DOCSLIB.ORG

Oregon Health Authority Division of Medical Assistance Programs Addendum a - Final OPPS Apcs for CY 2012 Effective October 1, 2012

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Oregon Health Authority Division of Medical Assistance Programs Addendum a - Final OPPS Apcs for CY 2012 Effective October 1, 2012 Oregon Health Authority Division of Medical Assistance Programs Addendum A - Final OPPS APCs for CY 2012 Effective October 1, 2012 Relative APC Group Title SI Weight 0001 Level I Photochemotherapy S 0.5042 0002 Fine Needle Biopsy/Aspiration T 1.6115 0003 Bone Marrow Biopsy/Aspiration T 3.5702 0004 Level I Needle Biopsy/ Aspiration Except Bone Marrow T 4.5746 0005 Level II Needle Biopsy/Aspiration Except Bone Marrow T 8.1566 0006 Level I Incision & Drainage T 1.4206 0007 Level II Incision & Drainage T 13.1250 0008 Level III Incision and Drainage T 20.5648 0012 Level I Debridement & Destruction T 0.3878 0013 Level II Debridement & Destruction T 0.8785 0015 Level III Debridement & Destruction T 1.4989 0016 Level IV Debridement & Destruction T 2.7592 0017 Level V Debridement & Destruction T 21.6661 0019 Level I Excision/ Biopsy T 4.4238 0020 Level II Excision/ Biopsy T 8.2746 0021 Level III Excision/ Biopsy T 17.0074 0022 Level IV Excision/ Biopsy T 23.2662 0028 Level I Breast Surgery T 25.5054 0029 Level II Breast Surgery T 33.4070 0030 Level III Breast Surgery T 44.8999 0031 Smoking Cessation Services X 0.2997 0034 Mental Health Services Composite S 2.7295 0035 Vascular Puncture and Minor Diagnostic Procedures X 0.2691 0037 Level IV Needle Biopsy/Aspiration Except Bone Marrow T 15.3499 0039 Level I Implantation of Neurostimulator Generator S 216.7598 0040 Level I Implantation/Revision/Replacement of Neurostimulator Electrodes S 63.7616 0041 Level I Arthroscopy T 29.6568 0042 Level II Arthroscopy T 57.0137 0045 Bone/Joint Manipulation Under Anesthesia T 15.4592 0047 Arthroplasty without Prosthesis T 41.2275 0048 Level I Arthroplasty or Implantation with Prosthesis T 60.6542 0049 Level I Musculoskeletal Procedures Except Hand and Foot T 22.0777 0050 Level II Musculoskeletal Procedures Except Hand and Foot T 32.4068 0051 Level III Musculoskeletal Procedures Except Hand and Foot T 47.4682 0052 Level IV Musculoskeletal Procedures Except Hand and Foot T 88.7314 0053 Level I Hand Musculoskeletal Procedures T 17.1918 0054 Level II Hand Musculoskeletal Procedures T 28.8534 0055 Level I Foot Musculoskeletal Procedures T 22.1041 0056 Level II Foot Musculoskeletal Procedures T 58.3595 0057 Bunion Procedures T 32.7118 0058 Level I Strapping and Cast Application S 1.1276 0060 Manipulation Therapy S 0.3587 0061 Level II Implantation/Revision/Replacement of Neurostimulator Electrodes S 88.8062 0062 Level I Treatment Fracture/Dislocation T 26.1699 0063 Level II Treatment Fracture/Dislocation T 49.9153 0064 Level III Treatment Fracture/Dislocation T 68.1442 0065 Level I Stereotactic Radiosurgery, MRgFUS, and MEG S 12.8879 0066 Level II Stereotactic Radiosurgery, MRgFUS, and MEG S 35.9898 0067 Level III Stereotactic Radiosurgery, MRgFUS, and MEG S 48.1747 0069 Thoracoscopy T 34.4761 Page 1 of 18 Last updated 1/17/2013 Oregon Health Authority Division of Medical Assistance Programs Addendum A - Final OPPS APCs for CY 2012 Effective October 1, 2012 Relative APC Group Title SI Weight 0070 Thoracentesis/Lavage