGEffective Date*: Various dates as described in theCR and attachmentsImplementation Date: January 3, 2006No additional funding will beprovided by CMS; contractoractivities are to be carried outwithin their FY 2006 operatingbudgets.Pre-Implementation Contact(s): Susan Guerin at410-786-6138 or susan.guerin@cms.hhs.gov; DianaMotsiopoulas at 410-786-3379 n Contact(s): AppropriateRegional Office*Unless otherwise specified, the effective date is the date of service.3 Attachments
OCE v21.1 Appendix AHCPCSShort DescriptionEffective DateK0731K0732Lith ion bat CID non-ear lvlLith ion batt CID ear 26MD service required for PMDLap inc/vent hernia repairLap umbilical hernia repairLap mesh implant hern repArthrosc sh tenodesis bicepsArthroereisis, subtalarMaternal serum quad Anesth, inc/missed ab procAnesth, induced ab procedureHarvest cultured skin graftEpidrm autogrft trnk/arm/legEpidrm autogrft t/a/l add-onEpidrm a-grft face/nck/hf/gEpidrm a-grft f/n/hf/g addlDerm autograft, trnk/arm/legDerm autograft t/a/l add-onDerm autograft face/nck/hf/gDerm autograft, f/n/hf/g addCult epiderm grft t/arm/legCult epiderm grft t/a/l addlCult epiderm graft t/a/l %Cult epiderm graft, f/n/hf/gCult epidrm grft f/n/hfg addCult epiderm grft f/n/hfg %Acell graft trunk/arms/legsAcell graft t/arm/leg add-onAcellular graft, f/n/hf/gAcell graft, f/n/hf/g add-onApply skinallogrft, t/arm/lgApply sknallogrft t/a/l addlApply skin allogrft f/n/hf/gAply sknallogrft f/n/hfg addAply acell alogrft t/arm/legAply acell grft t/a/l add-onApply acell graft, f/n/hf/gAply acell grft f/n/hf/g addApply cult skin substituteApply cult skin sub add-onApply cult derm sub, t/a/lAply cult derm sub t/a/l addApply cult derm sub f/n/hf/gApply cult derm f/hf/g addApply skin xgraft, f/n/hf/gApply skn xgrft f/n/hf/g addApply acellular xenograftApply acellular xgraft 61/1/061/1/061/1/061/1/061/1/061/1/06Page 1
OCE v21.1 Appendix 04671250250I&d, p-spine, c/t/cerv-thorI&d, p-spine, l/s/lsPercut kyphoplasty, thorPercut kyphoplasty, lumbarPercut kyphoplasty, add-onHigh energy eswt, plantar fResect apical lung tumorResect apical lung tum/chestRepair art, intramuralRestore/remodel, ventricleCavopulmonary shuntingEndovasc taa repr incl subclEndovasc taa repr w/o subclInsert endovasc prosth, taaEndovasc prosth, taa, add-onEndovasc prosth, delayedArtery transpose/endovas taaCar-car bp grft/endovas taaRpr pul art unifocal w/o cpbRepr pul art, unifocal w/cpbInj w/fluor, eval cv devicePrim art mech thrombectomyPrim art m-thrombect add-onSec art m-thrombect add-onVenous mech thrombectomyVenous m-thrombectomy add-onLigate/strip short leg veinLigate/strip long leg veinLap, place gastr adjust bandLap, revise adjust gast bandLap, remove adjust gast bandLap, change adjust gast bandLap remov adj gast band/portRevise gastric port, openRemove gastric port, openChange gastric port, openLap, enterolysisLap, jejunostomyLap, ileo/jejuno-stomyLap, colostomyLap, mobil splenic fl add-onLap, close enterostomyLap, removal of rectumLap, remove rectum w/pouchLaparoscopic proctopexyLap proctopexy w/sig resectLaparoscope proc, rectumSurg dx exam, anorectalChemodenervation anal muscRepr per/vag pouch sngl procRepr per/vag pouch dbl procCryoablate renal mass 1/061/1/061/1/06Page 2
