STATUS; INITIAL 15 MINUTES OF INTRASERVICE TIME, PATIENT AGE 5 YEARS OR OLDER

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1 Following is the 2017 HCPCS, which will be implemented on January 1, The inclusion of a procedure code does not necessarily indicate that it will be a covered procedure. This listing contains the addition, revision and deletion of codes, with a cross-reference provided when possible. The descriptors for the CPT national codes can be obtained from several sources, including the AMA. Visit the AMA s web site at or call them at (800) The alpha-numeric codes with descriptors is located on the Provider Resource Center under Claims, Payment & Reimbursement at the link titled HCPCS Alpha Numeric Codes. While the entire listing is extremely important, please note in particular the following changes: Conscious Sedation Codes Beginning January 1, 2017, the AMA is making significant changes to how providers are being reimbursed for conscious sedation. Due to the fact that codes previously included conscious sedation in the standard fee and going forward will not, we will be evaluating our currents fees for these impacted codes and making adjustments as appropriate. Going forward, providers rendering services for conscious sedation should use the appropriate code listed below based on the services provided. CODE TERMINOLOGY MODERATE SEDATION SERVICES PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTIC SERVICE THAT THE SEDATION SUPPORTS, REQUIRING THE PRESENCE OF AN INDEPENDENT TRAINED OBSERVER TO ASSIST IN THE MONITORING OF THE PATIENT'S LEVEL OF CONSCIOUSNESS AND PHYSIOLOGICAL STATUS; INITIAL 15 MINUTES OF INTRASERVICE TIME, PATIENT YOUNGER THAN 5 YEARS OF AGE QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTIC SERVICE THAT THE SEDATION SUPPORTS, REQUIRING THE PRESENCE OF AN INDEPENDENT TRAINED OBSERVER TO ASSIST IN THE MONITORING OF THE PATIENT'S LEVEL OF CONSCIOUSNESS AND PHYSIOLOGICAL STATUS; INITIAL 15 MINUTES OF INTRASERVICE TIME, PATIENT AGE 5 YEARS OR OLDER MODERATE SEDATION SERVICES PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR 1

2 THERAPEUTIC SERVICE THAT THE SEDATION SUPPORTS, REQUIRING THE PRESENCE OF AN INDEPENDENT TRAINED OBSERVER TO ASSIST IN THE MONITORING OF THE PATIENT'S LEVEL OF CONSCIOUSNESS AND PHYSIOLOGICAL STATUS; EACH ADDITIONAL 15 MINUTES INTRASERVICE TIME (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE) MODERATE SEDATION SERVICES PROVIDED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL OTHER THAN THE PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTIC SERVICE THAT THE SEDATION SUPPORTS; INITIAL 15 MINUTES OF INTRASERVICE TIME, PATIENT YOUNGER THAN 5 YEARS OF AGE MODERATE SEDATION SERVICES PROVIDED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL OTHER THAN THE PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTIC SERVICE THAT THE SEDATION SUPPORTS; INITIAL 15 MINUTES OF INTRASERVICE TIME, PATIENT AGE 5 YEARS OR OLDER MODERATE SEDATION SERVICES PROVIDED BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL OTHER THAN THE PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTIC SERVICE THAT THE SEDATION SUPPORTS; EACH ADDITIONAL 15 MINUTES INTRASERVICE TIME (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE) G0500 MODERATE SEDATION SERVICES PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING A GASTROINTESTINAL ENDOSCOPIC SERVICE THAT SEDATION SUPPORTS, REQUIRING THE PRESENCE OF AN INDEPENDENT TRAINED OBSERVER TO ASSIST IN THE MONITORING OF THE PATIENT'S LEVEL OF CONSCIOUSNESS AND PHYSIOLOGICAL STATUS; INITIAL 15 MINUTES OF INTRA-SERVICE TIME; PATIENT AGE 5 YEARS OR OLDER (ADDITIONAL TIME MAY BE REPORTED WITH 99153, AS APPROPRIATE) Multiple Procedure Payment Reduction (MPPR) for Certain Diagnostic Imaging Procedures Highmark currently applies the MPPR of 25 percent to the Professional Component of certain diagnostic imaging procedures. 2