Procedures T 5.5079 0071 Level I Endoscopy Upper Airway T 1.0751 0072 Level II Endoscopy Upper Airway T 1.8640 0073 Level III Endoscopy Upper Airway T 4.4183 0074 Level IV Endoscopy Upper Airway T 21.3453 0075 Level V Endoscopy Upper Airway T 30.4202 0076 Level I Endoscopy Lower Airway T 10.4721 0077 Level I Pulmonary Treatment S 0.4248 0078 Level III Pulmonary Treatment S 1.4123 0079 Ventilation Initiation and Management S 3.0710 0080 Diagnostic Cardiac Catheterization T 38.8595 0082 Coronary or Non-Coronary Atherectomy T 105.1880 0083 Coronary Angioplasty, Valvuloplasty, and Level I Endovascular Revascularization of the Lower Extremity T 66.0408 0084 Level I Electrophysiologic Procedures S 9.9253 0085 Level II Electrophysiologic Procedures T 53.7347 0086 Level III Electrophysiologic Procedures T 128.2375 0088 Thrombectomy T 41.0473 0089 Insertion/Replacement of Permanent Pacemaker and Electrodes T 111.8799 0090 Level I Insertion/Replacement of Permanent Pacemaker T 94.2889 0091 Level II Vascular Ligation T 44.2193 0092 Level I Vascular Ligation T 26.8758 0093 Vascular Reconstruction/Fistula Repair without Device T 30.8203 0094 Level I Resuscitation and Cardioversion S 2.2313 0095 Cardiac Rehabilitation S 0.9950 0096 Level II Noninvasive Physiologic Studies S 1.5246 0097 Level I Noninvasive Physiologic Studies S 0.9348 0099 Electrocardiograms/Cardiography S 0.3823 0100 Cardiac Stress Tests X 2.5475 0101 Tilt Table Evaluation S 4.2654 0102 Level II Pulmonary Treatment S 0.5344 0103 Miscellaneous Vascular Procedures T 16.4097 0104 Transcatheter Placement of Intracoronary Stents T 81.3305 0105 Repair/Revision/Removal of Pacemakers, AICDs, or Vascular Devices T 22.7903 0106 Insertion/Replacement of Pacemaker Leads and/or Electrodes T 49.6518 0107 Insertion of Cardioverter-Defibrillator Pulse Generator T 346.9174 0108 Insertion/Replacement/Repair of AICD Leads, Generator, and Pacing Electrodes T 425.1499 0110 Transfusion S 3.4289 0111 Blood Product Exchange S 11.6555 0112 Apheresis and Stem Cell Procedures S 32.6165 0113 Excision Lymphatic System T 25.2698 0114 Thyroid/Lymphadenectomy Procedures T 51.3780 0115 Cannula/Access Device Procedures T 37.3584 0121 Level I Tube or Catheter Changes or Repositioning T 6.2131 0126 Level I Urinary and Anal Procedures T 1.1092 0127 Level IV Stereotactic Radiosurgery, MRgFUS, and MEG S 106.5264 0128 Echocardiogram with Contrast S 7.9579 0129 Level I Closed Treatment Fracture T 1.5023 0130 Level I Laparoscopy T 38.8880 0131 Level II Laparoscopy T 48.0079 0132 Level III Laparoscopy T 71.5531 Page 2 of 18 Last updated 1/17/2013 Oregon Health Authority Division of Medical Assistance Programs Addendum A - Final OPPS APCs for CY 2012 Effective October 1, 2012 Relative APC Group Title SI Weight 0133 Level I Skin Repair T 1.1944 0134 Level II Skin Repair T 3.2563 0135 Level III Skin Repair T 4.9694 0136 Level IV Skin Repair T 16.7455 0137 Level V Skin Repair T 21.3314 0138 Level II Closed Treatment Fracture T 5.0918 0139 Level III Closed Treatment Fracture T 19.1606 0140 Esophageal Dilation without Endoscopy T 6.5842 0141 Level I Upper GI Procedures T 8.4514 0142 Level I Small Intestine Endoscopy T 10.3443 0143 Lower GI Endoscopy T 9.3677 0146 Level I Sigmoidoscopy and Anoscopy T 6.2297 0147 Level II Sigmoidoscopy and Anoscopy T 11.0754 0148 Level I Anal/Rectal Procedures T 5.5610 0149 