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2018 National Physician Fee Schedule Relative Value File January Release CPT Codes and Descriptions Only Are Copyright 2016 American Medical Association

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2018 National Physician Fee Schedule Relative Value File January Release CPT codes and descriptions only are copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2017/17 American Dental Association. All Rights Reserved. RELEASED 12/18/2017 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 10021 Fna w/o image 3.47 $70.00 $242.90 10022 Fna w/image 4.00 $70.00 $280.00 1003F Level of activity assess 0.00 $70.00 $0.00 10030 Guide cathet fluid drainage 16.04 $70.00 $1,122.80 10035 Perq dev soft tiss 1st imag 14.71 $70.00 $1,029.70 10036 Perq dev soft tiss add imag 12.90 $70.00 $903.00 1004F Clin symp vol ovrld assess 0.00 $70.00 $0.00 10040 Acne surgery 3.13 $70.00 $219.10 1005F Asthma symptoms evaluate 0.00 $70.00 $0.00 1006F Osteoarthritis assess 0.00 $70.00 $0.00 10060 Drainage of skin abscess 3.38 $70.00 $236.60 10061 Drainage of skin abscess 5.87 $70.00 $410.90 1007F Anti-inflm/anlgsc otc assess 0.00 $70.00 $0.00 1008F Gi/renal risk assess 0.00 $70.00 $0.00 10080 Drainage of pilonidal cyst 5.12 $70.00 $358.40 10081 Drainage of pilonidal cyst 7.68 $70.00 $537.60 1010F Severity angina by actvty 0.00 $70.00 $0.00 1011F Angina present 0.00 $70.00 $0.00 1012F Angina absent 0.00 $70.00 $0.00 10120 Remove foreign body 4.38 $70.00 $306.60 10121 Remove foreign body 7.83 $70.00 $548.10 10140 Drainage of hematoma/fluid 4.69 $70.00 $328.30 1015F Copd symptoms assess 0.00 $70.00 $0.00 10160 Puncture drainage of lesion 3.71 $70.00 $259.70 1018F Assess dyspnea not present 0.00 $70.00 $0.00 10180 Complex drainage wound 7.06 $70.00 $494.20 1019F Assess dyspnea present 0.00 $70.00 $0.00 1022F Pneumo imm status assess 0.00 $70.00 $0.00 1026F Co-morbid condition assess 0.00 $70.00 $0.00 1030F Influenza imm status assess 0.00 $70.00 $0.00 1031F Smoking & 2nd hand assessed 0.00 $70.00 $0.00 1032F Smoker/exposed 2nd hnd smoke 0.00 $70.00 $0.00 1033F Tobacco nonsmoker nor 2ndhnd 0.00 $70.00 $0.00 1034F Current tobacco smoker 0.00 $70.00 $0.00 1035F Smokeless tobacco user 0.00 $70.00 $0.00 1036F Tobacco non-user 0.00 $70.00 $0.00 1038F Persistent asthma 0.00 $70.00 $0.00 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 1039F Intermittent asthma 0.00 $70.00 $0.00 1040F Dsm-5 info mdd docd 0.00 $70.00 $0.00 1050F History of mole changes 0.00 $70.00 $0.00 1052F Type location activityassess 0.00 $70.00 $0.00 1055F Visual funct status assess 0.00 $70.00 $0.00 1060F Doc perm/cont/parox atr fib 0.00 $70.00 $0.00 1061F Doc lack perm+cont+parox fib 0.00 $70.00 $0.00 1065F Ischm stroke symp lt3 hrsb/4 0.00 $70.00 $0.00 1066F Ischm stroke symp ge3 hrsb/4 0.00 $70.00 $0.00 1070F Alarm symp assessed-absent 0.00 $70.00 $0.00 1071F Alarm symp assessed-1+ prsnt 0.00 $70.00 $0.00 1090F Pres/absn urine incon assess 0.00 $70.00 $0.00 1091F Urine incon characterized 0.00 $70.00 $0.00 1100F Ptfalls assess-docd ge2>/yr 0.00 $70.00 $0.00 11000 Debride infected skin 1.56 $70.00 $109.20 11001 Debride infected skin add-on 0.61 $70.00 $42.70 11004 Debride genitalia & perineum 16.69 $70.00 $1,168.30 11005 Debride abdom