3 Effective January 1, 2017, Highmark will only apply a lower MPPR of 5 percent for the Professional Component of each additional procedure furnished by the same physician (or physician in the same group practice) to the same patient, in the same session on the same day. New Bundled Mammography and CAD Codes Codes 77051, 77052, 77055, 77056, and were deleted and three new codes were created to bundle mammography and computer-aided detection (CAD) services. Code is unilateral mammography with CAD; code is bilateral mammography with CAD; and code is bilateral screening mammography with CAD. New G Codes (G0493-G0496) The following G codes will be non-covered as they are primarily related to facility based services: CODE G0493 G0494 G0495 G0496 TERMINOLOGY SKILLED SERVICES OF A REGISTERED NURSE (RN) FOR THE OBSERVATION AND ASSESSMENT OF THE PATIENT'S CONDITION, EACH 15 MINUTES (THE CHANGE IN THE PATIENT'S CONDITION REQUIRES SKILLED NURSING PERSONNEL TO IDENTIFY AND EVALUATE THE PATIENT'S NEED FOR POSSIBLE MODIFICATION OF TREATMENT IN THE HOME HEALTH OR HOSPICE SETTING) SKILLED SERVICES OF A LICENSED PRACTICAL NURSE (LPN) FOR THE OBSERVATION AND ASSESSMENT OF THE PATIENT'S CONDITION, EACH 15 MINUTES (THE CHANGE IN THE PATIENT'S CONDITION REQUIRES SKILLED NURSING PERSONNEL TO IDENTIFY AND EVALUATE THE PATIENT'S NEED FOR POSSIBLE MODIFICATION OF TREATMENT IN THE HOME HEALTH OR HOSPICE SETTING) SKILLED SERVICES OF A REGISTERED NURSE (RN), IN THE TRAINING AND/OR EDUCATION OF A PATIENT OR FAMILY MEMBER, IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES SKILLED SERVICES OF A LICENSED PRACTICAL NURSE (LPN), IN THE TRAINING AND/OR EDUCATION OF A PATIENT OR FAMILY MEMBER, IN THE HOME HEALTH OR HOSPICE SETTING, EACH 15 MINUTES 3

4 New Modifier FX CMS has established modifier FX to be reported to indicate that an imaging service that is an X-ray, was taken using film equipment. CMS plans to apply a 20% payment reduction to the technical component (and the technical component of the global fee) to services reported with the FX modifier. Highmark plans to implement a similar reduction for Commercial and Medicare Advantage products in the future, and will provide additional information when available. Pathology and Laboratory CMS has deleted the drug assay codes and established three new codes for reporting presumptive drug testing. These three codes are reported once per day of service regardless of the number of that type of test performed. Listed below are the codes and terminology: CODE TERMINOLOGY DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES (EG, IMMUNOASSAY); CAPABLE OF BEING READ BY DIRECT OPTICAL OBSERVATION ONLY (EG, DIPSTICKS, CUPS, CARDS, CARTRIDGES) INCLUDES SAMPLE VALIDATION WHEN PERFORMED, PER DATE OF SERVICE DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES (EG, IMMUNOASSAY); READ BY INSTRUMENT ASSISTED DIRECT OPTICAL OBSERVATION (EG, DIPSTICKS, CUPS, CARDS, CARTRIDGES), INCLUDES SAMPLE VALIDATION WHEN PERFORMED, PER DATE OF SERVICE DRUG TEST(S), PRESUMPTIVE, ANY NUMBER OF DRUG CLASSES, ANY NUMBER OF DEVICES OR PROCEDURES, BY INSTRUMENT CHEMISTRY ANALYZERS (EG, UTILIZING IMMUNOASSAY [EG, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), CHROMATOGRAPHY (EG, GC, HPLC), AND MASS SPECTROMETRY EITHER WITH OR WITHOUT CHROMATOGRAPHY, (EG, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC- MS/MS, LDTD, MALDI, TOF) INCLUDES SAMPLE VALIDATION WHEN PERFORMED, PER DATE OF SERVICE 4