Level III Anal/Rectal Procedures T 24.4054 0150 Level IV Anal/Rectal Procedures T 32.9746 0151 Endoscopic Retrograde Cholangio-Pancreatography (ERCP) T 24.7014 0152 Level I Percutaneous Abdominal and Biliary Procedures T 29.1698 0153 Peritoneal and Abdominal Procedures T 27.4109 0154 Hernia/Hydrocele Procedures T 32.9296 0155 Level II Anal/Rectal Procedures T 15.4662 0156 Level III Urinary and Anal Procedures T 3.1880 0157 Colorectal Cancer Screening: Barium Enema S 2.7505 0158 Colorectal Cancer Screening: Colonoscopy T 8.3099 0159 Colorectal Cancer Screening: Flexible Sigmoidoscopy S 5.4078 0160 Level I Cystourethroscopy and other Genitourinary Procedures T 6.7724 0161 Level II Cystourethroscopy and other Genitourinary Procedures T 17.4928 0162 Level III Cystourethroscopy and other Genitourinary Procedures T 26.2784 0163 Level IV Cystourethroscopy and other Genitourinary Procedures T 37.0430 0164 Level II Urinary and Anal Procedures T 1.9495 0165 Level IV Urinary and Anal Procedures T 20.4458 0166 Level I Urethral Procedures T 20.9473 0168 Level II Urethral Procedures T 32.3095 0169 Lithotripsy T 41.2299 0170 Dialysis S 6.6871 0172 Level I Partial Hospitalization (3 services) for CMHCs P 1.3941 0173 Level II Partial Hospitalization (4 or more services) for CMHCs P 1.6252 0174 Level IV Laparoscopy T 109.7169 0175 Level I Partial Hospitalization (3 services) for Hospital-based PHPs P 2.2950 0176 Level II Partial Hospitalization (4 or more services) for Hospital-based PHPs P 2.7295 0181 Level II Male Genital Procedures T 34.6230 0183 Level I Male Genital Procedures T 23.5985 0184 Prostate Biopsy T 13.8400 0188 Level II Female Reproductive Proc T 1.5839 0189 Level III Female Reproductive Proc T 3.4852 0190 Level I Hysteroscopy T 23.0056 0191 Level I Female Reproductive Proc T 0.1309 0192 Level IV Female Reproductive Proc T 6.7568 0193 Level V Female Reproductive Proc T 20.6451 0195 Level VI Female Reproductive Procedures T 36.0353 Page 3 of 18 Last updated 1/17/2013 Oregon Health Authority Division of Medical Assistance Programs Addendum A - Final OPPS APCs for CY 2012 Effective October 1, 2012 Relative APC Group Title SI Weight 0202 Level VII Female Reproductive Procedures T 46.0040 0203 Level IV Nerve Injections T 12.8988 0204 Level I Nerve Injections T 2.6121 0206 Level II Nerve Injections T 3.8988 0207 Level III Nerve Injections T 7.4744 0208 Laminotomies and Laminectomies T 50.8933 0209 Level II Extended EEG, Sleep, and Cardiovascular Studies S 11.3584 0213 Level I Extended EEG, Sleep, and Cardiovascular Studies S 2.4311 0215 Level I Nerve and Muscle Tests S 0.6313 0216 Level III Nerve and Muscle Tests S 2.6461 0218 Level II Nerve and Muscle Tests S 1.2024 0220 Level I Nerve Procedures T 18.8841 0221 Level II Nerve Procedures T 36.0414 0224 Implantation of Catheter/Reservoir/Shunt T 41.6996 0227 Implantation of Drug Infusion Device T 193.0257 0229 Level II Endovascular Revascularization of the Lower Extremity T 115.6270 0230 Level I Eye Tests & Treatments S 0.6423 0231 Level III Eye Tests & Treatments S 2.0291 0232 Level I Anterior Segment Eye Procedures T 2.8709 0233 Level III Anterior Segment Eye Procedures T 16.6052 0234 Level
Load more

Recommended publications
  • AHFS Pharmacologic-Therapeutic Classification System
