"READ ME" FILE FOR THE BERENSON-EGGERS TYPE OF SERVICE PUBLIC USE FILE (January 30, 2006) Berenson-Eggers Type of Service Public Use File -- 2006 Contents: This file contains the Centers for Medicare & Medicaid Services Health Care Common Procedure Coding System (HCPCS) procedure codes and the Berenson-Eggers Type of Service (BETOS) code to which each procedure code is assigned. Beginning in 1998, this file will also contain discontinued HCPCS codes, which will be identifiable by the presence of a termination date. The BETOS coding system was developed primarily for analyzing the growth in Medicare expenditures. The coding system covers all HCPCS codes; assigns a HCPCS code to only one BETOS code; consists of readily understood clinical categories (as opposed to statistical or financial categories); consists of categories that permit objective assignment; is stable over time; and is relatively immune to minor changes in technology or practice patterns. File Organization: The file contains one 17-character record for each unique combination of BETOS code and HCPCS procedure code. The file is sorted in ascending order of HCPCS codes. Record Layout: BETPUF06.TXT Record Layout Field Positions Content Description 1 1-5 CPT-4/HCPCS HCPCS codes A0010-V9999 AMA/CPT-4 codes 00100-99999 2 6 Filler 3 7-9 BETOS code BETOS codes D1A-Z2 See codes and descriptions below, presented in seven major categories. 4 10-17 Termination Date The last date on which a procedure code may be used by Medicare providers. Date in YYYYMMDD format. (1) EVALUATION AND MANAGEMENT M1A = Office visits - new M1B = Office visits - established M2A = Hospital visit - initial M2B = Hospital visit - subsequent M2C = Hospital visit - critical care M3 = Emergency room visit M4A = Home visit M4B = Nursing home visit M5A = Specialist - pathology (HCPCS moved to T1G in 2003) M5B = Specialist - psychiatry M5C = Specialist - opthamology M5D = Specialist - other M6 = Consultations (2) PROCEDURES P0 = Anesthesia P1A = Major procedure - breast P1B = Major procedure - colectomy P1C = Major procedure - cholecystectomy P1D = Major procedure - turp P1E = Major procedure - hysterctomy P1F = Major procedure - explor/decompr/excisdisc P1G = Major procedure - Other P2A = Major procedure, cardiovascular-CABG P2B = Major procedure, cardiovascular-Aneurysm repair P2C = Major Procedure, cardiovascular-Thromboendarterectomy P2D = Major procedure, cardiovascualr-Coronary angioplasty (PTCA) P2E = Major procedure, cardiovascular-Pacemaker insertion P2F = Major procedure, cardiovascular-Other P3A = Major procedure, orthopedic - Hip fracture repair P3B = Major procedure, orthopedic - Hip replacement P3C = Major procedure, orthopedic - Knee replacement P3D = Major procedure, orthopedic - other P4A = Eye procedure - corneal transplant P4B = Eye procedure - cataract removal/lens insertion P4C = Eye procedure - retinal detachment P4D = Eye procedure - treatment of retinal lesions P4E = Eye procedure - other P5A = Ambulatory procedures - skin P5B = Ambulatory procedures - musculoskeletal P5C = Ambulatory procedures - groin hernia repair P5D = Ambulatory procedures - lithotripsy P5E = Ambulatory procedures - other P6A = Minor procedures - skin P6B = Minor procedures - musculoskeletal P6C = Minor procedures - other (Medicare fee schedule) P6D = Minor procedures - other (non-Medicare fee schedule) P7A = Oncology - radiation therapy P7B = Oncology - other P8A = Endoscopy - arthroscopy P8B = Endoscopy - upper gastrointestinal P8C = Endoscopy - sigmoidoscopy P8D = Endoscopy - colonoscopy P8E = Endoscopy - cystoscopy P8F = Endoscopy - bronchoscopy P8G = Endoscopy - laparoscopic cholecystectomy P8H = Endoscopy - laryngoscopy P8I = Endoscopy - other P9A = Dialysis services (Medicare fee schedule) P9B = Dialysis services (non-Medicare fee schedule) (3) IMAGING I1A = Standard imaging - chest I1B = Standard imaging - musculoskeletal I1C = Standard imaging - breast I1D = Standard imaging - contrast gastrointestinal I1E = Standard imaging - nuclear medicine I1F = Standard imaging - other I2A = Advanced imaging - CAT/CT/CTA: brain/head/neck I2B = Advanced imaging - CAT/CT/CTA: other I2C = Advanced imaging - MRI/MRA: brain/head/neck I2D = Advanced imaging - MRI/MRA: other I3A = Echography/ultrasonography - eye I3B = Echography/untrasonography - abdomen/pelvis I3C = Echography/ultrasonography - heart I3D = Echography/ultrasonography - carotid arteries I3E = Echography/ultrasonography - prostate, transrectal I3F = Echography/ultrasonography - other I4A = Imaging/procedure - heart including cardiac catheter I4B = Imaging/procedure - other (4) TESTS T1A = Lab tests - routine venipuncture (non-Medicare fee schedule) T1B = Lab tests - automated general profiles T1C = Lab tests - urinalysis T1D = Lab tests - blood counts T1E = Lab tests - glucose T1F = Lab tests - bacterial cultures T1G = Lab tests - other (Medicare fee schedule) T1H = Lab tests - other (non-Medicare fee schedule) T2A = Other tests - electrocardiograms T2B = Other tests - cardiovascular stress tests T2C = Other tests - EKG monitoring T2D = Other tests - other (5) DURABLE MEDICAL EQUIPMENT D1A = Medical/surgical supplies D1B = Hospital beds D1C = Oxygen and supplies D1D = Wheelchairs D1E = Other DME D1F = Prosthetic/Orthotic devices D1G = Drugs administered through DME (6) OTHER O1A = Ambulance O1B = Chiropractic O1C = Enteral and parenteral O1D = Chemotherapy O1E = Other drugs O1F = Hearing and speech services O1G = Immunizations/Vaccinations (7) EXCEPTIONS/UNCLASSIFIED Y1 = Other - Medicare fee schedule Y2 = Other - non-Medicare fee schedule Z1 = Local codes Z2 = Undefined codes Source: Centers for Medicare & Medicaid Services Health Care Common Procedure Coding System (HCPCS), 2006 Update Schedule: The file is for a calendar year period and is updated annually. Copyright Warning: CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS\DFARS apply. The 5-character alpha-numeric procedure codes beginning with D are copyright 2004 by the American Dental Association. They are part of the American Dental Association's Current Dental Terminology--Third Edition (CDT-3). The codes may only be used for purposes directly related to participation in the Medicare program. Permission for any other use must be obtained from the American Dental Association. Disclaimer: These data are subject to change pending any coding revisions made to the 2006 HCPCS.