5 Ophthalmology Codes and were revised to state they would be used for unilateral or bilateral therefore, it would not be appropriate to report the bilateral modifier. Listed below are the codes and terminology: CODE TERMINOLOGY FLUORESCEIN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETAT7ION AND REPORT, UNILATERAL AND BILATERAL INDOCYANIN7E-GREEN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND REPORT, UNILATERAL OR BILATERAL Physical Medicine and Rehabilitation The AMA added new subsections for Physical Therapy Evaluations, Occupational Therapy Evaluations, and Athletic Training Evaluations with new codes and levels of complexity (low, moderate and high) for the evaluation services. New codes for re-evaluations were also added including requirements for when they can be reported. The definitions of the levels of complexity for these codes are different from those in the E/M codes. Code is for the physical therapy evaluation with low level of complexity, is the PT evaluation with moderate level complexity, is for the PT evaluation with high level complexity, and is for the PT re-evaluation. Code is for the occupational therapy evaluation with low level of complexity, is the OT evaluation with moderate level complexity, is for the OT evaluation with high level complexity, and is for the OT re-evaluation. Code is for the athletic training evaluation with low level of complexity, is the AT evaluation with moderate level complexity, is for the AT evaluation with high level complexity, and is for the AT re-evaluation. Procedure codes have been deleted. AMA directs providers to report these deleted codes using procedure codes 97161, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 97169, 97170, 97171,

6 CODE DESCRIPTION PHSYICAL THERAPY EVALUATION: LOW COMPLEXITY, REQUIRING THESE COMPONENTS: -A HISTORY WITH NO PERSONAL FACTORS AND/OR COMORBIDITIES THAT IMPACT THE PLAN OF CARE; -AN EXAMINATION OF BODY SYSTEM(S) USING STANDARDIZED TESTS AND MEASURES ADDRESSING 1-2 ELEMENTS FROM ANY OF THE FOLLOWING: BODY STRUCTURES AND FUNCTIONS, ACTIVITY LIMITATIONS, AND/OR PARTICIPATION RESTRICTIONS; - A CLINICAL PRESENTATION WITH STABLE AND/OR UNCOMPLICATED CHARACTERISTICS; AND -CLINICAL DECISION MAKING OF LOW COMPLEXITY USING STANDARDIZED PATIENT ASSESSMENT INSTRUMENT AND/OR MEASURABLE ASSESSMENT OF FUNCTIONAL OUTCOME. TYPICALLY, 20 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY PHYSICAL THERAPY EVALUATION: MODERATE COMPLEXITY, REQUIRING THESE COMPONENTS: -A HISTORY OF PRESENT PROBLEM WITH 1-2 PERSONAL FACTORS AND/OR COMORBIDITIES THAT IMPACT THE PLAN OF CARE -AN EXAMINATION OF BODY SYSTEMS USING STANDARDIZED TESTS AND MEASURES IN ADDRESSING A TOTAL OF 3 OR MORE ELEMENTS FROM ANY OF THE FOLLOWING: BODY STRUCTURES AND FUNCTIONS, ACTIVITY LIMITATIONS, AND/OR PARTICIPATION RESTRICTIONS; -AN EVOLVING CLINICAL PRESENTATION WITH CHANGING CHARACTERISTICS; AND - CLINICAL DECISION MAKING OF MODERATE COMLEXITY USING STANDARDIZED PATIENT ASSESSMENT INSTRUMENT AND/OR MEASURABLE ASSESSMENT OF FUNCTIONAL OUTCOME. TYPICALLY, 30 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY PHYSICAL THERAPY EVALUATION: HIGH COMPLEXITY, REQUIRING THESE COMPONENTS: -A HISTORY OF PRESENT PROBLEM WITH 3 OR MORE PERSONAL FACTORS AND/OR COMORBIDITIES THAT IMPACT THE PLAN OF CARE; -AN EXAMINATION OF BODY SYSTEMS USING STANDARDIZED TESTS AND MEASURES ADDRESSING A TOTAL OF 4 OR MORE ELEMENTS FROM ANY OF THE FOLLOWING: BODY STRUCTURES AND FUNCTIONS, ACTIVITY LIMITATIONS, AND/OR PARTICIPATION RESTRICTIONS; -A CLINICAL PRESENTATION WITH UNSTABLE AND UNPREDICTABLE CHARACTERISTICS; AND -CLINICAL DECISION MAKING OF HIGH COMPLEXITY USING STANDARDIZED PATIENT ASSESSMENT INSTRUMENT AND/OR MEASURABLE ASSESSMENT OF FUNCTIONAL OUTCOME. TYPICALLY, 45 MINUTES ARE SPENT FACE- TO-FACE WITH THE PATIENT AND/OR FAMILY. 6

