Services Bundled Into Treatment Management Codes

70.2 - Services Bundled Into Treatment Management Codes (Rev. 4267, Issued: 03-27-19, Effective: 01-01-19, Implementation: 03-25-19) A/B MACs (B) do not make separate payment for services rendered by the radiation oncologists or in conjunction with radiation therapy. 11920 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin; 6.0 sq. cm or less 11921 6.11 to 20.0 sq. cm 11922 Each additional 20.0 sq. cm 16000 Initial treatment, first-degree burn, when no more than local treatment is required 16010 Dressings and/or debridement, initial or subsequent; under anesthesia, small 16015 Under anesthesia, medium or large, or with major debridement 16020 Without anesthesia, office or hospital, small 16025 Without anesthesia, medium (e.g., whole face or whole extremity) 16030 Without anesthesia, large (e.g., more than one extremity) 36425 Venipuncture, cut down age 1 or over 53670 Catheterization, urethra; simple 53675 Complicated (may include difficult removal of balloon catheter) 99211 Office or other outpatient visit, established patient; Level I* 99212 Level II* 99213 Level III* 99214 Level IV 99215 Level V 99238 Hospital discharge day management 99281 Emergency department visit, new or established patient; Level I 99282 Level II 99283 Level III 99284 Level IV 99285 Level V 90780 IV Infusion therapy, administered by physician or under direct supervision of physician; up to one hour 90781 Each additional hour, up to 8 hours 90847 Family medical psychotherapy (conjoint psychotherapy) by a physician, with continuing medical diagnostic evaluation, and drug management when indicated 99050 Services requested after office hours in addition to basic service 99052 Services requested between 10:00 PM and 8:00 AM in addition to basic service 99054 Services requested on Sundays and holidays in addition to basic service 99058 Office services provided on an emergency basis 99071 Educational supplies, such as books, tapes, and pamphlets, provided by the physician for the patient’s education at cost to physician 99090 Analysis of information data stored in computers (e.g., ECG, blood pressures, hematologic data) 99185 Hypothermia; regional 99371 Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other health care professionals; simple or brief (e.g., to report on tests and/or laboratory results, to clarify or alter previous instructions, to integrate new information from other health professionals into the medical treatment plan, or to adjust therapy) 99372 Intermediate (e.g., to provide advice to an established patient on a new problem, to initiate therapy that can be handled by telephone, to discuss test results in detail, to coordinate medical management of a new problem in an established patient, to discuss and evaluate new information and details, or to initiate a new plan of care) 99373 Complex or lengthy (e.g., lengthy counseling session with anxious or distraught patient, detailed or prolonged discussion with family members regarding seriously ill patient, lengthy communication necessary to coordinate complex services or several different health professionals working on different aspects of the total patient care plan) • Anesthesia (whatever code billed) • Care of Infected Skin (whatever code billed) • Checking of Treatment Charts • Verification of Dosage, As Needed (whatever code billed) • Continued Patient Evaluation, Examination, Written Progress Notes, As Needed (whatever code billed) • Final Physical Examination (whatever code billed) • Medical Prescription Writing (whatever code billed • Nutritional Counseling (whatever code billed) • Pain Management (whatever code billed) • Review & Revision of Treatment Plan (whatever code billed) • Routine Medical Management of Unrelated Problem (whatever code billed) • Special Care of Ostomy (whatever code billed) • Written Reports, Progress Note (whatever code billed) • Follow-up Examination and Care for 90 Days After Last Treatment (whatever code billed) *NOTE: May be billed with Radiation Treatment Delivery, superficial and/or ortho voltage, for the purpose of reporting physician services consisting of radiation therapy planning (including, but not limited to clinical treatment planning, isodose planning, physics consultation), radiation treatment device construction, and radiation treatment management when performed on the same date of service as treatment delivery. Billing with modifier 25 may be necessary if National Correct Coding Initiative (NCCI) edits apply.