Transmittal 21 Date: MARCH 18, 2005 Change Request 3758€¦ · Transmittal 21 Date: MARCH 18, 2005 Change ... authorized to provide under their State practice acts that ... be identified

CMS Manual System Department of Health & Human Services

Pub 100-19 Demonstrations Center for Medicare and & Medicaid Services

Transmittal 21 Date: MARCH 18, 2005 Change Request 3758 SUBJECT: Full Replacement of CR 3639, Expansion of Coverage for Chiropractic Services Demonstration I. SUMMARY OF CHANGES: This change management request replaces confidential CR 3639. The main changes from the previous CR include making this CR public, including educational requirements, and adding an MSN message. Under the Demonstration of Coverage of Chiropractic Services Under Medicare mandated by Section 651 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Medicare is expanding coverage under Part B for services chiropractors are legally authorized to provide under their State practice acts that would otherwise be payable when provided by another Medicare-recognized practitioner, such as a physician or physical therapist. This demonstration shall last for two years through March 31, 2007 and is limited to four geographic areas. Only chiropractors practicing in these four geographic areas are eligible for payment under this demonstration. Beneficiaries are not required to live in the four geographic areas of the demonstration. This change management request applies to Part B services delivered to Medicare fee-for-service beneficiaries. The four geographic areas for this demonstration project are the State of New Mexico (rural HPSA), the State of Maine (rural), 26 northern counties in Illinois and Scott County in Iowa (urban), and 17 central counties in Richmond, Charlottesville, Lynchburg, and Danville MSAs in Virginia (urban HPSA). Under this demonstration project, chiropractors in four geographic areas will be able to be reimbursed for delivering diagnostic and other services related to the treatment of neuromusculoskeletal conditions that they are legally permitted to provide according to their State practice acts and as allowed within Medicare rules. The services that chiropractors in the demonstration will be allowed to bill Medicare for include plain x-rays, EMGs and nerve conductions studies, as well as clinical lab tests. In addition, Chiropractors can order clinical lab tests, x-rays, MRIs, and CT scans under the demonstration. Chiropractors may not perform MRIs or CT scans. Chiropractors in the demonstration will use existing CPT/HCPCS codes for diagnostic services they are allowed to provide as part of this project and will be subject to the same claims processing and payment policies as other providers delivering these same services. Thus, systems edits will be needed to recognize and permit reimbursement for chiropractors delivering these services in the four demonstration areas. Under this demonstration, chiropractors in the four geographic areas will be allowed to bill Medicare for CPT code 98943, extraspinal manipulation. Coverage will also be expanded to include other services chiropractors are legally allowed to provide and Medicare currently covers.

NEW/REVISED MATERIAL : EFFECTIVE DATE : April 01, 2005 IMPLEMENTATION DATE : April 04, 2005 Disclaimer for manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated) R = REVISED, N = NEW, D = DELETED – Only One Per Row. N/A

R/N/D Chapter / Section / SubSection / Title N/A III. FUNDING: Funding for Medicare contractors is available through the regular budget process for costs required for implementation. IV. ATTACHMENTS: Business Requirements *Unless otherwise specified, the effective date is the date of service.