    AHFS Pharmacologic-Therapeutic Classification System Abacavir 48:24 - Mucolytic Agents - 382638 8:18.08.20 - HIV Nucleoside and Nucleotide Reverse Acitretin 84:92 - Skin and Mucous Membrane Agents, Abaloparatide 68:24.08 - Parathyroid Agents - 317036 Aclidinium Abatacept 12:08.08 - Antimuscarinics/Antispasmodics - 313022 92:36 - Disease-modifying Antirheumatic Drugs - Acrivastine 92:20 - Immunomodulatory Agents - 306003 4:08 - Second Generation Antihistamines - 394040 Abciximab 48:04.08 - Second Generation Antihistamines - 394040 20:12.18 - Platelet-aggregation Inhibitors - 395014 Acyclovir Abemaciclib 8:18.32 - Nucleosides and Nucleotides - 381045 10:00 - Antineoplastic Agents - 317058 84:04.06 - Antivirals - 381036 Abiraterone Adalimumab; -adaz 10:00 - Antineoplastic Agents - 311027 92:36 - Disease-modifying Antirheumatic Drugs - AbobotulinumtoxinA 56:92 - GI Drugs, Miscellaneous - 302046 92:20 - Immunomodulatory Agents - 302046 92:92 - Other Miscellaneous Therapeutic Agents - 12:20.92 - Skeletal Muscle Relaxants, Miscellaneous - Adapalene 84:92 - Skin and Mucous Membrane Agents, Acalabrutinib 10:00 - Antineoplastic Agents - 317059 Adefovir Acamprosate 8:18.32 - Nucleosides and Nucleotides - 302036 28:92 - Central Nervous System Agents, Adenosine 24:04.04.24 - Class IV Antiarrhythmics - 304010 Acarbose Adenovirus Vaccine Live Oral 68:20.02 - alpha-Glucosidase Inhibitors - 396015 80:12 - Vaccines - 315016 Acebutolol Ado-Trastuzumab 24:24 - beta-Adrenergic Blocking Agents - 387003 10:00 - Antineoplastic Agents - 313041 12:16.08.08 - Selective
    [Show full text]
  • Photodynamic Therapy with Methyl Aminolevulinate for Primary Nodular Basal Cell Carcinoma: Results of Two Randomized Studies
    Clinical trial Photodynamic therapy with methyl aminolevulinate for primary nodular basal cell carcinoma: results of two randomized studies Peter Foley, MBBS, BMedSc, MD, FACD, Michael Freeman, MBBS, FACD, Alan Menter, MB, FAAD, Gregory Siller, MBBS, FACD, Rokea A. El-Azhary, MD, PhD, FAAD, Kurt Gebauer, MBBS, FACD, Nicholas J. Lowe, MD, FAAD, Michael T. Jarratt, MD, FAAD, Dedee F. Murrell, BMBCh, MD, FAAD, Phoebe Rich, MD, FAAD, David M. Pariser, MD, FAAD, Allan R. Oseroff, MD, PhD, FAAD, Ross Barnetson, MD, FRACP, FACD, Christopher Anderson, MBBS, FACD, Steven Kossard, MBBS, FACD, Lawrence E. Gibson, MD, FAAD, and Whitney D. Tope, MPhIL, MD, FAAD From the Department of Medicine Abstract (Dermatology), The University of Background Data suggest that photodynamic therapy using topical methyl aminolevulinate Melbourne, St. Vincent’s Hospital (MAL PDT) may be a noninvasive alternative to excisional surgery for nodular basal cell Melbourne, Fitzroy, Vic., Suite 5 ACH carcinoma (BCC). In the studies described here, we investigated the histologic response, House, Benowa and Department of Dermatology, Princess Alexandra tolerability, and cosmetic outcome with MAL PDT for primary nodular BCC (£ 5 mm in depth). Hospital, Woolloongabba, Qld, Fremantle Methods Two multicenter, randomized, double-blind studies with similar design and Dermatology, Fremantle, WA, and procedures were conducted. After surface debridement and minor tumor debulking, MAL cream Department of Dermatology, St. George 160 mg/g (66 patients with 75 lesions) or placebo cream (65 patients with 75 lesions) was applied Hospital, University of New South Wales, for 3 h, followed by illumination with broad-spectrum red light (75 J/cm2, 570–670 nm).
