Health Evidence Review Commission's Value-based Benefits Subcommittee

Straightforward Issues—March, 2016
Code Code Description Line(s) Involved Issue Recommendation(s)
92507-
92508
92526
92607-
92609
92633
Inpatient
and ICU
codes
Speech therapy services
501 CALCIUM PYROPHOSPHATE
DEPOSITION DISEASE (CPPD) AND
HYDROXYAPETITE DEPOSITION
DISEASE
A series of CPT codes for speech
therapy appear on line 501 with
no diagnosis which is appropriate
to pair.
Inpatient and ICU and similar
codes appear on this line and are
not appropriate.
Remove 92507-92508, 92526,
92607-92609, and 92633 from line
501
Remove all CPT codes for inpatient
care.
E11.49
E11.59
E11.628
Type 2 diabetes mellitus with
other diabetic neurological
complication
Type 2 diabetes mellitus with
other circulatory
complications
Type 2 diabetes mellitus with
other skin complications
169 PREVENTIVE FOOT CARE IN
HIGH RISK PATIENTS
HSD requested that E11.49 and
E11.59 and E11.628 pair with CPT
11721 (Debridement of nail(s) by
any method(s); 6 or more) which
appears on line 169. Similar
diagnosis codes appear on line
169
Add E11.49 and E11.59 and
E11.628 to line 169
27175-
27185
Treatment of slipped femoral
epiphysis
431 ACUTE PERIPHERAL MOTOR
AND DIGITAL NERVE INJURY
360 CLOSED FRACTURE OF
EXTREMITIES (EXCEPT MINOR
TOES)
508 PERIPHERAL ENTHESOPATHIES
27175-27185 pair with slipped
femoral epiphysis diagnosis codes
on line 360; no appropriate
diagnoses appear on lines 431 or
508
Remove 27175-27185 from lines
431 and 508
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