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PA Bulletin, Doc. No. 09-436

NOTICES

Medical Assistance Program Outpatient Fee Schedule Revisions for Vision Services

[39 Pa.B. 1272]
[Saturday, March 7, 2009]

   The purpose of this notice is to announce the Department of Public Welfare's (Department) change to the Medical Assistance (MA) Program Fee Schedule, effective with dates of service on and after April 1, 2009.

   The Department is end-dating Common Procedure Terminology (CPT) procedure code 65760, defined as ''Keratomileusis,'' from the MA Program Fee Schedule with dates of service on and after April 1, 2009. Keratomileusis is a surgical procedure in which a slice of the patient's cornea is removed, reshaped and replaced. It is performed to correct retractive error and, as such, is considered cosmetic surgery.

   Section 1141.59 of 55 Pa. Code (relating to noncompensable services) sets forth that payment will not be made for cosmetic surgery except when performed to improve the functioning of a malformed body member, to correct a visible disfigurement which would affect the ability of the person to obtain or hold employment, or as post-mastectomy breast reconstruction.

Fiscal Impact

   The end-dating of CPT procedure code 65760 will have no fiscal impact. There have been no paid claims for procedure code 65760 from Fiscal Year 2006-2007 to the present time.

Public Comment

   Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revisions of the MA Program Fee Schedule.

   Persons with a disability who require auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-584. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 09-436. Filed for public inspection March 6, 2009, 9:00 a.m.]


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