    [Show full text]
  • PHOTOSTENT-02: Porfimer Sodium Photodynamic Therapy Plus Stenting Versus Stenting Alone in Patients with Locally Advanced Or Metastatic Biliary Tract Cancer
    Open access Original research ESMO Open: first published as 10.1136/esmoopen-2018-000379 on 23 July 2018. Downloaded from PHOTOSTENT-02: porfimer sodium photodynamic therapy plus stenting versus stenting alone in patients with locally advanced or metastatic biliary tract cancer Stephen P Pereira,1,2 Mark Jitlal,3 Marian Duggan,3 Emma Lawrie,3 Sandy Beare,3 Pam O'Donoghue,4 Harpreet S Wasan,5 Juan W Valle,6 John Bridgewater,7 on behalf of the PHOTOSTENT-02 investigators To cite: Pereira SP, ABSTRACT Key questions Jitlal M, Duggan M, et al. Background Endobiliary stenting is standard practice for PHOTOSTENT-02: porfimer palliation of obstructive jaundice due to biliary tract cancer sodium photodynamic therapy What is already known about this subject? (BTC). Photodynamic therapy (PDT) may also improve plus stenting versus stenting In patients with obstructive jaundice due to unre- biliary drainage and previous small studies suggested ► alone in patients with locally sectable cholangiocarcinoma, small studies have survival benefit. advanced or metastatic biliary suggested that photodynamic therapy (PDT) may Aims To assess the difference in outcome between tract cancer. ESMO Open improve biliary drainage and patient survival. 2018;3:e000379. doi:10.1136/ patients with BTC undergoing palliative stenting plus PDT esmoopen-2018-000379 versus stenting alone. What does this study add? Methods 92 patients with confirmed locally advanced ► We conducted a large randomised controlled trial or metastatic BTC, ECOG performance status 0–3 and of porfimer sodium PDT in patients with confirmed JWV and JB contributed equally. adequate biliary drainage were randomised (46 per locally advanced or metastatic biliary tract cancer.
    [Show full text]
  • BC Cancer Benefit Drug List September 2021
    Page 1 of 65 BC Cancer Benefit Drug List September 2021 DEFINITIONS Class I Reimbursed for active cancer or approved treatment or approved indication only. Reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to Restricted Funding (R) provide the appropriate clinical information for each patient. NOTES 1. BC Cancer will reimburse, to the Communities Oncology Network hospital pharmacy, the actual acquisition cost of a Benefit Drug, up to the maximum price as determined by BC Cancer, based on the current brand and contract price. Please contact the OSCAR Hotline at 1-888-355-0355 if more information is required. 2. Not Otherwise Specified (NOS) code only applicable to Class I drugs where indicated. 3. Intrahepatic use of chemotherapy drugs is not reimbursable unless specified. 4. For queries regarding other indications not specified, please contact the BC Cancer Compassionate Access Program Office at 604.877.6000 x 6277 or [email protected] DOSAGE TUMOUR PROTOCOL DRUG APPROVED INDICATIONS CLASS NOTES FORM SITE CODES Therapy for Metastatic Castration-Sensitive Prostate Cancer using abiraterone tablet Genitourinary UGUMCSPABI* R Abiraterone and Prednisone Palliative Therapy for Metastatic Castration Resistant Prostate Cancer abiraterone tablet Genitourinary UGUPABI R Using Abiraterone and prednisone acitretin capsule Lymphoma reversal of early dysplastic and neoplastic stem changes LYNOS I first-line treatment of epidermal
    [Show full text]
  • Exhibit #4 Outpatient Surgery Facility Codes and Fees Source: 2019 CN2 Addendum A.12212018 Effective 1/1/2020
