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Jamie Hermansen, (410) 786-2064 or gov"[email protected]gov, for issues related to ultrasound screening for abdominal aortic aneurysms or colorectal cancer screening. Allowed Expenditures for Physicians' Services and the Sustainable Growth Rate H. RAND will consult with a technical expert panel on model design issues and the test results. Given the central role of time in establishing work RVUs and the concerns that have been raised about the current time values, a key focus of the project is collecting data from several practices for selected services. Urban Institute will use a variety of approaches to develop objective time estimates, depending on the type of service, which will be a very resource-intensive part of the project. Commenters provided a variety of suggestions including setting the all surgical services to a 0-day global period, requiring all E/M services to be separately billed, validating the global surgical packages with the hospital Diagnosis- Related Group length of stay data, and setting auditable documentation standards for post-operative E/M services. We note that not all voting participants voted for every CPT code. A list of the PFS procedure status indicators can be found in Addendum A. hyperkeratotic lesion (eg, corn or callus); more than 4 lesions. In the unusual situation that a pathologist is requested to assist an endoscopist in optical endomicroscopy, we would expect the pathologist to report other codes more appropriate to the service (e.g.Anne Tayloe-Hauswald, (410) 786-4546 or [email protected] Page 74229 Vol. 237 December 10, 2013 Part II Department of Health and Human Services ----------------------------------------------------------------------- Centers for Medicare & Medicaid Services ----------------------------------------------------------------------- 42 CFR Parts 405, 410, 411, et al. Follow the instructions for ``submitting a comment.'' 2. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1600-FC, P. A stamp- in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.) b. A summary of the comments along with our responses are included in the CY 2011 PFS final rule with comment period (75 FR 73217) and the CY 2012 PFS final rule with comment period (73054 through 73055). For these 12 CPT codes, all commenters requested increased work RVUs. EMG non-extremity add-on 0.47 0.73 0.73 0.71 95908................. lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less. The AMA RUC recommended an intraservice time of 25 minutes and a work RVU of 1.08 for CPT code 88375.Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2014; Final Rule Federal Register / Vol. 237 / Tuesday, December 10, 2013 / Rules and Regulations Page 74230 ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 405, 410, 411, 414, 423, and 425 [CMS-1600-FC] RIN 0938-AR56 Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2014 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ----------------------------------------------------------------------- SUMMARY: This major final rule with comment period addresses changes to the physician fee schedule, clinical laboratory fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. For delivery in Baltimore, MD--Centers for Medicare & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244-1850. As we indicated in the CY 2014 PFS proposed rule (78 FR 43304), we have entered into two contracts with outside entities to develop validation models for RVUs. For ease of discussion, we will be referring to these services as ``refinement codes.'' Consistent with the process described above, we convened a multi-specialty panel of physicians to assist us in the review of the information submitted to support increased work RVUs. Nerve conduction 1.25 1.37 1.37 1.25 studies; 3-4 studies. Nerve conduction 1.50 1.77 1.77 1.50 studies; 5-6 studies. Nerve conduction 2.00 2.80 2.80 2.00 studies; 7-8 studies. Nerve conduction 2.50 3.34 3.34 2.50 studies; 9-10 studies. Nerve conduction 3.00 4.00 4.00 3.00 studies; 11-12 studies. Nerve conduction 3.56 4.20 4.20 3.56 studies; 13 or more studies. lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm. Based on our analysis of this recommendation, we believe that the typical optical endomicroscopy case will involve only the endoscopist, and CPT codes 4323 are valued to reflect this.We post all comments received before the close of the comment period on the following Web site as soon as possible after they have been received: Resource-Based Practice Expense (PE) Relative Value Units (RVUs) B. Colorectal Cancer Screening: Modification to Coverage of Screening Fecal Occult Blood Tests D. Policies Regarding the Clinical Laboratory Fee Schedule F. For additional information, please visit our Web site ( Fee Sched/Downloads/RVUs-Validation-Model.pdf). CY 2014 Identification and Review of Potentially Misvalued Services a. We responded to this comment in the CY 2013 final rule with comment period by saying that we would review this file and, if appropriate, propose modifications. Table 23--Codes Reviewed by the 2013 Multi-Specialty Refinement Panel ---------------------------------------------------------------------------------------------------------------- CY 2013 AMA RUC/HCPAC Refinement HCPCS code Short descriptor interim final recommended panel median CY 2014 work work RVU work RVU rating RVU ---------------------------------------------------------------------------------------------------------------- 35475................. The time values for all codes are listed in a file called ``CY 2014 PFS Physician Time,'' available on the CMS Web site under downloads for the CY 2014 PFS final rule with comment period at Fee Sched/ In establishing CY 2013 values for the psychitry codes, our general approach was to maintain the CY 2012 values for the services or adopt values that approximated the CY 2012 values after adjusting for differences in code structure between CY 20, for all psychiatry/psychotherapy services on an interim final basis.Follow the search instructions on that Web site to view public comments. Liability for Overpayments to or on Behalf of Individuals Including Payments to Providers or Other Persons G. Physician Payment, Efficiency, and Quality Improvements-- Physician Quality Reporting System I. Public Nomination of Potentially Misvalued Codes The public and stakeholders may nominate potentially misvalued codes for review by submitting the code with supporting documentation during the 60-day public comment period following the release of the annual PFS final rule with comment period under a process we finalized in the CY 2012 PFS final rule with comment period (76 FR 73058). ------------------------------------------------------------------------ CPT codes 17311 (Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histpathologic preparation including routine stain(s) (for example, hematoxylin and eosin, toluidine blue), head, neck, hands, feet genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks) and 17313 (Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stains(s) (for example, hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; first stage, up to 5 tissue blocks) were proposed as potentially misvalued codes because we believe that these codes may be overvalued based on CMD comments suggesting excessive utilization. We noted in the CY 2013 final rule with comment period that if time had been removed from the physician time file inadvertently, it would have resulted in a small impact on the indirect allocation of PE at the specialty level, but it would not have affected the physician work RVUs or direct PE inputs for these services. Table 24--Codes With CY 2013 Interim Final Work Values ---------------------------------------------------------------------------------------------------------------- CY 2013 CY 2014 HCPCS code Long descriptor work RVU work RVU CY 2014 action ---------------------------------------------------------------------------------------------------------------- 10120..................... We noted in the CY 2013 final rule with comment period that we intended to review the values for all the codes in the family once the survey process was complete and we had recommendations for all the codes.The nonfacility RVUs reflect all of the direct and indirect PEs involved in furnishing a service described by a particular HCPCS code. Given the importance of ensuring that codes are appropriately valued, we believe it is appropriate to call upon the experience of CMDs in developing our proposal. Therefore, we are finalizing our proposal to review the codes described above as potentially misvalued codes. Response: We agree that code 76936 is not a code used to supplement a surgical procedure and therefore does not raise the concerns we discussed in the proposed rule. Response: We appreciate the concern regarding insufficient time to adopt new codes.