Attachment - Business Requirements Pub. 100-19 Transmittal: 21 Date: March 18, 2005 Change Request 3758 SUBJECT: Expansion of Coverage for Chiropractic Services Demonstration I. GENERAL INFORMATION A. Background: Section 651 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) requires the Centers for Medicare & Medicaid Services (CMS) to conduct the Expansion of Coverage for Chiropractic Services Demonstration. The purpose of the demonstration is to evaluate the feasibility and advisability of expanding coverage of chiropractic services under Medicare. The legislation requires CMS to expand coverage for chiropractic services to include “care for neuromusculoskeletal conditions typical among eligible beneficiaries and diagnostic and other services that a chiropractor is legally authorized to perform by the State or jurisdiction in which such treatment is provided.” Any beneficiary enrolled under Part B, including one enrolled in an M+C (or MA) program, would be eligible to participate. No other physician approval is required for the receipt of chiropractic services under the demonstration. The demonstration is for two years and must be conducted in four geographic areas—two rural and two urban. One rural and one urban geographic area must be located in an area designated as a health professional shortage area (HPSA). A Report to Congress must be submitted not later than one year after the demonstration ends, which includes an evaluation of the costs of the demonstration, beneficiary satisfaction, and other matters as the Secretary deems appropriate. The demonstration is expected to start April 4, 2005. B. Policy: This change management request applies to Part B services delivered to Medicare fee-for-service beneficiaries. Although Medicare Advantage (MA) enrollees of plans who chose to participate in the demonstration are eligible for chiropractic services under this demonstration, MA plans will be addressed separately. The four geographic areas for this demonstration project are the state of New Mexico (rural HPSA), the state of Maine (rural), 26 northern counties in Illinois and Scott County in Iowa (urban), and 17 central counties in Richmond, Charlottesville, Lynchburg, and Danville MSAs in Virginia (urban HPSA). Table 1 includes a description of the sites. Zip codes are provided in Table 2 for Illinois, Table 3 for Virginia, and Table 4 for Iowa. Only chiropractors providing services in these geographic areas will be eligible to participate in this demonstration. Beneficiaries are not required to live in these areas to receive demonstration services. In addition, chiropractors may refer patients to providers that are not located in the demonstration areas. For example, a chiropractor may refer a patient to a radiologist outside of the demonstration area for an MRI. We will not be implementing the demonstration in geographic areas covered by VIPS (VMS).

Under this demonstration project, chiropractors in four geographic areas will be able to be reimbursed for delivering diagnostic and other services related to the treatment of neuromusculoskeletal conditions that they are legally permitted to provide according to their State practice acts and as allowed within Medicare rules. The services that chiropractors in the demonstration will be allowed to bill Medicare for include plain x-rays, EMGs and nerve conductions studies, as well as clinical lab tests. In addition, Chiropractors can order clinical lab tests, x-rays, MRIs, and CT scans under the demonstration. Chiropractors may not perform MRIs or CT scans. Any chiropractor performing lab tests must comply with the Clinical Laboratory Improvement Amendments (CLIA) program and the site must be CLIA certified. Chiropractors are also subject to laboratory State practice requirements. Chiropractors must also comply with the Stark requirements regarding limitations on physician self-referrals. The clinical lab services that chiropractors can perform are listed in the clinical lab fee schedule which can be found at http://www.cms.hhs.gov/providers/pufdownload/#labfee. Any chiropractor performing clinical lab tests, and any labs that chiropractors order tests from, must comply with the Clinical Laboratory Improvement Amendments (CLIA) program and the site must be CLIA certified. Chiropractors are also subject to clinical laboratory State practice requirements. Chiropractors must also comply with the Stark requirements regarding limitations on physician self-referrals. Information regarding these requirements can be found in Medlearn Matters article number MM 3036, which may be found at: http://www.cms.hhs.gov/medlearn/matters/mmarticles/2003/MM3036.pdf Under this demonstration, chiropractors in the four geographic areas will be allowed to bill Medicare for CPT code 98943—extraspinal manipulation. The fee amounts per geographic area can be found in Table 5. Coverage will also be expanded to include other services chiropractors are legally allowed to provide and Medicare currently covers. These procedures include electrotherapy, ultrasound, TENS therapy, and other services that are medically necessary for the treatment of neuromusculoskeletal conditions. Chiropractors delivering these services would be subject to the same payment policies as other Medicare clinicians currently delivering these services. These requirements can be found in the Medicare Benefit Policy Manual 100-2 in Chapter 15, Sections 220 and 230 and the Medicare Claims Processing Manual 100-4 in Chapter 5, Section 20 and other manual sections. For example, Physical Therapy services must be identified through the use of modifier GP as described in the claims manual above. Chiropractors will also be allowed to make referrals for therapy services under the demonstration. Chiropractors will also be reimbursed for E&M services delivered for neuromusculoskeletal conditions. Under the demonstration, chiropractors will be allowed to bill Medicare for both an E&M visit and for treatment the first time they assess a patient, as well as for current patients in such instances as when there is a new condition, exacerbation or recurrence of the current condition, or for a reassessment midway through treatment. Chiropractors should not bill for an E&M service every time they treat a patient. Chiropractors billing Medicare under this demonstration must follow the same documentation guidelines that physicians follow for E&M services. For example, chiropractic manipulation codes include a brief pre-manipulation patient assessment. Additional E&M services may be reported separately using the modifier “-25” if, and only if, the patient’s condition requires a significant separately identifiable E&M service. When manipulation and E&M codes are billed for the same visit, it is necessary to attach a “-25” modifier to the E&M code. These guidelines can be found at: http://www.cms.hhs.gov/medlearn/emdoc.asp.