OCE v21.1 Appendix 48838588386Change ureter stent, percutRemove ureter stent, percutChange ext/int ureter stentRemove renal tube w/fluoroPerc rf ablate renal tumorLaparoscope proc, bladderChange vaginal graftBx done w/colposcopy add-onIntracranial angioplastyIntracran angioplsty w/stentDilate ic vasospasm, initDilate ic vasospasm add-onDilate ic vasospasm add-onChemodenerv eccrine glandsChemodenerv eccrine glandsXray, endovasc thor ao reprXray, endovasc thor ao reprXray, place prox ext thor aoXray, place dist ext thor ao3d render w/o postprocess3d rendering w/postprocessStereoscopic x-ray guidanceNeutron beam tx, simpleNeutron beam tx, complexAssay of sirolimusOccult blood, feces, singleBlood occult peroxidaseGlycosylated hb, home deviceLactoferrin, fecal (quant)Assay of lipoprotein(a)Lipopro bld, electrophoreticLipoprotein bld, hr fractionLipoprotein, bld, by nmrMolecule nucleic ampli 2 seqLyse cells for nucleic extNucleic acid, signal ampliNucleic acid, high resoluteMutation ident ola/sbce/aspeCcp antibodyB cells, total countNk cells, total countStem cells, total countTb test, cell immun measureCompatibility test, electricVol reduction of blood/prodSmear, complex stainPhenotype, infect agent drugIntraop cyto path consult, 1Intraop cyto path consult, 2Eval molecular probes, 11-50Eval molecul probes, 51-250Eval molecul probes, 61/1/061/1/061/1/06Page 3
OCE v21.1 Appendix 19905399060Chct for mal hyperthermiaH papilloma vacc 3 dose imTd vaccine no prsrv / 7 imZoster vacc, scHydration iv infusion, initHydrate iv infusion, add-onTher/proph/diag iv inf, initTher/proph/dg iv inf, add-onTx/proph/dg addl seq iv infTher/diag concurrent infTher/proph/diag inj, sc/imTher/proph/diag inj, iaTher/proph/diag inj, iv pushTher/proph/diag inj add-onTher/prop/diag inj/inf procDuodenal motility studyEval aud rehab statusEval aud status rehab add-onAud rehab pre-ling hear lossAud rehab postling hear lossGluc monitor, cont, phys i&rMuscle test, larynxMuscle test, hemidiaphragmGuide nerv destr, elec stimGuide nerv destr, needle emgPsycho testing by psych/physPsycho testing by technicianPsycho testing admin by compNeurobehavioral status examNeuropsych tst by psych/physNeuropsych testing by techNeuropsych tst admin w/compChemo, anti-neopl, sq/imChemo hormon antineopl sq/imChemo, iv push, sngl drugChemo, iv push, addl drugChemo, iv infusion, 1 hrChemo, iv infusion, addl hrChemo prolong infuse w/pumpChemo iv infus each addl seqRefill/maint, portable pumpRefill/maint pump/resvr systIrrig drug delivery deviceOrthotic mgmt and trainingProsthetic trainingC/o for orthotic/prosth useSelf-mgmt educ & train, 1 ptSelf-mgmt educ/train, 2-4 ptSelf-mgmt educ/train, 5-8 ptMed serv, eve/wkend/holidayMed serv 10pm-8am, 24 hr facOut of office emerg med 1/061/1/061/1/06Page 4
OCE v21.1 Appendix T0111T0115TMod cs by same phys, 5 yrsMod cs by same phys, 5 yrs Mod cs by same phys add-onMod cs diff phys 5 yrsMod cs diff phys 5 yrs Mod cs diff phys add-onIc, infant pbw 2501-5000 gmNursing facility care, initNursing facility care, initNursing facility care, initNursing fac care, subseqNursing fac care, subseqNursing fac care, subseqNursing fac care, subseqAnnual nursing fac assessmntDomicil/r-home visit new patDomicil/r-home visit new patDomicil/r-home visit new patDomicil/r-home visit new patDomicil/r-home visit new patDomicil/r-home visit est patDomicil/r-home visit est patDomicil/r-home visit est patDomicil/r-home visit est patDomicil/r-home care supervisDomicil/r-home care supervisHeart failure assessedOsteoarthritis assessedActigraphy testing, 3-dayCervical artific discLumbar artific discArtific disc addlCervical artific diskectomyLumbar artific diskectomyArtific diskectomy addlRev cervical artific discRev lumbar artific discRev artific disc addlImplant corneal ringProsth retina receive&genExtracorp shockwv tx,hi enrgExtracorp shockwv tx,anesthHolotranscobalaminAt rest cardio gas rebreatheExerc cardio gas rebreatheTouch quant sensory testVibrate quant sensory testCool quant sensory testHeat quant sensory testNos quant sensory testRbc membranes fatty acidsMed tx mngmt 15 /061/1/061/1/06Page 5
