April Update to 2011 Physician Fee Schedule Released

The Centers for Medicare & Medicaid Services (CMS) released, Feb. 4, the April update to the 2011 Medicare Physician Fee Schedule Database (MPFSDB). Changes to payment files include revised payment indicators and practice expense relative-value units (PE RVUs). A handful of procedure and supply codes were added or deleted, as well.

Here is a summary of changes you can expect to see in the annual quarterly update to the MPFSDB:

CPT® Code Indicator Changes

CPT® Code Long Descriptor Indicator
31579 Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy Global Surgery: 000
57155 Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy Co-Surgeons: 2
64613 Chemodenervation of muscle(s); neck muscle(s) (eg, for spasmodic torticollis, spasmodic dysphonia) Bilateral Surgery: 2
64614 Chemodenervation of muscle(s); extremity(s) and/or trunk muscle(s) (eg, for dystonia, cerebral palsy, multiple sclerosis) Bilateral Surgery: 2
77071 Manual application of stress performed by physician for joint radiography, including contralateral joint if indicated Bilateral Surgery: 2
92511 Nasopharyngoscopy with endoscope (separate procedure) Global Surgery: 000
93464-26 Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) Multiple Surgery: 0

PE RVU Changes

Both the 2011 MPFS final rule and various 2010 legislation affected payment rates for fee-for-service physicians this year. In the April update, codes with PE RVU changes effective Jan. 1 are:

CPT® Code Long Descriptor
93503 Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes
93224 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, physician review and interpretation
93225 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)
93226 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report

See CMS Transmittal 2150, Change Request (CR) 7319 for specific PE RVUs for these codes.

Code Additions and Deletions

The following code is being added to the MPFSDB, effective April 1:

Q2040 Injection, incobotulinumtoxin a, 1 unit

The following codes are being deleted from the MPFSDB:

Effective for dates of service on or after Jan. 1:

90470 H1N1 immunization administration (intramuscular, intranasal), including counseling when performed

90663 Influenza virus vaccine, pandemic formulation, H1N1

The CPT® code deletions for this quarter are no surprise. 2011 vaccinations include both seasonal and H1N1 virus strains, rendering these H1N1-specific codes outdated.

Also deleted effective for dates of service on or after April 1 is one ambulatory surgery center (ASC) Q code and three temporary S codes:

Q1003 New technology intraocular lens category 3 (reduced spherical aberration)

S2270 Insertion of vaginal cylinder for application of radiation source or clinical brachytherapy (report separately in addition to radiation source delivery)

S2344 Nasal/sinus endoscopy, surgical; with enlargement of sinus ostium opening using inflatable device (i.e., balloon sinuplasty)

S3905 Non-invasive electrodiagnostic testing with automatic computerized hand-held device to stimulate and measure neuromuscular signals in diagnosing and evaluating systemic and entrapment neuropathies

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2 Responses to “April Update to 2011 Physician Fee Schedule Released”

  1. sandy ebert says:

    Does anyone know why the 2011 RVU’s did not change from 2010 but we
    did get an increase in allowables?

  2. amal n tosson says:

    is there a hicpcs code to bill medicare for h1n1 90470, and 90663 influenza vaccine

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