Additional E&M guidance can also be found in the Medicare Claims Processing Manual, publication 100-04, Chapter 12, Section 30. This manual may be accessed at: http://www.cms.hhs.gov/manuals/104_claims/clm104index.asp Codes currently exist for the services that shall be covered under this demonstration by chiropractors; see the attached tables of procedure (Table 6) and diagnosis codes (Table 7). Edits shall be needed to recognize chiropractors in these four geographic areas and allow them to be reimbursed for medical, radiology, and therapy services they are legally authorized to provide and that will be covered under this demonstration. The diagnosis on the claim must be one of the diagnoses listed in Table 7. It is inappropriate for chiropractors in this demonstration to bill any of the osteopathic manipulation codes since these codes are valued specifically for the manipulation services done by osteopaths. Current Medicare coverage for chiropractic services--codes 98940, 98941, and 98942-- remains unchanged. These services are not part of the demonstration. Chiropractors must submit separate claims for these services and demonstration services. Chiropractors will continue to be paid according to the current fee schedule rates for these three codes. Services provided under this demonstration must apply demonstration code “45” to all claims. On the 837 Professional transaction, chiropractors should report the demonstration number of “45” in Loop 2300 REF02 (REF01=P4). If chiropractors are using the CMS-1500 claim form, the demonstration number should be inserted in Box 19 (Reserved for Local Use) along with “demo” before the number 45. Chiropractors will be required to submit claims for demonstration services separately from claims for CPT codes 98940, 98941, and 98942. For example, if a chiropractor submits claims for CPT codes 98940 through 98942 with demonstration services and the demonstration code, the non-demonstration services should be rejected and they will be required to resubmit the non-demonstration services. The demonstration services will be paid. If chiropractors submit a claim for CPT codes 98940 through 98942 with demonstration services and the demonstration code is not included, the demonstration services should be rejected and the chiropractor should be required to resubmit them as a separate claim. The non-demonstration services should be paid in this instance. These claims should be processed as a regular FFS claim. In addition, services provided under this demonstration must be related to acute or active treatment, not maintenance or prevention of neuromusculoskeletal conditions. For Medicare purposes, a chiropractor must place an AT modifier next to every CPT code on all claims when providing active/corrective treatment to treat acute or chronic subluxation. Chiropractors must also follow physician requirements for incident to services. Information regarding these requirements can be found in a Medlearn Matters article at: http://www.cms.hhs.gov/medlearn/matters/mmarticles/2004/SE0441.pdf. In addition, chiropractors must follow physician rules for providing therapy services under the incident to provision of the physician regulation. When a physical therapy service is provided incident to the service of a chiropractor, the person who furnishes the service must meet the standards and conditions that apply to physical therapists, except that a license is not required. This means that unless chiropractic students, chiropractic assistants, or sports trainers have graduated from a physical therapy curriculum approved by; 1) the American Physical Therapy Association, or 2) The Committee on Allied Health Education and

Accreditation of the American Medical Association, or 3) the Council on Medical Education of the American Medical Association and the American Physical Therapy Association, they cannot provide therapy services incident to a chiropractor. The only exception is that certain persons trained prior to January 1, 1966 may be grandfathered (see 42 CFR 484.4). II. BUSINESS REQUIREMENTS “Shall" denotes a mandatory requirement "Should" denotes an optional requirement Requirement Number