OCE v21.1 Appendix 6A4363A4411Med tx mngmt subsqtMed tx mngmt addl 15 minFibroadenoma cryoablate, eaScleral fistulizationConjunctival drug placementChd risk imt studyChron care drug investigatnEsophageal implant injexnPerq cryoablate renal tumorProstate saturation samplingExhaled breath condensate phPerq islet transplantOpen islet transplantLaparoscopic islet transplntCT heart wo dye; qual calcCT heart w/wo dye functCCTA w/wo dyeCCTA w/wo, quan calciumCCTA w/wo, strxrCCTA w/wo, strxr quan calcCCTA w/wo, disease strxrCT heart funct add-onComputer chest add-onImplant aneur sensor add-onImplant aneur sensor studyLevel of activity assessClin symp vol ovrld assessAsthma symptoms evaluateOsteoarthritis assessAnti-inflm/anlgsc otc assessGi/renal risk assessWeight recordClin sign vol ovrld assessAuscultation heart performInitial exam involved jointsBlood press / 140/90 mmhgBlood pressure 140/90 mmhgPt ed write/oral, pts w/ hfWarfarin therapy rxWritten discharge instr prvdPersist asthma medicine ctrlAnti-inflm/anlgsc agent rxGi prophylaxis for nsaid rxTherapy exercise joint rxAmbulance response/treatmentSterile saline or waterAlkalin batt for glucose monJ-cell batt for glucose monLithium batt for glucose monSilvr oxide batt glucose monOstomy clamp, replacementOst skn barr extnd /061/1/061/1/06Page 6
OCE v21.1 Appendix 7A9558A9559Ost pouch drain high outputDisposable underpad smallTubing with heating elementSkin barrier, wipe or swabMulti den insert direct formMulti den insert custom moldTubular dressingCompress burn mask face/neckCompression stocking BK18-30Compression stocking BK30-40Compression stocking BK40-50Gc stocking thighlngth 18-30Gc stocking thighlngth 30-40Gc stocking thighlngth 40-50Gc stocking full lngth 18-30Gc stocking full lngth 30-40Gc stocking full lngth 40-50Gc stocking waistlngth 18-30Gc stocking waistlngth 30-40Gc stocking waistlngth 40-50Gc stocking custom madeGc stocking lymphedemaGc stocking garter beltG compression stockingDisp home glucose monitorReaching/grabbing deviceWig any typeInjection, methylene blueTc99m depreotideTc99m mebrofeninTc99m pyrophosphateTc99m pentetateTc99m MAATc99m sulfur colloidIn111 ibritumomab, dxY90 ibritumomab, rxI131 tositumomab, dxI131 tositumomab, rxCo57/58In111 oxyquinolineIn111 pentetateTc99m arcitumomabTc99m gluceptateTc99m succimerF18 fdgCr51 chromateI125 iothalamate, dxRb82 rubidiumGa67 galliumTc99m bicisateXe133 xenon 10mciCo57 /1/061/1/061/1/06Page 7
