"READ ME" FILE FOR THE BERENSON-EGGERS TYPE OF SERVICE PUBLIC USE
FILE  (November 1, 2010)


Berenson-Eggers Type of Service Public Use File -- 2011

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: BETPUF08.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/excis disc
    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/ultrasonography - 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 = Prosthestic/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), 2011

Update Schedule:    The file is for a calendar year period and is
                    updated annually. 

Copyright Warning:  CPT codes and descriptions only are copyright 2010
                    American Medical Association. All Rights Reserved. 
                    Applicable FARS\DFARS apply.

                    

Disclaimer:         These data are subject to change pending any
                    coding revisions made to the 2011 HCPCS.