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Jamie Hermansen, (410) 786-2064 or gov"[email protected]gov, for issues related to ultrasound screening for abdominal aortic aneurysms or colorectal cancer screening. Allowed Expenditures for Physicians' Services and the Sustainable Growth Rate H. RAND will consult with a technical expert panel on model design issues and the test results. Given the central role of time in establishing work RVUs and the concerns that have been raised about the current time values, a key focus of the project is collecting data from several practices for selected services. Urban Institute will use a variety of approaches to develop objective time estimates, depending on the type of service, which will be a very resource-intensive part of the project. Commenters provided a variety of suggestions including setting the all surgical services to a 0-day global period, requiring all E/M services to be separately billed, validating the global surgical packages with the hospital Diagnosis- Related Group length of stay data, and setting auditable documentation standards for post-operative E/M services. We note that not all voting participants voted for every CPT code. A list of the PFS procedure status indicators can be found in Addendum A. hyperkeratotic lesion (eg, corn or callus); more than 4 lesions. In the unusual situation that a pathologist is requested to assist an endoscopist in optical endomicroscopy, we would expect the pathologist to report other codes more appropriate to the service (e.g.

Anne Tayloe-Hauswald, (410) 786-4546 or [email protected] Page 74231 gov, for issues related to ambulance fee schedule and clinical lab fee schedule. Medicare Telehealth Services for the Physician Fee Schedule I. Requirements for Billing ``Incident to'' Services K. Collecting Data on Services Furnished in Off-Campus Provider- Based Departments M. Objective time estimates will be compared to the current time values used in the fee schedule. In addition to the broader comments, the AMA RUC noted that many surgical procedures did not have the correct hospital and discharge day management services in the global period, resulting in incorrect times in the time file. There was no attempt to achieve consensus among the panel members. If the CY 2014 Action column indicates that the CY 2014 values are interim final, public comments on these values will be accepted during the public comment period on this final rule with comment period. hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions. CPT code 88392 Pathology consultation during surgery).