OCE v21.1 Appendix 3E2224E2225Tc99m labeled rbcTc99m oxidronateTc99m mertiatideP32 Na phosphateP32 chromic phosphateIn111 pentetreotideTc99m fanolesomabTechnetium TC-99m aerosolNon-rad contrast materialNOCParenteral sol 10 gm lipidsGenerator neuro rechg bat syIV inf, tx/dx, up to 1 hrIV inf, tx/dx, each addl hrTx, prophy, dx IV pushChemotx adm, IV pushChemotx adm, IV inf up to 1hChemotx adm, IV inf, addl hrProlonged IV inf, req pumpRxt breast appl place/removCommode chair electricCommode chair non-electricSeat lift mechanism toiletOral device/appliance prefabOral device/appliance cusfabMulti-position stnd fram sysDynamic standing frameTransfer board or deviceTrans elec jt stim dev sysFunctional neuromuscularstimHD trapeze bar attach to bedHD trapeze bar free standingPortable oxygen concentratorKnee ext/flex w act res ctrlCrutch and cane holderCylinder tank carrierArm trough eachWheelchair bearingsPneumatic propulsion tirePneumatic prop tire tubePneumatic prop tire insertPneumatic caster tire eachPneumatic caster tire tubeFoam filled propulsion tireFoam filled caster tire eachFoam propulsion tire eachFoam caster tire any size eaSolid propulsion tire eachSolid caster tire eachSolid caster integrated whlValve replacement only eachPropulsion whl excludes tireCaster wheel excludes 1/061/1/061/1/06Page 8
OCE v21.1 Appendix 8G8059G8060Caster fork replacement onlyGr27 sealed leadacid batteryGr27 non-sealed leadacidPreadm IV immunoglobulinDispense fee initial 30 dayHospital observation per hrDirect admit hospital observAMI pt recd aspirin at arrivAMI pt did not receiv aspiriAMI pt ineligible for aspiriAMI pt recd Bblock at arrAMI pt did not rec bblockAMI pt inelig Bbloc at arrivPneum pt recv antibiotic 4 hPneum pt w/o antibiotic 4 hrPneum pt not elig antibioticDiabetic pt w/ HBA1c 9%Diabetic pt w/ HBA1c or 9%DM pt inelig for HBA1c measuCare not provided for HbA1cDiabetic pt w/LDL 100mg/dlDiab pt w/LDL or 100mg/dlDiab pt inelig for LDL measDiabet inelig for LDL measurDM pt w BP 140/90Diabetic pt wBP 140/90Diabetic pt inelig for BP meDiabet pt w no care re BP meHF p w/LVSD on ACE-I/ARBHF pt w/LVSD not on ACE-I/ARHF pt not elig for ACE-I/ARBHF pt w/LVSD on BblockerHF pt w/LVSD not on BblockerHF pt not elig for BblockerAMI pt recd Bblock on arrivaAMI pt did not rec Bblock onAMI pt not elig Bblock on arAMI-CAD pt doc on antiplatelAMI-CAD pt not docu on antipAMI-CAD not elig antiplateCAD pt w/LDL 100mg/dlCAD pt w/LDL or 100mg/dlCAD pt not eligible for LDLAssessed for osteoporosisPt not assess for osteoporPt inelig for osteopor measPt assess for falls w/12 monNot elig for falls assessmenPt receive hearing assessPt w/o hearing assessPt inelig for hearing assessPt assess for urinary 1/1/061/1/061/1/06Page 9
OCE v21.1 Appendix 7G8170G8171Pt not assess for urinary inPt not elig for urinary incoESRD pt w/ dialy of URR 65%ESRD pt w/ dialy of URR 65%ESRD pt not elig for URR/KtVESRD pt w/Hct 33ESRD pt w/Hct 33ESRD pt not elig for HcT meaESRD pt rec oth th auto AV fESRD pt rec nonauto AV fisCOPD rec annual smoke cessaCOPD w/o annual smoke cessaOsteo pt given Ca VitD suppOsteo pt inelig for Ca VitDNew dx osteo pt w/antiresorpOsteo pt inelig for antiresoBone dens meas test done toBone dens meas test ineligPt receiv influenza vaccPt w/o influenza vaccPt inelig for influenza vaccPt receiv mammogramPt not doc mammogramPt ineligible mammographyMD did not prov care for mamPt receiv pneumo vaccPt did not have pneumo vaccPt was inelig for pneumo vacPt treat w/antidepress12wksPt not treat w/antidepres12wPt inelig for antidepres medPt treat w/antidepres for 6mPt not treat w/antidepres 6mPt inelig for antidepres medPt w/AB 1 hr prior to incisiPt not doc for AB 1 hr pr toPt ineligi for AB therapyPt w/ receipt of thromboemboPt w/o recpt of thromboemboPt ineligi for thrombolismPt recv CABGw/IMAPt w/CABG w/o IMAPt inelig for CABG w/IMAPt w/iso CABG rec preop BbloP w/iso CABG w/o preop BblocPt w/iso CAG inelig for preoPt w/iso CABG w/prolng intubPt w/iso CABG w/o prolng intPt w/iso CABG req surg rexpoPt w/iso CABG w/o surg exploPt w/carot endarct/ext bypasPt w/carot endarct/ext /1/061/1/061/1/06Page 10
