2013-128 Health - Wake Radiology Diagnostic Imagin for Scope of Services - Breast and Cervical Cancer Control Program $ N/A

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North Carolina Breast and Cervical Cancer Control Program 2012-2013 Services Fee Schedule(1) Physician Visits Omce Visits(5) CPT 12-13 Code Fee New patient,brief 99201 $ 40.32 New patient,limited 99202 $ 68.97 New patient,intermediate 99203 $ 99.92 Established patient,brief 99211 $ 18.67 Established patient,limited 99212 $ 40.32 Established patient,intermediate 99213 $ 67.17 00400 Anesthesia Not to exceed 3 Base Units plus Time Units(length of time spent providing anesthesia service in 15 minute increments)times Conversion Rate($20.61)or$250,whichever is lower. Global and Split Fees Both global and split fees apply to the breast procedures listed on page 1 of this fee schedule. The method and direction of payment will determine their usage for your facility. The following are the codes and definitions that apply: G=Global;the all-inclusive fee for performing and interpreting the service. TC=Technical Component;the fee for performing the service. 26=Professional Component;the fee for interpreting the service. Notes: (1) NC BCCCP covers only the physician's fee. Any facility charges associated with these CPT codes are not covered. (Z) Use office visit codes for these services. Consultation codes have been discontinued. (3) HPV DNA testing is a reimbursable procedure if used in the fallow-up of an ASC-US result from the screening exam, or for surveillance at one year following an LSIL Pap test and no CIN2,3 on colposcopy-directed biopsy. It is not reimbursable as a primary screening test or as an adjunctive screening test to the Pap. Providers should specify the high-risk HPV DNA panel only;reimbursement of screening for low-risk HPV types is not permitted. The CDC will allow for reimbursement of Cervista HPV HR,however,only at the same rate as the Digene Hyrid- Capture 2 HPV DNA Assay.CDC funds cannot be used for reimbursement of Cervista HPV 16/18. (4) Up to three cervical biopsies,including ECC(endocervical currettage),per colposcopy will be covered by the BCCCP when the appropriate algorithm is followed. Each specimen container is counted as one biopsy. Under no circumstances are endometrial or vaginal biopsies covered by the BCCCP. (5) Effective January 1,2010,Consultation Visit codes 99241 through 99255 have been eliminated. Codes 99201,99202, and 99203 are to be used in their place. Revised:3/22/12