[Federal Register Volume 78, Number 237 (Tuesday, December 10, 2013)] [Rules and Regulations] [Pages 74229-74823] From the Federal Register Online via the Government Publishing Office [gov] [FR Doc No: 2013-28696] Page 74229 Vol. 237 December 10, 2013 Part II Department of Health and Human Services ----------------------------------------------------------------------- Centers for Medicare & Medicaid Services ----------------------------------------------------------------------- 42 CFR Parts 405, 410, 411, et al. Follow the instructions for ``submitting a comment.'' 2. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1600-FC, P. A stamp- in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.) b. A summary of the comments along with our responses are included in the CY 2011 PFS final rule with comment period (75 FR 73217) and the CY 2012 PFS final rule with comment period (73054 through 73055). For these 12 CPT codes, all commenters requested increased work RVUs. EMG non-extremity add-on 0.47 0.73 0.73 0.71 95908................. lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less. The AMA RUC recommended an intraservice time of 25 minutes and a work RVU of 1.08 for CPT code 88375.

Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2014; Final Rule Federal Register / Vol. 237 / Tuesday, December 10, 2013 / Rules and Regulations Page 74230 ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 405, 410, 411, 414, 423, and 425 [CMS-1600-FC] RIN 0938-AR56 Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2014 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ----------------------------------------------------------------------- SUMMARY: This major final rule with comment period addresses changes to the physician fee schedule, clinical laboratory fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. For delivery in Baltimore, MD--Centers for Medicare & Medicaid Services, Department of Health and Human Services, 7500 Security Boulevard, Baltimore, MD 21244-1850. As we indicated in the CY 2014 PFS proposed rule (78 FR 43304), we have entered into two contracts with outside entities to develop validation models for RVUs. For ease of discussion, we will be referring to these services as ``refinement codes.'' Consistent with the process described above, we convened a multi-specialty panel of physicians to assist us in the review of the information submitted to support increased work RVUs. Nerve conduction 1.25 1.37 1.37 1.25 studies; 3-4 studies. Nerve conduction 1.50 1.77 1.77 1.50 studies; 5-6 studies. Nerve conduction 2.00 2.80 2.80 2.00 studies; 7-8 studies. Nerve conduction 2.50 3.34 3.34 2.50 studies; 9-10 studies. Nerve conduction 3.00 4.00 4.00 3.00 studies; 11-12 studies. Nerve conduction 3.56 4.20 4.20 3.56 studies; 13 or more studies. lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm. Based on our analysis of this recommendation, we believe that the typical optical endomicroscopy case will involve only the endoscopist, and CPT codes 4323 are valued to reflect this.

We post all comments received before the close of the comment period on the following Web site as soon as possible after they have been received: Resource-Based Practice Expense (PE) Relative Value Units (RVUs) B. Colorectal Cancer Screening: Modification to Coverage of Screening Fecal Occult Blood Tests D. Policies Regarding the Clinical Laboratory Fee Schedule F. For additional information, please visit our Web site ( Fee Sched/Downloads/RVUs-Validation-Model.pdf). CY 2014 Identification and Review of Potentially Misvalued Services a. We responded to this comment in the CY 2013 final rule with comment period by saying that we would review this file and, if appropriate, propose modifications. Table 23--Codes Reviewed by the 2013 Multi-Specialty Refinement Panel ---------------------------------------------------------------------------------------------------------------- CY 2013 AMA RUC/HCPAC Refinement HCPCS code Short descriptor interim final recommended panel median CY 2014 work work RVU work RVU rating RVU ---------------------------------------------------------------------------------------------------------------- 35475................. The time values for all codes are listed in a file called ``CY 2014 PFS Physician Time,'' available on the CMS Web site under downloads for the CY 2014 PFS final rule with comment period at Fee Sched/ In establishing CY 2013 values for the psychitry codes, our general approach was to maintain the CY 2012 values for the services or adopt values that approximated the CY 2012 values after adjusting for differences in code structure between CY 20, for all psychiatry/psychotherapy services on an interim final basis.

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(These data sources are described in greater detail in the CY 2012 final rule with comment period (76 FR 73033).) Separate PE RVUs are established for services furnished in facility settings, such as a hospital outpatient department (HOPD) or an ambulatory surgical center (ASC), and in non-facility settings, such as a physician's office. If, following our consideration of public comments, we determine that these codes are potentially misvalued, the AMA RUC and others will have further opportunity to submit information and public comment about the appropriate value of the codes before we would determine the codes are in fact misvalued and make changes to the values. Response: We believe that further review is needed to determine if this procedure is typically performed by the physician, or the auxiliary personnel with physician supervision. One commenter stated that 76936 should be removed from the list because it is not an image guidance technique used to supplement a surgical procedure. Other commenters suggested that CMS should revise CPT code descriptors for codes to conform to Medicare policies.

