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Official Description

Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery
Short Descr Recon, cta for surg plan
Coverage Carrier Priced
Pricing Indicator(s) 11 – Physician Fee Schedule - Price established using national RVUs
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS I2B – Advanced imaging - CAT/CT/CTA: other
TOS Code(s) 4 – Diagnostic radiology
Added Date 1/1/2003
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 3 - Technical Component Only Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 01 - Procedure must be performed under the general supervision of a physician.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
MUE 1
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 189 - Contrast aortogram
GC This service has been performed in part by a resident under the direction of a teaching physician
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
FS Split (or shared) evaluation and management visit
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
MH Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Date
Action
Notes
2003-01-01 Added Code added 1/1/2003
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