wall 22.64 $70.00 $1,584.80 11006 Debride genit/per/abdom wall 20.44 $70.00 $1,430.80 11008 Remove mesh from abd wall 7.96 $70.00 $557.20 1101F Pt falls assess-docd le1/yr 0.00 $70.00 $0.00 11010 Debride skin at fx site 14.43 $70.00 $1,010.10 11011 Debride skin musc at fx site 15.48 $70.00 $1,083.60 11012 Deb skin bone at fx site 20.25 $70.00 $1,417.50 11042 Deb subq tissue 20 sq cm/< 3.35 $70.00 $234.50 11043 Deb musc/fascia 20 sq cm/< 6.53 $70.00 $457.10 11044 Deb bone 20 sq cm/< 8.94 $70.00 $625.80 11045 Deb subq tissue add-on 1.18 $70.00 $82.60 11046 Deb musc/fascia add-on 2.09 $70.00 $146.30 11047 Deb bone add-on 3.54 $70.00 $247.80 11055 Trim skin lesion 1.37 $70.00 $95.90 11056 Trim skin lesions 2 to 4 1.67 $70.00 $116.90 11057 Trim skin lesions over 4 1.89 $70.00 $132.30 1110F Pt lft inpt fac w/in 60 days 0.00 $70.00 $0.00 11100 Biopsy skin lesion 3.00 $70.00 $210.00 11101 Biopsy skin add-on 0.93 $70.00 $65.10 1111F Dschrg med/current med merge 0.00 $70.00 $0.00 1116F Auric/peri pain assessed 0.00 $70.00 $0.00 1118F Gerd symps assessed 12 month 0.00 $70.00 $0.00 1119F Init eval for condition 0.00 $70.00 $0.00 11200 Removal of skin tags <w/15 2.55 $70.00 $178.50 11201 Remove skin tags add-on 0.55 $70.00 $38.50 1121F Subs eval for condition 0.00 $70.00 $0.00 1123F Acp discuss/dscn mkr docd 0.00 $70.00 $0.00 1124F Acp discuss-no dscnmkr docd 0.00 $70.00 $0.00 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 1125F Amnt pain noted pain prsnt 0.00 $70.00 $0.00 1126F Amnt pain noted none prsnt 0.00 $70.00 $0.00 1127F New episode for condition 0.00 $70.00 $0.00 1128F Subs episode for condition 0.00 $70.00 $0.00 1130F Bk pain & fxn assessed 0.00 $70.00 $0.00 11300 Shave skin lesion 0.5 cm/< 2.79 $70.00 $195.30 11301 Shave skin lesion 0.6-1.0 cm 3.42 $70.00 $239.40 11302 Shave skin lesion 1.1-2.0 cm 4.03 $70.00 $282.10 11303 Shave skin lesion >2.0 cm 4.45 $70.00 $311.50 11305 Shave skin lesion 0.5 cm/< 2.82 $70.00 $197.40 11306 Shave skin lesion 0.6-1.0 cm 3.48 $70.00 $243.60 11307 Shave skin lesion 1.1-2.0 cm 4.13 $70.00 $289.10 11308 Shave skin lesion >2.0 cm 4.31 $70.00 $301.70 11310 Shave skin lesion 0.5 cm/< 3.25 $70.00 $227.50 11311 Shave skin lesion 0.6-1.0 cm 3.18 $70.00 $222.60 11312 Shave skin lesion 1.1-2.0 cm 4.58 $70.00 $320.60 11313 Shave skin lesion >2.0 cm 5.31 $70.00 $371.70 1134F Epsd bk pain for 6 wks/< 0.00 $70.00 $0.00 1135F Epsd bk pain for >6 wks 0.00 $70.00 $0.00 1136F Epsd bk pain for 12 wks/< 0.00 $70.00 $0.00 1137F Epsd bk pain for >12 wks 0.00 $70.00 $0.00 11400 Exc tr-ext b9+marg 0.5 cm< 3.58 $70.00 $250.60 11401 Exc tr-ext b9+marg 0.6-1 cm 4.27 $70.00 $298.90 11402 Exc tr-ext b9+marg 1.1-2 cm 4.76 $70.00 $333.20 11403 Exc tr-ext b9+marg 2.1-3cm 5.50 $70.00 $385.00 11404 Exc tr-ext b9+marg 3.1-4 cm 6.23 $70.00 $436.10 11406 Exc tr-ext b9+marg >4.0 cm 8.99 $70.00 $629.30 11420 Exc h-f-nk-sp b9+marg 0.5/< 3.50 $70.00 $245.00 11421 Exc h-f-nk-sp b9+marg 0.6-1 4.48 $70.00 $313.60 11422 Exc h-f-nk-sp b9+marg 1.1-2 5.04 $70.00 $352.80 11423 Exc h-f-nk-sp b9+marg 2.1-3 5.74 $70.00 $401.80 11424 Exc h-f-nk-sp b9+marg 3.1-4 6.67 $70.00 $466.90 11426 Exc h-f-nk-sp b9+marg >4 cm 9.56 $70.00 $669.20 11440 Exc face-mm b9+marg 0.5 cm/< 3.87 $70.00 $270.90 11441 Exc face-mm b9+marg 0.6-1 cm 4.80 $70.00 $336.00 11442 