    Exhibit #4 Outpatient Surgery Facility Codes and Fees source: 2019 CN2 Addendum A.12212018 Effective 1/1/2020 APC Short Descriptor Outpatient ASC Rate Additional Hospital Rate (85% of Instructions (180% of Hospital Rate) Medicare $) 0701 Sr89 strontium $ 2,704.24 $ 2,298.60 0726 Dexrazoxane HCl injection $ 413.87 $ 351.79 0731 Sargramostim injection $ 67.69 $ 57.54 0736 Amphotericin b liposome inj $ 86.52 $ 73.54 0738 Rasburicase $ 500.66 $ 425.56 0751 Mechlorethamine hcl inj $ 579.10 $ 492.24 0752 Dactinomycin injection $ 2,569.80 $ 2,184.33 0759 Naltrexone, depot form $ 5.86 $ 4.98 0800 Leuprolide acetate $ 2,148.60 $ 1,826.31 0802 Etoposide oral $ 136.01 $ 115.61 0807 Aldesleukin injection $ 7,448.66 $ 6,331.36 0809 Bcg live intravesical vac $ 253.11 $ 215.14 0810 Goserelin acetate implant $ 916.24 $ 778.80 0812 Carmustine injection $ 7,292.71 $ 6,198.80 0820 Daunorubicin injection $ 91.19 $ 77.51 0823 Docetaxel injection $ 2.72 $ 2.31 0825 Nelarabine injection $ 273.99 $ 232.89 0836 Interferon alfa-2b inj $ 61.46 $ 52.24 0840 Inj melphalan hydrochl $ 1,466.65 $ 1,246.65 0843 Pegaspargase injection $ 27,051.68 $ 22,993.93 0844 Pentostatin injection $ 3,773.31 $ 3,207.31 0850 Streptozocin injection $ 627.67 $ 533.52 0851 Thiotepa injection $ 1,334.84 $ 1,134.61 0856 Porfimer sodium injection $ 38,195.22 $ 32,465.94 0858 Inj cladribine $ 40.75 $ 34.64 0864 Mitoxantrone hydrochl $ 49.25 $ 41.86 0873 Hyalgan supartz visco-3 dose $ 153.55 $ 130.52 0874 Synvisc or synvisc-one $ 21.29 $ 18.10 0875 Euflexxa inj per dose $ 254.65 $ 216.45 0877
    [Show full text]
  • Aminolevulinic Acid (ALA) As a Prodrug in Photodynamic Therapy of Cancer
    Molecules 2011, 16, 4140-4164; doi:10.3390/molecules16054140 OPEN ACCESS molecules ISSN 1420-3049 www.mdpi.com/journal/molecules Review Aminolevulinic Acid (ALA) as a Prodrug in Photodynamic Therapy of Cancer Małgorzata Wachowska 1, Angelika Muchowicz 1, Małgorzata Firczuk 1, Magdalena Gabrysiak 1, Magdalena Winiarska 1, Małgorzata Wańczyk 1, Kamil Bojarczuk 1 and Jakub Golab 1,2,* 1 Department of Immunology, Centre of Biostructure Research, Medical University of Warsaw, Banacha 1A F Building, 02-097 Warsaw, Poland 2 Department III, Institute of Physical Chemistry, Polish Academy of Sciences, 01-224 Warsaw, Poland * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel. +48-22-5992199; Fax: +48-22-5992194. Received: 3 February 2011 / Accepted: 3 May 2011 / Published: 19 May 2011 Abstract: Aminolevulinic acid (ALA) is an endogenous metabolite normally formed in the mitochondria from succinyl-CoA and glycine. Conjugation of eight ALA molecules yields protoporphyrin IX (PpIX) and finally leads to formation of heme. Conversion of PpIX to its downstream substrates requires the activity of a rate-limiting enzyme ferrochelatase. When ALA is administered externally the abundantly produced PpIX cannot be quickly converted to its final product - heme by ferrochelatase and therefore accumulates within cells. Since PpIX is a potent photosensitizer this metabolic pathway can be exploited in photodynamic therapy (PDT). This is an already approved therapeutic strategy making ALA one of the most successful prodrugs used in cancer treatment. Key words: 5-aminolevulinic acid; photodynamic therapy; cancer; laser; singlet oxygen 1. Introduction Photodynamic therapy (PDT) is a minimally invasive therapeutic modality used in the management of various cancerous and pre-malignant diseases.
    [Show full text]
  • Pub 100-04 Medicare Claims Processing
    Department of Health CMS Manual System & Human Services (DHHS) Pub 100-04 Medicare Claims Centers for Medicare Processing & Medicaid Services (CMS) Transmittal 2128 Date: DECEMBER 29, 2010 Change Request 7275 SUBJECT: January 2011 Update of the Ambulatory Surgical Center (ASC) Payment System I. SUMMARY OF CHANGES: This Recurring Update Notification describes changes to and billing instructions for various payment policies implemented in the January 2011 ASC update. As appropriate, this notification also includes updates to the Healthcare Common Procedure Coding System (HCPCS). EFFECTIVE DATE: January 1, 2011 IMPLEMENTATION DATE: January 3, 2011 Disclaimer for manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive 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=DELETED-Only One Per Row. R/N/D CHAPTER / SECTION / SUBSECTION / TITLE N/A III. FUNDING: For Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs): No additional funding will be provided by CMS; Contractor activities are to be carried out within their operating budgets. For Medicare Administrative Contractors (MACs): The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the Contracting Officer.