7 97164 RE-EVALUATION OF PHYSICAL THERAPY ESTABLISHED PLAN OF CARE, REQUIRING THESE COMPONENTS: -AN EXAMINATION INCLUDING A REVIEW OF HISTORY AND USE OF STANDARDIZED TESTS AND MEASURES IS REQUIRED; AND -REVISED PLAN OF CARE USING A STANDARDIZED PATIENT ASSESSMENT INSTRUMENT AND/OR MEASURABLE ASSESSMENT OF FUNCTIONAL OUTCOME. TYPICALLY, 20 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY OCCUPATIONAL THERAPY EVALUATION, LOW COMPLEXITY, REQUIRING THESE COMPONENTS: -AN OCCUPATION PROFILE AND MEDICAL AND THERAPY HISTORY, WHICH INCLUDES A BRIEF HISTORY INCLUDING REVIEW OF MEDICAL AND/OR THERAPY RECORDS RELATING TO THE PRESENTING PROBLEM; -AN ASSESSMENT(S) THAT IDENTIFIES 1-3 PERFORMANCE DEFICITS (IE, RELATING TO PHYSICAL, COGNITIVE, OR PSYCHOSOCIAL SKILLS) THAT RESULT IN ACTIVITY LIMITATIONS AND/OR PARTICIPATION RESTRICTIONS; AND -CLINICAL DECISION MAKING OF LOW COMPLEXITY, WHICH INCLUDES AN ANALYSIS OF THE OCCUPATIONAL PROFILE, ANALYSIS OF DATA FROM PROBLEM-FOCUSED ASSESSMENT(S), AND CONSIDERATION OF A LIMITED NUMBER OF TREATMENT OPTIONS. PATIENT PRESENTS WITH NO COMORBIDITIES THAT AFFECT OCCUPATIONAL PERFORMANCE. MODIFICATION OF TAKS OR ASSISTANCE (EG, PHYSICAL OR VERBAL) WITH ASSESSMENT(S) IS NOT NECESSARY TO ENABLE COMPLETION OF EVALUATION COMPONENT. TYPICALLY, 30 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY OCCUPATIONAL THERAPY EVALUATION, MODERATE COMPLEXITY, REQUIRING THESE COMPONENTS: -AN OCCUPATIONAL PROFILE AND MEDICAL AND THERAPY HISTORY, WHICH INCLUDES AN EXPANDED REVIEW OF MEDICAL AND/OR THERAPY RECORDS AND ADDITIONAL REVIEW OF PHSYICAL, COGNITIVE, OR PSYCHOSOCIAL HISTORY RELATED TO CURRENT FUNCTIONAL PERFORMANCE; -AN ASSESSMENT(S) THAT IDENTIFIES 3-5 PERFORMANCE DEFICITS (IE, RELATING TO PHYSICAL, COGNITIVE, OR PSYCHOSOCIAL SKILLS) THAT RESULT IN ACTIVITY LIMITATIONS AND/OR PARTICIPATION RESTRICTIONS; AND -CLINICAL DECISION MAKING OF MODERATE ANALYTIC COMPLEXITY, WHICH INCLUDES AN ANALYSIS OF THE OCCUPATIONAL PROFILE, ANALYSIS OF DATA FROM DETAILED ASSESSMENT(S), AND CONSIDERATION OF SEVERAL TREATMENT OPTIONS. PATIENT MAY PRESENT WITH COMORBIDITIES THAT AFFECT OCCUPATIONAL PERFORMANCE. MINIMAL TO MODERATE MODIFICATION OF TAKS OR ASSISTANCE (EG, PHYSICAL OR VERBAL) WITH ASSESSMENT(S) IS NECESSARY TO ENABLE PATIENT TO COMPLETE EVALUATION COMPONENT. TYPICALLY, 45 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY. 7