Requirements Responsibility (“X” indicates the columns that apply)

Shared System Maintainers

FI

RHHI

Car r ier

DMERC

F I SS

MCS

VMS

CWF

Other

3758.1 Effective immediately upon implementation, carrier(s) in demonstration areas shall include claim level messages on MSNs to beneficiaries who receive currently covered chiropractic services, 98940-98942, from chiropractors who are located in the demonstration areas notifying the beneficiaries of the expansion of chiropractic services. The language to be used is attached in Table 8 (including the Spanish translation).

X

3758.2 Effective for dates of service April 1, 2005 through March 31, 2007, chiropractors practicing in the four demonstration areas shall apply demonstration code 45 to all demonstration claims.

X Chiropractors

3758.3 Effective for dates of service April 1, 2005 through March 31, 2007, chiropractors practicing in the four demonstration areas shall submit separate claims for demonstration services and claims submitted for CPT codes 98940, 98941, and 98942. For example, if claims for CPT codes 98940 through 98942 are submitted with demonstration services and the demonstration code 45, the non-demonstration services shall be rejected and should be resubmitted as a separate claim. If claims for CPT codes 98940 through 98942 are submitted with demonstration services and the demonstration code 45 is not included, the demonstration services shall be rejected and should be resubmitted as a separate claim.

X Chiropractors

Requirement Number

Requirements Responsibility (“X” indicates the columns that apply)

Shared System Maintainers

FI

RHHI

Car r ier

DMERC

F I SS

MCS

VMS

CWF

Other

3758.4 Effective for dates of service April 1, 2005 through March 31, 2007, carrier(s) shall process claims submitted by chiropractors for acute or active treatment, not prevention or maintenance, of neuromusculoskeletal conditions. Chiropractors in the four geographic areas will be permitted to provide the following services under this demonstration:

• Diagnostic services: Plain x-rays, EMG and nerve conduction studies, and tests listed in table 6 will be covered under the demonstration. They will also be permitted to provide any laboratory services that their site is qualified to provide under CLIA and meets state practice requirements.

• Other services: CPT code 98943—extraspinal manipulation, would be covered under the demonstration. The fee amounts for 98943 per geographic area are found in Table 5. In addition, services considered medically necessary and reasonable for the treatment of neuromusculoskeletal conditions, and that chiropractors are legally allowed to provide according to state practice acts, would be covered in the four demonstration areas using existing rules and systems edits for processing claims for the same services delivered by physicians and physical therapists who are currently reimbursed for these same services. These services include electrotherapy, ultrasound, TENS therapy, and other procedures in the attached table 6. Chiropractors shall use the same codes as other recognized practitioners for delivering the same services, but must place an AT modifier on the claim.

• E&M services: E&M codes are listed in table 6.

It is inappropriate for chiropractors in this demonstration to bill any of the osteopathic manipulation codes, since these codes are valued specifically for the manipulation services done by osteopaths.

X X

Requirement Number

Requirements Responsibility (“X” indicates the columns that apply)

Shared System Maintainers

FI

RHHI

Car r ier

DMERC

F I SS

MCS

VMS

CWF

Other

3758.5 Effective for dates of service April 1, 2005 through March 31, 2007, chiropractors in the four geographic areas will be permitted to order x-rays, MRIs, CT scans, and lab tests as well as provide referrals for therapy services. The providers that accept referrals from chiropractors are not required to be located in the demonstration areas.

X X

3758.6 Effective for dates of service April 1, 2005 through March 31, 2007, coinsurance or deductible rules that currently apply to diagnostic and other services delivered by other practitioners, such as physicians and physical therapists, shall apply to these services if delivered by chiropractors.

X X

3758.7 Effective for dates of service April 1, 2005 through March 31, 2007, chiropractors in the four demonstration areas shall be subject to the same rules as physicians and physical therapists regarding services they are legally authorized to provide. For example, chiropractors delivering evaluation and management services are subject to the same rules as physicians delivering the same services.