This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs. If you intend to deliver your comments to the Baltimore address, please call telephone number (410) 786-7195 in advance to schedule your arrival with one of our staff members. During a 2-year project, the RAND Corporation will use available data to build a validation model to predict work RVUs and the individual components of work RVUs, time and intensity. The panel was moderated by our physician advisors, and consisted of the following voting members: One to two clinicians with practices in related specialties, who were expected to have knowledge of the services under review. ---------------------------------------------------------------------------------------------------------------- (ii) Code-Specific Issues Table 24 of this final rule with comment period lists all codes that had a CY 2013 interim final work value. lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm. Accordingly, we believe a separate payment for CPT code 88375 would result in double payment for a portion of the overall optical endomicroscopy service.

(See the Table of Contents for a listing of the specific issues addressed in the final rule with comment period.) DATES: Effective date: The provisions of this final rule with comment period are effective on January 1, 2014, except for the amendments to Sec. 405.350, 405.355, 405.405.2413, 405.2415, 405.2452, 410.19, 410.26, 410.37, 410.71, 410.74, 410.75, 410.76, 410.77, and 414.511, which are effective January 27, 2014, and the amendments to Sec. Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period. The model design will be informed by the statistical methodologies and approach used to develop the initial work RVUs and to identify potentially misvalued procedures under current CMS and AMA RUC processes. The panel process was designed to capture each participant's independent judgment and his or her clinical experience which informed and drove the discussion of the refinement code during the refinement panel proceedings. This chart provides the CY 2013 work RVUs, the CY 2014 work RVUs and indicates whether we are finalizing the CY 2014 work RVUs. lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm. Therefore, we are assigning a PFS procedure status of I (Not valid for Medicare purposes.

