Medicare Data Utilities Appendices

G0156 SERVICES OF HOME HEALTH AIDE IN HOME HEALTH SETTING, EACH 15 MINUTES
G0159 PERCUTANEOUS THROMBECTOMY AND/OR REVISION, ARTERIOVENOUS FISTULA, AUTOGENOUS OR
NONAUTOGENOUS DIALYSIS GRAFT
G0160 CRYOSURGICAL ABLATION OF LOCALIZED PROSTATE CANCER, PRIMARY TREATMENT ONLY
(POST OPERATIVE IRRIGATIONS AND ASPIRATION OF SLOUGHING TISSUE INCLUDED)
G0161 ULTRASONIC GUIDANCE FOR INTERSTITIAL PLACEMENT OF CRYOSURGICAL PROBES
G0163 POSITRON EMISSION TOMOGRAPHY (PET), WHOLE BODY, FOR RECURRENCE OF COLORECTAL
METASTATIC CANCER
G0164 POSITRON EMISSION TOMOGRAPHY (PET), WHOLE BODY, FOR STAGING AND
CHARACTERIZATION OF LYMPHOMA
G0165 POSITRON EMISSION TOMOGRAPHY (PET), WHOLE BODY, FOR RECURRENCE OF MELANOMA OR
MELANOMA METASTATIC CANCER
G0166 EXTERNAL COUNTERPULSATION, PER TREATMENT SESSION
G0167 HYPERBARIC OXYGEN TREATMENT NOT REQUIRING PHYSICIAN ATTENDANCE, PER TREATMENT
SESSION
G0168 WOUND CLOSURE UTILIZING TISSUE ADHESIVE(S) ONLY
G0169 REMOVAL OF DEVITALIZED TISSUE, WITHOUT USE OF ANESTHESIA (CONSCIOUS SEDATION,
LOCAL, REGIONAL, GENERAL)
G0170 APPLICATION OF TISSUE CULTURED SKIN GRAFTS, INCLUDING BILAMINATE SKIN
SUBSTITUTES OR NEODERMIS, INCLUDING SITE PREPARATION, INITIAL 25 SQ CMS
G0171 APPLICATION OF TISSUE CULTURED SKIN GRAFTS, INCLUDING BILAMINATE SKIN
SUBSTITUTES OR NEODERMIS, INCLUDING SITE PREPARATION, EACH ADDITIONAL 25 SQ CMS
G0172 TRAINING AND EDUCATIONAL SERVICES FURNISHED AS A COMPONENT OF A PARTIAL
HOSPITALIZATION TREATMENT PROGRAM, PER DAY
G0173 STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION
G0174 [IMRT] INTENSITY MODULATED RADIATION THERAPY PLAN, PER SESSION
G0175 SCHEDULED INTERDISCIPLINARY TEAM CONFERENCE (MINIMUM OF THREE EXCLUSIVE OF
PATIENT CARE NURSING STAFF) WITH PATIENT PRESENT
G0176 ACTIVITY THERAPY, SUCH AS MUSIC, DANCE, ART OR PLAY THERAPIES NOT FOR
RECREATION, RELATED TO THE CARE AND TREATMENT OF PATIENT’S DISABLING MENTAL
HEALTH PROBLEMS, PER SESSION (45 MINUTES OR MORE)
G0177 TRAINING AND EDUCATIONAL SERVICES RELATED TO THE CARE AND TREATMENT OF
PATIENT’S DISABLING MENTAL HEALTH PROBLEMS PER SESSION (45 MINUTES OR MORE)
G0178 INTENSITY MODULATED RADIATION THERAPY (IMRT) DELIVERY TO MULTIPLE AREAS WITH
TREATMENT SETUP AND VERIFICATION IMAGES
G0179 INTENSITY MODULATED RADIATION THERAPY (IMRT) PLANNING, INCLUDES DOSE VOLUME
NISTOGRAMS, INVERSE PLAN OPTIMIZATION, PLAN POSITIONAL ACCURACY AND DOSE
VERIFICATION
G0180 PHYSICIAN CERTIFICATION SERVICES FOR MEDICARE-COVERED SERVICES PROVIDED BY A
PARTICIPATING HOME HEALTH AGENCY (PATIENT NOT PRESENT), INCLUDING REVIEW OF
INITIAL OR SUBSEQUENT REPORTS OF PATIENT STATUS, REVIEW OF PATIENT’S RESPONSES
TO THE OASIS ASSESSMENT INSTRUMENT, CONTACT WITH THE HOME HEALTH AGENCY TO
ASCERTAIN THE INITIAL IMPLEMENTATION PLAN OF CARE, AND DOCUMENTATION IN THE
PATIENT’S OFFICE RECORD, PER CERTIFICATION PERIOD
G0181 PHYSICIAN SUPERVISION OF A PATIENT RECEIVING MEDICARE-COVERED SERVICES PROVIDED
BY A PARTICIPATING HOME HEALTH AGENCY (PATIENT NOT PRESENT) REQUIRING COMPLEX
AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING REGULAR PHYSICIAN DEVELOPMENT
AND/OR REVISION OF CARE PLANS, REVIEW OF SUBSEQUENT REPORTS OF PATIENT STATUS,
REVIEW OF LABORATORY AND OTHER STUDIES, COMMUNICATION (INCLUDING TELEPHONE
CALLS) WITH OTHER HEALTH CARE PROFESSIONALS INVOLVED IN THE PATIENT’S CARE,
INTEGRATION OF NEW INFORMATION INTO THE MEDICAL TREATMENT PLAN AND/OR
ADJUSTMENT OF MEDICAL THERAPY, WITHIN A CALENDAR MONTH, 30 MINUTES OR MORE
G0182 PHYSICIAN SUPERVISION OF A PATIENT UNDER A MEDICARE-APPROVED HOSPICE (PATIENT
NOT PRESENT) REQUIRING COMPLEX AND MULTIDISCIPLINARY CARE MODALITIES INVOLVING
REGULAR PHYSICIAN DEVELOPMENT AND/OR REVISION OF CARE PLANS, REVIEW OF
SUBSEQUENT REPORTS OF PATIENT STATUS, REVIEW OF LABORATORY AND OTHER STUDIES,
COMMUNICATION (INCLUDING TELEPHONE CALLS) WITH OTHER HEALTH CARE PROFESSIONALS