| (E) Service Provider ZIP;
(26) Service Provider Secondary Identifier--THCIC 6-digit
Hospital ID assigned to each facility.
(f) Facilities shall submit the required minimum data
set to DSHS for each patient who has one or more of the following
revenue codes in this subsection or one or more of the outpatient
surgical or radiological procedures (which are covered by the service
and procedure categories listed in subsection (g) of this section)
for services rendered to the patient in the facility. Facilities operating
in the State of Texas shall submit the required data elements as specified
in subsection (d) or (e) of this section relating to the revenue codes
in this subsection or the procedure codes covered in the service and
procedure categories listed in subsection (g) of this section.
(1) 0320 Radiology--Diagnostic General Classification.
(effective 90 calendar days after being published in the Texas Register );
(2) 0321 Radiology--Diagnostic Angiocardiology;
(3) 0322 Radiology--Diagnostic Arthrography;
(4) 0323 Radiology--Diagnostic Arteriography;
(5) 0329 Radiology--Diagnostic Other Radiology - Diagnostic;
(6) 0330 Radiology--Therapeutic General Classification;
(7) 0333 Radiology--Therapeutic Radiation Therapy;
(8) 0339 Radiology--Therapeutic Other Radiology - Therapeutic;
(9) 0340 Nuclear Medicine General Classification;
(10) 0341 Nuclear Medicine Diagnostic;
(11) 0342 Nuclear Medicine Therapeutic;
(12) 0343 Nuclear Medicine Diagnostic Pharmaceuticals;
(13) 0344 Nuclear Medicine Therapeutic Pharmaceuticals;
(14) 0349 Nuclear Medicine Other Nuclear Medicine;
(15) 0350 Computed Tomography (CT) Scan General Classification;
(16) 0351 Computed Tomography (CT)--Head Scan;
(17) 0352 Computed Tomography (CT)--Body Scan;
(18) 0359 Computed Tomography (CT)--Other;
(19) 0360 Operating Room Services General Classification;
(20) 0361 Operating Room Services Minor Surgery;
(21) 0369 Operating Room Services Other Operating Room
Services;
(22) 0400 Other Imaging Services General Classification;
(23) 0401 Other Imaging Services Diagnostic Mammography;
(24) 0403 Other Imaging Services Screening Mammography;
(25) 0404 Other Imaging Services Positron Emission
Tomography (PET);
(26) 0409 Other Imaging Services Other Imaging Services;
(27) 0481 Cardiology Cardiac Catheterization Lab;
(28) 0483 Cardiology Echocardiology;
(29) 0489 Cardiology Other Cardiology Services;
(30) 0490 Ambulatory Surgical Care General Classification;
(31) 0499 Ambulatory Surgical Care Other Ambulatory
Surgical;
(32) 0500 Outpatient Services General Classification;
(33) 0509 Outpatient Services Other Outpatient;
(34) 0610 Magnetic Resonance Technology General Classification;
(35) 0611 Magnetic Resonance Technology Magnetic Resonance
Imaging (MRI)--Brain/Brainstem;
(36) 0612 Magnetic Resonance Technology Magnetic Resonance
Imaging (MRI)--Spinal Cord/Spine;
(37) 0614 Magnetic Resonance Technology Magnetic Resonance
Imaging (MRI)--Other;
(38) 0615 Magnetic Resonance Technology Magnetic Resonance
Angiography (MRA)--Head and Neck;
(39) 0616 Magnetic Resonance Technology Magnetic Resonance
Angiography (MRA)--Lower Extremities;
(40) 0618 Magnetic Resonance Technology Magnetic Resonance
Angiography (MRA)--Other;
(41) 0619 Magnetic Resonance Technology Other Magnetic
Resonance Technology;
(42) 0760 Specialty Room--Treatment/Observation Room
General Classification;
(43) 0761 Specialty Room--Treatment Room;
(44) 0762 Specialty Room--Observation Room; and
(45) 0769 Specialty Room--Other Specialty Room.
(g) Service and Procedure Categories. The HCPCS code
ranges relating to the surgical and radiological or imaging categories
to be reported shall be specified by DSHS and published on DSHS' website
by November 1st of the year prior to the date on which the services
are performed.
(1) Incision or excision of Central Nervous System
(CNS);
(2) Insertion, replacement, or removal of extracranial
ventricular shunt;
(3) Laminectomy, excision intervertebral disc;
(4) Diagnostic spinal tap;
(5) Insertion of catheter or spinal stimulator and
injection into spinal canal;
(6) Decompression of peripheral nerves;
(7) Other diagnostic nervous system procedures (requiring
surgical or radiological procedures);
(8) Other operating room therapeutic nervous system
surgical procedures;
(9) Thyroidectomy, partial or complete;
(10) Diagnostic endocrine procedures (requiring surgical
or radiological procedures);
(11) Other therapeutic endocrine procedures (requiring
surgical or radiological procedures);
(12) Corneal transplant;
(13) Glaucoma procedures (requiring surgical or radiological
procedures);
(14) Lens and cataract procedures (requiring surgical
or radiological procedures);
(15) Repair of retinal tear, detachment (requiring
surgical or radiological procedures);
(16) Destruction of lesion of retina and choroid (requiring
surgical or radiological procedures);
(17) Diagnostic procedures on eye (requiring surgical
or radiological procedures);
(18) Other therapeutic procedures on eyelids, conjunctiva,
cornea (requiring surgical or radiological procedures);
(19) Other intraocular therapeutic procedures (requiring
surgical or radiological procedures);
(20) Other extraocular muscle and orbit therapeutic
procedures (requiring surgical or radiological procedures);
(21) Tympanoplasty;
(22) Myringotomy;
(23) Mastoidectomy;
(24) Diagnostic procedures on ear (requiring surgical
or radiological procedures);
(25) Other therapeutic ear procedures (requiring surgical
or radiological procedures);
(26) Control of epistaxis (requiring surgical or radiological
procedures);
(27) Plastic procedures on nose (requiring surgical
or radiological procedures);
(28) Oral and Dental Services (requiring surgical or
radiological procedures);
(29) Tonsillectomy or adenoidectomy;
(30) Diagnostic procedures on nose, mouth and pharynx
(requiring surgical or radiological procedures);
(31) Other non-operating room therapeutic procedures
on nose, mouth and pharynx (requiring surgical procedures);
(32) Other operating room therapeutic procedures on
nose, mouth and pharynx (requiring surgical or radiological procedures);
(33) Tracheostomy, temporary and permanent;
(34) Tracheoscopy and laryngoscopy with biopsy;
(35) Lobectomy or pneumonectomy;
(36) Diagnostic bronchoscopy and biopsy of bronchus
(requiring surgical or radiological procedures);
(37) Other diagnostic procedures on lung and bronchus
(requiring surgical or radiological procedures);
(38) Incision of pleura, thoracentesis, chest drainage;
(39) Other diagnostic procedures of respiratory tract
and mediastinum (requiring surgical or radiological procedures);
(40) Other non-operating room therapeutic procedures
on respiratory system (requiring surgical procedures);
(41) Other operating room therapeutic procedures on
respiratory system (requiring surgical or radiological procedures);
(42) Heart valve procedures;
(43) Coronary artery bypass graft (CABG);
(44) Percutaneous transluminal coronary angioplasty
(PTCA);
(45) Coronary thrombolysis (requiring surgical or radiological
procedures);
(46) Diagnostic Cardiovascular (Cardiac) catheterization,
coronary arteriography;
Cont'd... |