8 97167 OCCUPATIONAL THERAPY EVLUATION, HIGH COMPLEXITY, REQUIRING THESE COMPONENTS: -AN OCCUPATIONAL PROFILE AND MEDICAL AND THERAPY HISTORY, WHICH INCLUDES REVIEW OF MEDICAL AND/OR THERAPY RECORDS AND EXTENSIVE ADDITIONAL REVIEW OF PHSYICAL, COGNITIVE, OR PSYCHOSOCIAL HISTORY RELATED TO CURRENT FUNCTIONAL PERFORMANCE; -AN ASSESSMENT(S) THAT IDENTIFIES 5 OR MORE PERFORMANCE DEFICITS (IE, RELATING TO PHYSICAL, COGNITIVE, OR PSYCHOSOCIAL SKILLS) THAT RESULT IN ACTIVITY LIMITATIONS AND/OR PARTICIPATION RESTRICTIONS; AND -CLINICAL DECISION MAKING OF HIGH ANALYTIC COMPLEXITY, WHICH INCLUDES AN ANALYSIS OF THE PATIENT PROFILE, ANALYSIS OF DATA FROM COMPREHENSIVE ASSESSMENT(S), AND CONSIDERATION OF MULTIPLE TREATMENT OPTIONS. PATIENT PRESENTS WITH COMORBIDITIES THAT AFFECT OCCUPATIONAL PERFORMANCE. SIGNIFICANT MODIFICATION OF TASKS OR ASSISTANCE (EG, PHYSICAL OR VERBAL) WITH ASSESSMENT(S) IS NECESSARY TO ENABLE PATIENT TO COMPLETE EVALUATION COMPONENT. TYPICALLY, 60 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY RE-EVALUATION OF OCCUPATIONAL THERAPY ESTABLISHED PLAN OF CARE, REQUIRING THESE COMPONENTS: -AN ASSESSMENT OF CHANGES IN PATIENT FUNCTIONAL OR MEDICAL STATUS WITH REVISED PLAN OF CARE; -AN UPDATE TO THE INITIAL OCCUPATIONAL PROFILE TO RELFECT CHANGES IN CONDITION OR ENVIRONMENT THAT AFFECT FUTURE INTERVENTIONS AND/OR GOALS; AND -A REVISED PLAN OF CARE. A FORMAL REEVALUATION IS PERFORMED WHEN THERE IS A DOCUMENTED CHANGE IN FUNCTIONAL STATUS OR A SIGNIFICANT CHANGE TO THE PLAN OF CARE IS REQUIRED. TYPICALLY, 30 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY ATHLETIC TRAINING EVALUATION, LOW COMPLEXITY, REQUIRING THESE COMPONENTS: -A HISTORY AND PHSYICAL ACTIVITY PROFILE WITH NO COMORBIDITIES THAT AFFECT PHSYICAL ACTIVITY; -AN EXAMINATION OF AFFECTED BODY AREA AND OTHER SYMPTOMATIC OR RELATED SYSTEMS ADDRESSING 1-2 ELEMENTS FROM ANY OF THE FOLLOWING: BODY STRUCTURES, PHSYICAL ACTIVITY, AND/OR PARTICIPATION DEFICIENCIES; AND -CLINICAL DECISION MAKING OF LOW COMPLEXITY USING STANDARDIZED PATIENT ASSESSMENT INSTRUMENT AND/OR MEASURABLE ASSESSMENT OF FUNCTIONAL OUTCOME. TYPICALLY, 15 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY. 8

