Page 112 - Medicare Benefit Policy Manual

• Procedures requiring the administration of a substance to the patient or injection
of a substance into the patient and/or special manipulation of the patient;

• Procedures which require special medical skill or knowledge possessed by a
doctor of medicine or doctor of osteopathy or which require that medical
judgment be exercised;

• Procedures requiring special technical competency and/or special equipment or
materials;

• Routine screening procedures; and

• Procedures which are not of a diagnostic nature.

80.4.5 - Electrocardiograms
(Rev. 1, 10-01-03)
B3-2070.4.F

The taking of an electrocardiogram tracing by an approved supplier of portable x-ray
services may be covered as an “other diagnostic test.” The health and safety standards
referred to in §80.4.2 are applicable to such diagnostic EKG services, e.g., the technician
must meet the personnel qualification requirements in the conditions for coverage of
portable x-ray services.

80.5 - Bone Mass Measurements (BMMs)
(Rev.70, Issued: 05-11-07, Effective: 01-01-07, Implementation: 07-02-07)

80.5.1 - Background
(Rev. 70, Issued: 05-11-07, Effective: 01-01-07, Implementation: 07-02-07)

On June 24, 1998, CMS published an Interim Final Rule with Comment Period (IFC) in
the Federal Register entitled "Medicare Coverage of and Payment for Bone Mass
Measurements." This IFC implemented section 4106 of the Balanced Budget Act of
1997 by establishing conditions for coverage and frequency standards thereby providing
uniform coverage under Medicare Part B. It was effective July1, 1998.

On December 1, 2006, CMS published the CY 2007 Physician Fee Schedule final rule.
This rule implemented several changes effective January 1, 2007, which are reflected
below.

80.5.2 - Authority
(Rev. 70, Issued: 05-11-07, Effective: 01-01-07, Implementation: 07-02-07)

Definitions can be found in sections 1861(s)(15) and (rr)(1) of the Social Security Act
(the Act). Conditions for coverage and frequency standards can be found in 42 CFR