Exc face-mm b9+marg 1.1-2 cm 5.37 $70.00 $375.90 11443 Exc face-mm b9+marg 2.1-3 cm 6.38 $70.00 $446.60 11444 Exc face-mm b9+marg 3.1-4 cm 8.02 $70.00 $561.40 11446 Exc face-mm b9+marg >4 cm 11.14 $70.00 $779.80 11450 Removal sweat gland lesion 10.98 $70.00 $768.60 11451 Removal sweat gland lesion 13.90 $70.00 $973.00 11462 Removal sweat gland lesion 10.72 $70.00 $750.40 11463 Removal sweat gland lesion 14.05 $70.00 $983.50 11470 Removal sweat gland lesion 11.82 $70.00 $827.40 11471 Removal sweat gland lesion 14.62 $70.00 $1,023.40 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 1150F Doc pt rsk death w/in 1yr 0.00 $70.00 $0.00 1151F Doc no pt rsk death w/in 1yr 0.00 $70.00 $0.00 1152F Doc advncd dis comfort 1st 0.00 $70.00 $0.00 1153F Doc advncd dis cmfrt not 1st 0.00 $70.00 $0.00 1157F Advnc care plan in rcrd 0.00 $70.00 $0.00 1158F Advnc care plan tlk docd 0.00 $70.00 $0.00 1159F Med list docd in rcrd 0.00 $70.00 $0.00 1160F Rvw meds by rx/dr in rcrd 0.00 $70.00 $0.00 11600 Exc tr-ext mal+marg 0.5 cm/< 5.52 $70.00 $386.40 11601 Exc tr-ext mal+marg 0.6-1 cm 6.53 $70.00 $457.10 11602 Exc tr-ext mal+marg 1.1-2 cm 7.08 $70.00 $495.60 11603 Exc tr-ext mal+marg 2.1-3 cm 8.11 $70.00 $567.70 11604 Exc tr-ext mal+marg 3.1-4 cm 8.99 $70.00 $629.30 11606 Exc tr-ext mal+marg >4 cm 12.86 $70.00 $900.20 11620 Exc h-f-nk-sp mal+marg 0.5/< 5.56 $70.00 $389.20 11621 Exc s/n/h/f/g mal+mrg 0.6-1 6.56 $70.00 $459.20 11622 Exc s/n/h/f/g mal+mrg 1.1-2 7.32 $70.00 $512.40 11623 Exc s/n/h/f/g mal+mrg 2.1-3 8.59 $70.00 $601.30 11624 Exc s/n/h/f/g mal+mrg 3.1-4 9.68 $70.00 $677.60 11626 Exc s/n/h/f/g mal+mrg >4 cm 11.63 $70.00 $814.10 11640 Exc f/e/e/n/l mal+mrg 0.5cm< 5.73 $70.00 $401.10 11641 Exc f/e/e/n/l mal+mrg 0.6-1 6.78 $70.00 $474.60 11642 Exc f/e/e/n/l mal+mrg 1.1-2 7.74 $70.00 $541.80 11643 Exc f/e/e/n/l mal+mrg 2.1-3 9.12 $70.00 $638.40 11644 Exc f/e/e/n/l mal+mrg 3.1-4 11.26 $70.00 $788.20 11646 Exc f/e/e/n/l mal+mrg >4 cm 14.66 $70.00 $1,026.20 1170F Fxnl status assessed 0.00 $70.00 $0.00 11719 Trim nail(s) any number 0.41 $70.00 $28.70 11720 Debride nail 1-5 0.94 $70.00 $65.80 11721 Debride nail 6 or more 1.29 $70.00 $90.30 11730 Removal of nail plate 3.01 $70.00 $210.70 11732 Remove nail plate add-on 0.90 $70.00 $63.00 11740 Drain blood from under nail 1.43 $70.00 $100.10 1175F Function stat assessed rvwd 0.00 $70.00 $0.00 11750 Removal of nail bed 4.37 $70.00 $305.90 11755 Biopsy nail unit 3.75 $70.00 $262.50 11760 Repair of nail bed 5.35 $70.00 $374.50 11762 Reconstruction of nail bed 7.97 $70.00 $557.90 11765 Excision of nail fold toe 4.77 $70.00 $333.90 11770 Remove pilonidal cyst simple 7.89 $70.00 $552.30 11771 Remove pilonidal cyst exten 16.49 $70.00 $1,154.30 11772 Remove pilonidal cyst compl 19.86 $70.00 $1,390.20 1180F Thromboemb risk assessed 0.00 $70.00 $0.00 1181F Neuropsychia sympts assessed 0.00 $70.00 $0.00 1182F Neuropsychi sympt 1+present 0.00 $70.00 $0.00 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 1183F Neuropsychiatric symp absent 0.00 $70.00 $0.00 11900 Inject skin lesions </w 7 1.60 $70.00 $112.00 11901 Inject skin lesions >7 2.01 $70.00 $140.70 11920 Correct skin color 6.0 cm/< 4.91 $70.00