X Chiropractors

3758.8 Effective for dates of service April 1, 2005 through March 31, 2007, carriers shall apply the current version of the National Correct Coding Edits (NCCI edits) for this demonstration

X X

3758.9 Claims submitted without a valid ICD-9-CM diagnosis code listed in Table 7 shall be denied.

X

3758.10 Claims submitted without a valid CPT/HCPCS procedure code (Table 6) shall be denied. However, covered lab codes are based on CLIA qualifications and are not included in Table 6.

X Chiropractor

3758.11 Claims submitted for CPT code 98940, 98941, or 98942 with the demonstration code “demo 45” shall be rejected.

X Chiropractor

3758.12 Claims submitted without an AT modifier shall be denied.

X Chiropractor

3758.13 Claims submitted for Physical Therapy services that do not include a GP modifier shall be denied except for 64550. Chiropractors should place a modifier on claims for 64550, except in cases where it is not part of a therapy plan of care.

X Chiropractor

3758.14 Claims submitted for CPT 98943 that do not identify the provider as being a chiropractor shall be denied.

X Chiropractor

Requirement Number

Requirements Responsibility (“X” indicates the columns that apply)

Shared System Maintainers

FI

RHHI

Car r ier

DMERC

F I SS

MCS

VMS

CWF

Other

3758.15 Claims submitted for demonstration services that do not identify chiropractors who are located in an eligible demonstration zip code shall be denied.

X X Chiropractor

3758.16 Claims submitted for dates of service prior to April 1, 2005 or after March 31, 2007 for services only covered under the demonstration shall be denied.

X Chiropractor

3758.17 Effective April 1, 2005 through March 31, 2007 rules that currently apply as described in Chapter 30 of the Medicare Claims Processing Manual for the responsibility of charges incurred for returned or denied claims shall apply to services covered under the demonstration.

X Chiropractor

3758.18 Effective April 1, 2005 through March 31, 2007, chiropractors practicing in HPSAs designated as demonstration areas shall continue to be eligible for bonus payments for the demonstration services.

X X Chiropractors

3758.19 Effective April 1, 2005 through March 31, 2007, chiropractors practicing in the demonstration areas shall not be eligible for physician scarcity area payments.

X X Chiropractors

3758.20 Effective for dates of service April 1, 2005 through March 31, 2007, chiropractors must follow physician requirements for “incident to” services.

X Chiropractors

3758.21 Effective for dates of service April 1, 2005 through March 31, 2007, chiropractors must follow physician rules for providing physical therapy services under the incident to provision of the physician regulation.

X Chiropractors

3758.22 Claims submitted for E&M services on the same visit as a manipulation without a -25 modifier shall be rejected.

X X Chiropractors

III. PROVIDER EDUCATION

Requirement Number

Requirements Responsibility (“X” indicates the columns that apply)

Shared System Maintainers

FI

RHHI

Car r ier

DMERC

F I SS

MCS

VMS

CWF

Other

3758.23 A special edition Medlearn Matters provider education article number 0514 related to this demonstration is available at www.cms.hhs.gov/medlearn/pubs.asp. Contractors shall post this article, or a direct link to this article, on their Web site and include information about it in a listserv message within one week of the release of this instruction. In addition, the provider education article shall be included in your next regularly scheduled bulletin and incorporated into your outreach activities, as appropriate. Contractors are free to supplement Medlearn Matters articles with localized information that would benefit their provider community in billing and administering the Medicare program correctly.

X

3758.24 Effective immediately, carrier(s) shall educate chiropractors delivering services in the four demonstration areas that they are eligible to be reimbursed for diagnostic and other services they are legally authorized to provide and that have been included in the demonstration for the two-year period of the demonstration. This education must also inform chiropractors that they are subject to the same coverage and payment rules as current Medicare providers of these services.