    [Show full text]
  • APPENDICES: a Systematic Review of Photodynamic Therapy in the Treatment of Pre-Cancerous Skin Conditions, Barrett's Oesophagu
    Health Technology Assessment 2010; Vol. 14: No.371 Health Technology Assessment 2010; Vol. 14: No. 37 Appendix 5 Pre-cancerous skin scoping Appendix 6 Appendices Go to main text Skin cancer scoping Appendix 7 Barrett’s oesophagus scoping Appendix 8 Oesophageal cancer scoping A systematic review of photodynamic Appendix 9 therapy in the treatment of pre- Lung cancer scoping cancerous skin conditions, Barrett’s Appendix 10 oesophagus and cancers of the biliary Biliary tract cancer scoping Appendix 11 tract, brain, head and neck, lung, Brain cancer scoping oesophagus and skin Appendix 12 Head and neck cancer scoping D Fayter, M Corbett, M Heirs, D Fox Appendix 13 and A Eastwood Actinic keratosis data extraction Appendix 14 Bowen’s disease data extraction Appendix 15 Basal cell carcinoma data extraction Appendix 16 Barrett’s oesophagus data extraction Appendix 17 Oesophageal cancer data extraction Appendix 18 Lung cancer data extraction Appendix 19 Biliary tract cancer data extraction Appendix 20 Brain cancer data extraction Appendix 21 July 2010 Head and neck cancer data extraction 10.3310/hta14370 Health Technology Assessment NIHR HTA programme www.hta.ac.uk HTA How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below). Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.
    [Show full text]
  • Original New Drug Applications
    New Drugs Reviewed by CPG January 23, 2017 (Original New Drug Applications: FDA) Generic Name Trade Name Indication(s) CPG Action Immune globulin Cuvitru Biologic and In accordance with subcutaneous Immunological the SCA [human] 20% solution Agents/Immune Globulins/ Immune Globulin (Human) subcutaneous. Indicated as replacement for primary humoral immunodeficiency in adult and pediatric patients age two and older. eteplirsen Exondys 51 Central Nervous System In accordance with Agents/Antisense the SCA Oligonucleotides. Treatment of patients who have a confirmed mutation of the dystrophin gene amenable to exon 51 skipping. First drug approved for reatment of patients with Duchenne muscular dystrophy. levonorgestrel- Kyleena Endocrine and May prescribe releasing intrauterine Metabolic Agents/sex system 19.5 mg homones/contraceptive Hormones. Prevention of pregnancy for up to five years. **Phentermine Lomaira Central Nervous System In accordance with hydrochloride 8 mg Agents/ the SCA anorexiants/sympathomi metic anorexiants. Short term use weight reduction in adults with **(new formulation at an initial BMI of 30 or lower dosage) more or 27 with at least one weight-related condition. 1 New Drugs January 2017 canaglifozin/ Invokamet XR Endocrine and May prescribe metformin HCL Metabolic Agents/ extended-release antidiabetic agents/antidiabetic combination products. Treatment of adults with type 2 diabetes as an adjunct to diet and exercise. Adalimumab-atto Amjevita Biologic and In accordance with Immunological Agents/ the SCA Immunologic Agents/Immunomodulat ors/Tumor necrosis Factor-Alpha Blockers. Indicated for treatment of adults with: rheumatoid arthritis, psoriatic arthritis,ankylosing spondylitis, Crohn disease, ulcerative colitis, and plaque psoriasis. Also indicated for juvenile idiopathic arthritis in pts age 4 years and older.