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    Policy Name: Once in a Lifetime Procedures Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010 Family Rhinectomy Code Description 30160 Rhinectomy; total Family Laryngectomy Code Description 31360 Laryngectomy; total, without radical neck dissection 31365 Laryngectomy; total, with radical neck dissection Family Pneumonectomy Code Description 32440 Removal of lung, pneumonectomy; Removal of lung, pneumonectomy; with resection of segment of trachea followed by 32442 broncho-tracheal anastomosis (sleeve pneumonectomy) 32445 Removal of lung, pneumonectomy; extrapleural Family Splenectomy Code Description 38100 Splenectomy; total (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List 38102 in addition to code for primary procedure) Family Glossectomy Code Description Glossectomy; complete or total, with or without tracheostomy, without radical neck 41140 dissection Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 dissection Family Uvulectomy Code Description 42140 Uvulectomy, excision of uvula Family Gastrectomy Code Description 43620 Gastrectomy, total; with esophagoenterostomy 43621 Gastrectomy, total; with Roux-en-Y reconstruction 43622 Gastrectomy, total; with formation of intestinal pouch, any type Family Colectomy Code Description 44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44155 Colectomy,
  • Microperforated Hymen Presenting Spontaneous Pregnancy with Cesarean Delivery and Hymenotomy Surgery: a Case Report

    Microperforated Hymen Presenting Spontaneous Pregnancy with Cesarean Delivery and Hymenotomy Surgery: a Case Report

    ID Design Press, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2018 Mar 15; 6(3):528-530. https://doi.org/10.3889/oamjms.2018.123 eISSN: 1857-9655 Case Report Microperforated Hymen Presenting Spontaneous Pregnancy with Cesarean Delivery and Hymenotomy Surgery: A Case Report Brikene Elshani1, Heroid Arifi1, Armond Daci2* 1Department of Obstetrics and Gynecology, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo; 2Department of Pharmacy, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo Abstract Citation: Elshani B, Arifi H, Daci A. Microperforated BACKGROUND: Female genital tract anomalies including imperforate hymen affect sexual life and fertility. Hymen Presenting Spontaneous Pregnancy with Cesarean Delivery and Hymenotomy Surgery: A Case Report. Open Access Maced J Med Sci. 2018 Mar 15; CASE PRESENTATION: In the present case, we describe a pregnant woman diagnosed with imperforate hymen 6(3):528-530. https://doi.org/10.3889/oamjms.2018.123 which never had penetrative vaginal sex. A 27–year-old married patient with 2 months of amenorrhea presented Keywords: Cesarean Delivery; Imperforate Hymen; in a clinic without any other complications. Her history of difficult intercourse and prolonged menstrual flow were Hymen Incision Surgery reported, and subsequent vaginal examination confirmed the diagnosis of imperforate hymen even though she *Correspondence: Armond Daci. Department of claims to made pinhole surgery in hymen during puberty. Her urine pregnancy test was positive, and an Pharmacy, Faculty of Medicine, University of Prishtina, ultrasound examination revealed 8.3 weeks pregnant. The pregnancy was followed up to 39.5 weeks when she Prishtina, Kosovo. E-mail: [email protected] entered in cesarean delivery in urgency.