9 97170 ATHLETIC TRAINING EVALUATION, MODERATE COMPLEXITY, REQUIRING THESE COMPONENTS: -A MEDICAL HISTORY AND PHSYICAL ACTIVITY PROFILE WITH 1-2 COMORBIDITIES THAT AFFECT PHSYICAL ACTIVITY; -AN EXAMINATION OF AFFECTED BODY AREA AND OTHER SYMPTOMATIC OR RELATED SYSTEMS ADDRESSING A TOTAL OF 3 OR MORE ELEMENTS FROM ANY OF THE FOLLOWING: BODY STRUCTURES, PHSYICAL ACTIVITY, AND/OR PARTICIPATION DEFICIENCIES; AND -CLINICAL DECISION MAKING OF MODERATE COMPLEXITY USING STANDARDIZED PATIENT ASSESSMENT INSTRUMENT AND/OR MEASURABLE ASSESSMENT OF FUNCTIONAL OUTCOME. TYPICALLY, 30 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY ATHLETIC TRAINING EVALUATION, HIGH COMPLEXITY, REQUIRING THESE COMPONENTS: -A MEDICAL HISTORY AND PHYSICAL ACTIVITY PROFILE, WITH 3 OR MORE COMORBIDITIES THAT AFFECT PHSYICAL ACTIVITY; -A COMPREHENSIVE EXAMINATION OF BODY SYSTEMS USING STANDARDIZED TESTS AND MEASURES ADDRESSING A TOTAL OF 4 OR MORE ELEMENTS FROM ANY OF THE FOLLOWING: BODY STRUCTURES, PHYSICAL ACTIVITY, AND/OR PARTICIPATION DEFICIENCIES; - CLINICAL PRESENTATION WITH UNSTABLE AND UNPREDICTABLE CHARACTERISTICS; AND -CLINICAL DECISION MAKING OF HIGH COMPLEXITY USING STANDARDIZED PATIENT ASSESSMENTOF FUNCTIONAL OUTCOME. TYPICALLY, 45 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY RE-EVALUATION OF ATHLETIC TRAINING ESTABLISHED PLAN OF CARE REQUIRING THESE COMPONENTS: -AN ASSESSMENT OF PATIENT'S CURRENT FUNCTIONAL STATUS WHEN THERE IS A DOCUMENTED CHANGE; AND -A REVISED PLAN OF CARE USING A STANDARDIZED PATIENT ASSESSMENT INSTRUMENT AND/OR MEASURABLE ASSESSMENT OF FUNCTIONAL OUTCOME WITH AN UPDATE IN MANAGEMENT OPTIONS, GOALS, AND INTERVENTIONS. TYPICALLY, 20 MINUTES ARE SPENT FACE- TO-FACE WITH THE PATIENT AND/OR FAMILY. 9

10 ADDITIONS T 0447T 0448T 0449T 0450T 0451T 0452T 0453T 0454T 0455T 0456T 0457T 0458T 0459T 0460T 0461T 0462T 0463T 0464T 0465T 0466T 0467T 0468T A4224 A4225 A4467 A4553 A9285 A9286 A9515 A9587 A9588 A9597 A9598 C1889 C9140 C9482 C9483 G0491 G0492 G0493 G0494 G0495 G0496 G0499 G0500 G0501 G0502 G0503 G0504 G0505 G0506 G0507 G0508 G0509 G9687 G9688 G9689 G9690 G9691 G9692 G9693 G9694 G9695 G9696 G9697 G9698 G9699 G9700 G9701 G9702 G9703 G9704 G9705 G9706 G9707 G9708 G9709 G9710 G9711 G9712 G9713