OCE v21.1 Appendix 7J9025J9027Carotid endart/extr bypassCardiac pt care not prov LDLPt w/ HF/atrial fib on warfaPt w/ HF/atrial fib inelig fPt w/osteoarth w/assess painPt w/osteoarth inelig assessAcetylcysteine injectionAcyclovir injectionAmikacin sulfate injectionAprotonin, 10,000 kiuBasiliximabCorticorelin ovine triflutalDarbepoetin alfa, non-esrdDarbepoetin alfa, esrd useEpoetin alfa, non-esrdEpoetin alfa, esrdDigoxin immune fab (ovine)Dopamine injectionEthanolamine oleate 100 mgFomepizole, 15 mgImmune globulin, powderImmune globulin, liquidHemin, 1 mgHistrelin acetateIron dextran 165 injectionIron dextran 267 injectionLepirudinZiconotide injectionNesiritide injectionPalifermin injectionPegaptanib sodium injectionPegademase bovine, 25 iuPentastarch 10% solutionSincalide injectionInj secretin synthetic humanTreprostinil injectionUrofollitropin, 75 iuOvine, up to 999 USP unitsOvine, 1000 USP unitsInj Vonwillebrand factor iuFactor viiaLevonorgestrel implant sysNon-human, metabolic tissueAlbuterol non-compoundedBudesonide, compoundedFormorterol injectionAntiemetic rectal/supp NOSCabergoline, oral 0.25mgOral dexamethasoneAntiemetic drug oral NOSAzacitidine injectionClofarabine /061/1/061/1/061/1/06Page 11
OCE v21.1 Appendix 8L5703L5858Elliotts b solution per mlHistrelin implantPaclitaxel injectionTLSO 2 piece rigid shellTLSO 3 piece rigid shellSIO flex pelvisacral prefabSIO flex pelvisacral customSIO panel prefabSIO panel customLO flexibl L1-below L5 preLO sag stays/panels pre-fabLO sagitt rigid panel prefabLO flex w/o rigid stays preLSO flex w/rigid stays custLSO post rigid panel preLSO sag-coro rigid frame preLSO sag rigid frame custLSO flexion control prefabLSO flexion control customLSO sagit rigid panel prefabLSO sagittal rigid panel cusLSO sag-coronal panel prefabLSO sag-coronal panel customLSO s/c shell/panel prefabLSO s/c shell/panel customMRI compatible systemKAFO pla sin up w/wo k/a cusAdd LE poly knee custom KAFOSO cap design w/o jnts CFSO airplane w/o jnts CFSO airplane w/joint CFEO w/o joints CFEWHO rigid w/o jnts CFEWHO w/joint(s) CFEWHFO rigid w/o jnts CFEWHFO w/joint(s) CFWHO w/nontorsion jnt(s) CFHFO w/o join
L3440 Heel leather reinforced L3450 Shoe heel sach cushion type L3455 . & depress for L3485 Shoe heel pad removable for L3500 Ortho shoe add leather insol L3510 Orthopedic shoe add rub insl L3520 O shoe add felt w leath insl L3530 Ortho sho
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LIGA LATINOAMERICANA DE ROBÓTICA EN COMPETENCIA TABLA de CATEGORIAS SUMO CATEGORÍA DIMENSIONES ALTURA PESO DOJO MATERIAL BORDE NANOSUMO 2.5 cm 2.5 cm 25 g 19.25 cms Madera 0.625 cm MICROSUMO 5cms 5cms .1 kg ( 100grs ) 38.5 cms Madera 1.25 cm MINISUMO 10 cms Sin restricción .5 kg ( 500grs ) 77 cms Madera 2.5 cm MEGASUMO 20 cms Sin restricción 3 kgs 154 cms Metal 5 cm
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Innovation Center is promoting this measure for BPCI Advanced because it may inform how patients select care options, providers allocate resources, and payers evaluate performance. CMS uses the CMS PSI 90 v.9.0 software to produce the CMS PSI 90 results. CMS has used or is curr
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