Discussion of Budget Neutrality for the Chiropractic Services Demonstration N. Waiver of Proposed Rulemaking and Waiver of Delay of Effective Date VII. National surveys of physician time and intensity from professional and management societies and organizations, such as hospital associations. Response: The commenters are correct that the codes were under review by the AMA RUC. To correct this inadvertent error, in the CY2014 proposed rule, we proposed to replace the missing post-operative hospital E/M visit information and time for the 117 codes that were identified by the AMA RUC and displayed in Table 14. We have now received AMA RUC recommendations for all of the codes in the family and are establishing CY 2014 Page 74302 interim final work RVUs based on these recommendations.Physician Self-Referral Prohibition: Annual Update to the List of CPT/HCPCS Codes IV. Regulatory Impact Analysis Regulations Text Acronyms In addition, because of the many organizations and terms to which we refer by acronym in this final rule with comment period, we are listing these acronyms and their corresponding terms in alphabetical order below: AAA Abdominal aortic aneurysms ACA Affordable Care Act (Pub. 111-148) ACO Accountable care organization AHE Average hourly earnings AMA American Medical Association AMA RUC AMA [Specialty Society] Relative (Value) Update Committee ASC Ambulatory surgical center ATRA American Taxpayer Relief Act (Pub. 112-240) AWV Annual wellness visit BBA Balanced Budget Act of 1997 (Pub. 105-33) BBRA [Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget Refinement Act of 1999 (Pub. 106-113) BEA Bureau of Economic Analysis CAH Critical access hospital CBSA Core-Based Statistical Area CCM Chronic Care Management CED Coverage with evidence development CEHRT Certified EHR technology CF Conversion factor CLFS Clinical Laboratory Fee Schedule CMD Contractor medical director CMHC Community mental health center CMT Chiropractic manipulative treatment CORF Comprehensive outpatient rehabilitation facility CPC Comprehensive Primary Care CPEP Clinical Practice Expert Panel CPI-U Consumer Price Index for Urban Areas CPS Current Population Survey CPT [Physicians] Current Procedural Terminology (CPT codes, descriptions and other data only are copyright 2013 American Medical Association. After we receive the nominated codes during the 60-day comment period following the release of the annual PFS final rule with comment period, we evaluate the supporting documentation and assess whether the nominated codes appear to be potentially misvalued codes appropriate for review under the annual process. Since the publication of the proposed rule, we have received recommendations from the AMA RUC for these codes. Thus, we believe this correction will populate the physician time file with data that, absent the inadvertent error, would have been present in the time file. The CY 2014 interim work values displayed in Table 24 correspond with the AMA RUC recommended values, with the exception of CPT code 90863, which has been assigned a PFS procedure status of I (Not valid for Medicare purposes.In addition, this final rule with comment period includes discussions and/or policy changes regarding: Updating the-- Physician Compare Web site. In constructing the code-specific vignettes used in determining the original physician work RVUs, Harvard worked with panels of experts, both inside and outside the federal government, and obtained input from numerous physician specialty groups. Comment: Many commenters supported our seeking input from the CMDs in developing our proposal for codes to be considered as potentially misvalued codes, while others expressed concern about using input from CMDs. CPT codes 55845 (Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes) and 55866 (Laparoscopy, surgical prostatectomy, retropubic radial, including nerve sparing, includes robotic assistance, when performed) were proposed as potentially misvalued because the RVUs for the laparoscopic procedure (CPT 55866) are higher than those for the open procedure (CPT 55845) and we believe that, in general, a laparoscopic procedure would not require greater resources than the open procedure. Several other commenters suggested alternative work values for the codes with and without corresponding AMA RUC recommendations.We establish work RVUs for new and revised codes based, in part, on our review of recommendations received from the American Medical Association/Specialty Society Relative Value Update Committee (AMA RUC). Practice Expense RVUs Initially, only the work RVUs were resource-based, and the PE and MP RVUs were based on average allowable charges. Some asked for details on the process that the CMDs used to identify codes and some questioned whether CMDs possess the specialty- related expertise to determine if a service is misvalued when that service is not generally performed by a CMD's designated specialty. Comment: A few comments suggested that these codes were not potentially misvalued because the laparoscopic code (CPT 55866) does require a higher level of work than the open procedure (CPT 55845) so the codes are in the appropriate rank order. Response: We appreciate commenters' concerns regarding the appropriate valuation of this family of codes.For the CY 2014 PFS final rule with comment period, refer to item CMS-1600-FC. We did not receive any public nominations of codes for consideration as potentially misvalued codes in response to the CY 2013 final rule with comment period. Contractor Medical Director Identified Potentially Misvalued Codes We began considering additional ways to broaden participation in the process of identifying potentially misvalued codes; we solicited the input of Medicare Administrative Contractor medical directors (CMDs) in making suggestions for codes to consider proposing as potentially misvalued codes. CPT codes 33960 (Prolonged extracorporeal circulation for cardiopulmonary insufficiency; initial day) and 33961 (Prolonged extracorporeal circulation for cardiopulmonary insufficiency; each subsequent day) were proposed for review because the service was originally valued when it was used primarily in premature neonates; but the service is now being furnished to adults with severe influenza, pneumonia and respiratory distress syndrome. This is consistent with the approach we described in the CY 2013 PFS final rule with comment period (77 FR 69060-69063).Readers who experience any problems accessing any of the Addenda or other documents referenced in this final rule with comment period and posted on the CMS Web site identified above should contact gov"[email protected]gov. As a result, we did not propose any publicly nominated potentially misvalued codes in the CY 2014 proposed rule. In the proposed rule, we noted several reasons why we believed that CMD input would be valuable in developing our proposal. We also noted in the proposed rule that, while the code currently includes 523 minutes of total physician time with 133 minutes of intraservice time, physicians are not typically furnishing the service over that entire time interval; rather, hospital-employed pump technicians are furnishing much of the work. Response: We are finalizing our proposal to review these codes as potentially misvalued codes. Because of the changes for this relativity new code set, we are establishing these values on an interim final basis. You may submit comments in one of four ways (please choose only one of the ways listed): 1. You may submit electronic comments on this regulation to Please allow sufficient time for mailed comments to be received before the close of the comment period. Humphrey Building, 200 Independence Avenue SW., Washington, DC 20201. Humphrey Building is not readily available to persons without federal government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. In the CY 2011 PFS proposed rule (75 FR 40068) and CY 2012 PFS proposed rule (76 FR 42790), we solicited public comments on possible approaches, methodologies, and data sources that we should consider for a validation process. (2) CY 2013 Interim Final Work RVUs Considered by the Refinement Panel We referred to the CY 2013 refinement panel 12 CPT codes with CY 2013 interim final work values for which we received a request for refinement that met the requirements described above. lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm. CPT code 88375 provides a code for reporting the pathology service when one is required to assist in the procedure. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1600-FC, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. For delivery in Washington, DC--Centers for Medicare & Medicaid Services, Department of Health and Human Services, Room 445-G, Hubert H. Furthermore, the Secretary may conduct the validation using methods similar to those used to review potentially misvalued codes, including conducting surveys, other data collection activities, studies, or other analyses as the Secretary determines to be appropriate to facilitate the validation of RVUs of services. To achieve this goal, CMS will continue to critically evaluate the need to refer codes to refinement panels in future years, specifically considering any new information provided by commenters. lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm. We received a recommendation from the AMA RUC for a work RVU of 1.08 for CPT code 88375.

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