11 ADDITIONS G9714 G9715 G9716 G9717 G9718 G9719 G9720 G9721 G9722 G9723 G9724 G9725 G9726 G9727 G9728 G9729 G9730 G9731 G9732 G9733 G9734 G9735 G9736 G9737 G9738 G9739 G9740 G9741 G9742 G9743 G9744 G9745 G9746 G9747 G9748 G9749 G9750 G9751 G9752 G9753 G9754 G9755 G9756 G9757 G9758 G9759 G9760 G9761 G9762 G9763 G9764 G9765 G9766 G9767 G9768 G9769 G9770 G9771 G9772 G9773 G9774 G9775 G9776 G9777 G9778 G9779 G9780 G9781 G9782 G9783 G9784 G9785 G9786 G9787 G9788 G9789 G9790 G9791 G9792 G9793 G9794 G9795 G9796 G9797 G9798 G9799 G9800 G9801 G9802 G9803 G9804 G9805 G9806 G9807 G9808 G9809 G9810 G9811 G9812 G9813 G9814 G9815 G9816 G9817 G9818 G9819 G9820 G9821 G9822 G9823 G9824 G9825 G9826 G9827 G9828 G9829 G9830 G9831 G9832 G9833 G9834 G9835 G9836 G9837 G9838 G9839 G9840 G9841 G9842 G9843 G9844 G9845 G9846 G9847 G9848 G9849 G9850 G9851 G9852 G9853 G9854 G9855 G9856 G9857 G9858 G9859 G9860 G9861 G9862 J0570 J0883 J0884 J1130 J1942 J2182 J2786 J2840 J7175 J7179 J7202 J7207 J7209 J7320 J7322 J7342 J8670 J9034 J9145 J9176 J9205 J9295 J9325 J9352 L1851 L1852 Q4166 Q4167 Q4168 Q4169 Q4170

12 Q4171 Q4172 Q4173 Q4174 Q4175 T1040 T1041 ADDITIONS 2017 Modifiers -95 -FX -PN -V1 -V2 -V3 12

13 REVISIONS T 0275T 4151F A4221 A9599 B9002 E0627 E0629 E0740 E0967 E0995 E2206 E2220 E2221 E2222 E2224 G0202 G0204 G0206 G8427 G8428 G8430 G8431 G8432 G8433 G8510 G8511 G8598 G8599 G8649 G8653 G8655 G8656 G8657 G8658 G8659 G8660 G8661 G8662 G8665 G8669 G8671 G8672 G8673 G8674 G8697 G8815 G8924 G8925 G8968 G9229 G9231 G9232 G9239 G9264 G9307 G9308 G9326 G9327 G9359 G9361 G9381 G9416 G9417 G9497 G9500 G9501 G9519 G9520 G9531 G9532 G9547 G9549 G9551 G9554 G9555 G9556 G9557 G9584 G9585 G9595 G9596 G9607 G9609 G9610 G9611 G9625 G9626 G9627 G9628 G9629 G9630 G9632 G9633 G9642 J0573 J1745 J3357 J7201 J7297 J7298 J7301 J7340 J9033 K0019 K0037 K0042 K0043 K0044 K0045 K0046 K0047 K0050 K0051 K0052

14 REVISIONS 2017 K0069 K0071 K0072 K0077 K0098 K0552 L1906 P9072 Q2039 Q4105 Q4131 Modifiers -PO -Q

15 DELETIONS M 0019T 0169T 0171T 0172T 0281T 0282T 0283T 0284T 0285T 0286T 0287T 0289T 0291T 0292T 0336T 0392T 0393T A4466 A9544 A9545 B9000 C9121 C9137 C9138 C9139 C9349 C9461 C9470 C9471 C9472 C9473 C9474 C9475 C9476 C9477 C9478 C9479 C9480 C9481 C9742 C9800 E0628 G0163 G0164 G0389 G3001 G8401 G8458 G8460 G8461 G8485 G8486 G8487 G8489 G8490 G8491 G8494 G8495 G8496 G8497 G8498 G8499 G8500 G8544 G8545 G8548 G8549 G8551 G8634 G8645 G8646 G8725 G8726 G8728 G8757 G8758 G8759 G8761 G8762 G8765 G8784 G8848 G8853 G8868 G8898 G8899 G8900 G8902 G8903 G8906 G8927 G8928 G8929 G8940 G8948 G8953 G8977 G9203 G9204 G9205 G9206 G9207 G9208 G9209 G9210 G9211 G9217 G9219 G9222 G9233 G9234 G9235 G9236 G9237 G9238 G9244

16 DELETIONS 2017 G9245 G9324 G9435 G9436 G9437 G9438 G9439 G9440 G9441 G9442 G9443 G9463 G9464 G9465 G9466 G9467 G9499 G9572 G9581 G9619 G9650 G9652 G9653 G9657 G9667 G9669 G9670 G9671 G9672 G9673 G9677 J0760 J1590 K0901 K0902 Q4119 Q4120 Q4129 Q9980 Q9981 Modifiers -L1 16