    [Show full text]
  • Methyl-Aminolevulinate-Based-Photodynamic-Therapy-O 2019 Photodiagnosis-And.Pdf
    Photodiagnosis and Photodynamic Therapy 26 (2019) 295–299 Contents lists available at ScienceDirect Photodiagnosis and Photodynamic Therapy journal homepage: www.elsevier.com/locate/pdpdt Methyl aminolevulinate-based photodynamic therapy of Bowen´s disease: Observational study of 21 lesions T ⁎ Clara Gómeza, , Marian Cobosb, Enrique Alberdib a Institute of Physical Chemistry Rocasolano, Spanish National Research Council, CSIC, Madrid, Spain b Private clinic of Dr. Alberdi, Madrid, Spain ARTICLE INFO ABSTRACT Keywords: Background: Although surgical removal is the treatment of choice in Bowen's disease (BD), there are cases in Photodynamic therapy which by age, comorbidities, use of anticoagulants, location, cosmetic result, or size, it is preferable to use other Methyl aminolevulinate treatments such as cryotherapy, 5-fluorouracil cream, imiquimod 5% cream or photodynamic therapy (PDT). ’ Bowen s disease Efficacy of PDT in BD is supported by substantial research and clinical data. Objectives: This study aimed to evaluate the long term effectiveness of methyl aminolevulinate-PDT (MAL/PDT) on a wide range of Bowen lesions in different locations and sizes. Methods: Patients diagnosed with BD were treated in 3 sessions with a 4-week interval in between with MAL/ PDT between January 2016 and January 2017 in a private clinic. Clinical response and relevant patient and tumour characteristics were analyzed during the first year after start of the PDT sessions. Results: In total, 21 BD lesions in 18 patients were included in the study. Complete regression (CR) after 3rd PDT session was 87.5% and 100% at the 6-month follow-up. Treatment was well tolerated and local adverse reactions were very scarce.
    [Show full text]
  • Pharmaceuticals As Environmental Contaminants
    PharmaceuticalsPharmaceuticals asas EnvironmentalEnvironmental Contaminants:Contaminants: anan OverviewOverview ofof thethe ScienceScience Christian G. Daughton, Ph.D. Chief, Environmental Chemistry Branch Environmental Sciences Division National Exposure Research Laboratory Office of Research and Development Environmental Protection Agency Las Vegas, Nevada 89119 [email protected] Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada Why and how do drugs contaminate the environment? What might it all mean? How do we prevent it? Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada This talk presents only a cursory overview of some of the many science issues surrounding the topic of pharmaceuticals as environmental contaminants Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada A Clarification We sometimes loosely (but incorrectly) refer to drugs, medicines, medications, or pharmaceuticals as being the substances that contaminant the environment. The actual environmental contaminants, however, are the active pharmaceutical ingredients – APIs. These terms are all often used interchangeably Office of Research and Development National Exposure Research Laboratory, Environmental Sciences Division, Las Vegas, Nevada Office of Research and Development Available: http://www.epa.gov/nerlesd1/chemistry/pharma/image/drawing.pdfNational
    [Show full text]
  • Prevalence and Safety of Off-Label Use of Chemotherapeutic Agents in Older Patients with Breast Cancer: Estimates from SEER-Medicare Data
    Supplemental online content for: Prevalence and Safety of Off-Label Use of Chemotherapeutic Agents in Older Patients With Breast Cancer: Estimates From SEER-Medicare Data Anne A. Eaton, MS; Camelia S. Sima, MD, MS; and Katherine S. Panageas, DrPH J Natl Compr Canc Netw 2016;14(1):57–65 • eAppendix 1: J-Codes Representing Intravenous Chemotherapy • eAppendix 2: Established Sequential Adjuvant Chemotherapy Regimens for Breast Cancer • eTable 1: Patient Characteristics © JNCCN—Journal of the National Comprehensive Cancer Network | Volume 14 Number 1 | January 2016 Eaton et al - 1 eAppendix 1: J-Codes Representing Intravenous Chemotherapy J-Code Agent J-Code Agent J9000 Injection, doxorubicin HCl, 10 mg J9165 Injection, diethylstilbestrol diphosphate, 250 J9001 Injection, doxorubicin HCl, all lipid mg formulations, 10 mg J9170 Injection, docetaxel, 20 mg J9010 Injection, alemtuzumab, 10 mg J9171 Injection, docetaxel, 1 mg J9015 Injection, aldesleukin, per single use vial J9175 Injection, Elliotts’ B solution, 1 ml J9017 Injection, arsenic trioxide, 1 mg J9178 Injection, epirubicin HCl, 2 mg J9020 Injection, asparaginase, 10,000 units J9179 Injection, eribulin mesylate, 0.1 mg J9025 Injection, azacitidine, 1 mg J9180 Epirubicin HCl, 50 mg J9027 Injection, clofarabine, 1 mg J9181 Injection, etoposide, 10 mg J9031 BCG (intravesical) per instillation J9182 Etoposide, 100 mg J9033 Injection, bendamustine HCl, 1 mg J9185 Injection, fludarabine phosphate, 50 mg J9035 Injection, bevacizumab, 10 mg J9190 Injection, fluorouracil, 500 mg J9040 Injection,
    [Show full text]