  • Current Fee Schedule 2018 11 01

    Current Fee Schedule 2018 11 01

    Procedure Procedure Unit Charge in Procedure Description Code Modifier Dollars 10021 PR FINE NEEDLE ASP;W/O IMAGING GUIDANCE 247.00 10022 PR FINE NEEDLE ASP;W/IMAGING GUIDANCE 494.00 10040 PR ACNE SURGERY OF SKIN ABSCESS 203.00 10060 PR DRAIN SKIN ABSCESS SIMPLE 240.00 10061 PR DRAIN SKIN ABSCESS COMPLIC 328.00 10080 PR DRAIN PILONIDAL CYST SIMPL 261.00 10081 PR DRAIN PILONIDAL CYST COMPLIC 1248.00 10120 PR REMOVE FOREIGN BODY SIMPLE 360.00 10121 PR REMOVE FOREIGN BODY COMPLIC 616.00 10140 PR DRAINAGE OF HEMATOMA/FLUID 1343.00 10160 PR PUNCTURE DRAINAGE OF LESION 240.00 10180 PR COMPLEX DRAINAGE, WOUND 505.00 11000 PR DEBRIDEMENT, INFECTED SKIN, UP TO 10% BSA 321.00 11004 PR DEBRIDE NECR SKIN/TISS,SUBQ/MUSC/FASC,GENIT& 1378.00 11005 PR DEBRIDE NECROTIC SKIN/ TISSUE, ABD WALL 1757.00 11006 PR DEBR NEC SKIN/TISS,GEN/PERI/ADB WALL W/WO C 1592.00 11008 PR REMOVE MESH FROM ABD WALL FOR INFECTION 617.00 11010 PR DEBRIDE ASSOC OPEN FX/DISLOC SKIN/SUBQ 1118.00 11011 PR DEBRIDE ASSOC OPEN FX/DISLOC SKIN/MUSCLE 1217.00 11012 PR DEBRIDE ASSOC OPEN FX/DISLO SKIN/MUS/BONE 1632.00 11040 PR DEBRIDEMENT, SKIN, PARTIAL THICKNESS 91.00 11041 PR DEBRIDEMENT, SKIN, FULL THICKNESS 343.00 11042 PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM 322.00 11043 PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,=<20 SQ CM 451.00 11044 PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,BONE,=<20 SQ CM 679.00 11045 PR PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,EACH ADD 20 SQ CM 96.00 11046 PR PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,MUSCLE,EACH ADD 20 SQ CM 168.00 11047 PR PR DEBRIDEMENT, SKIN, SUB-Q
  • Overview of Surgical Techniques in Gender-Affirming Genital Surgery

    Overview of Surgical Techniques in Gender-Affirming Genital Surgery

    208 Review Article Overview of surgical techniques in gender-affirming genital surgery Mang L. Chen1, Polina Reyblat2, Melissa M. Poh2, Amanda C. Chi2 1GU Recon, Los Angeles, CA, USA; 2Southern California Permanente Medical Group, Los Angeles, CA, USA Contributions: (I) Conception and design: ML Chen, AC Chi; (II) Administrative support: None; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Amanda C. Chi. 6041 Cadillac Ave, Los Angeles, CA 90034, USA. Email: [email protected]. Abstract: Gender related genitourinary surgeries are vitally important in the management of gender dysphoria. Vaginoplasty, metoidioplasty, phalloplasty and their associated surgeries help patients achieve their main goal of aligning their body and mind. These surgeries warrant careful adherence to reconstructive surgical principles as many patients can require corrective surgeries from complications that arise. Peri- operative assessment, the surgical techniques employed for vaginoplasty, phalloplasty, metoidioplasty, and their associated procedures are described. The general reconstructive principles for managing complications including urethroplasty to correct urethral bulging, vaginl stenosis, clitoroplasty and labiaplasty after primary vaginoplasty, and urethroplasty for strictures and fistulas, neophallus and neoscrotal reconstruction after phalloplasty are outlined as well. Keywords: Transgender; vaginoplasty; phalloplasty; metoidioplasty Submitted May 30, 2019. Accepted for publication Jun 20, 2019. doi: 10.21037/tau.2019.06.19 View this article at: http://dx.doi.org/10.21037/tau.2019.06.19 Introduction the rectum and the lower urinary tract, formation of perineogenital complex for patients who desire a functional The rise in social awareness of gender dysphoria has led vaginal canal, labiaplasty, and clitoroplasty.