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Five Year Review code level update
September 2007
As part of its periodic review of physician work relativity, the Centers for Medicare and Medicaid Services (CMS), the agency with oversight of the Medicare program, requested that the anesthesia work associated with CPT® code 00142—Anesthesia for procedures on eye; lens surgery - be reviewed. ASA recently conducted a survey to evaluate the work, risk, intensity and complexity of this anesthesia work and will present the results of this survey to the AMA/Specialty Society RVS Update Committee (the RUC) in late September.
CMS also requested a review of the following two codes:
- 00210—Anesthesia for intracranial procedures; not otherwise specified
- 00562—Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator
These codes will be addressed in 2008. As always, ASA will continue working through proper channels to ensure that CPT® codes that describe anesthesia, pain and critical care are properly valued. ASA members interested in participating in future surveys should send their contact information to Sharon Merrick, Coding and Reimbursement Manager, at s.merrick@asawash.org
In the past, ASA has achieved successful revaluation of CPT® codes. For example, in August 2005, ASA presented to the RUC new information regarding CPT® code 00797—Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity. For the 2007 fee schedule effective Jan. 1 of this year, CMS increased the base units for code 00797 from 8 to 11.
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