X

3758.25 Effective immediately, carrier(s) shall educate chiropractors in the four demonstration sites that current Medicare coverage policies for codes 98940, 98941, and 98942 remain in effect. Chiropractors will continue to be paid according to the current fee schedule rate for these three codes.

X

IV. SUPPORTING INFORMATION AND POSSIBLE DESIGN CONSIDERATIONS

A. Other Instructions: NA X-Ref Requirement # Instructions

B. Design Considerations: NA X-Ref Requirement # Recommendation for Medicare System Requirements

C. Interfaces: NA D. Contractor Financial Reporting /Workload Impact: NA E. Dependencies: NA F. Testing Considerations: NA IV. SCHEDULE, CONTACTS, AND FUNDING Effective Date: April 1, 2005 Implementation Date: April 4, 2005 Pre-Implementation Contact(s): Julie Jones, (410-786-3039) Sidney Trieger, (410-786-6613) Pauline Lapin, (410-786-6883) Post-Implementation Contact(s): Julie Jones, (410-786-3039) Pauline Lapin, (410-786-6883) Sidney Trieger, (410-786-6613)

Funding for implementation activities will be provided to contractors through the regular budget process.

*Unless otherwise specified, the effective date is the date of service. Attachment

Table 1: Geographic Areas Providing Expanded Chiropractic Services Under This Demonstration

Site Type Demonstration Site

Rural Maine Rural- HPSA New Mexico Urban Illinois --26 northern counties including

Cook, DeKalb, DuPage, Grundy, Kane, Kendall, McHenry, Will, Boone, Bureau, Carroll, Henry, JoDaviess, Kankakee, Lake, LaSalle, Lee, Marshall, Mercer, Ogle, Putnam, Rock Island, Stark, Stephenson, Whiteside, and Winnebago counties and Scott County, Iowa.

Urban- HPSA Virginia--17 central HPSA counties in Richmond, Charlottesville, Lynchburg, and Danville MSAs (Pittsylvania, Campbell, Appomattox, Nelson, Buckingham, Fluvanna, Louisa, Caroline, Hanover, New Kent, Henrico, Richmond City, Danville City, Goochland, Cumberland, Powhatan, and Amelia Counties)

Table 2: Illinois Zip Codes ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY

61008 BELVIDERE BOONE 60004 ARLINGTON HEIGHTS COOK 60130 FOREST PARK COOK 61011 CALEDONIA BOONE 60005 ARLINGTON HEIGHTS COOK 60131 FRANKLIN PARK COOK 61012 CAPRON BOONE 60006 ARLINGTON HEIGHTS COOK 60133 HANOVER PARK COOK 61038 GARDEN PRAIRIE BOONE 60007 ELK GROVE VILLAGE COOK 60141 HINES COOK 61065 POPLAR GROVE BOONE 60008 ROLLING MEADOWS COOK 60153 MAYWOOD COOK 61312 ARLINGTON BUREAU 60009 ELK GROVE VILLAGE COOK 60154 WESTCHESTER COOK 61314 BUDA BUREAU 60016 DES PLAINES COOK 60155 BROADVIEW COOK 61315 BUREAU BUREAU 60017 DES PLAINES COOK 60159 SCHAUMBURG COOK 61317 CHERRY BUREAU 60018 DES PLAINES COOK 60160 MELROSE PARK COOK 61320 DALZELL BUREAU 60019 DES PLAINES COOK 60161 MELROSE PARK COOK 61322 DEPUE BUREAU 60022 GLENCOE COOK 60162 HILLSIDE COOK 61323 DOVER BUREAU 60025 GLENVIEW COOK 60163 BERKELEY COOK 61328 KASBEER BUREAU 60026 GLENVIEW COOK 60164 MELROSE PARK COOK 61329 LADD BUREAU 60029 GOLF COOK 60165 STONE PARK COOK 61330 LA MOILLE BUREAU 60038 PALATINE COOK 60168 SCHAUMBURG COOK 61337 MALDEN BUREAU 60043 KENILWORTH COOK 60171 RIVER GROVE COOK 61338 MANLIUS BUREAU 60053 MORTON GROVE COOK 60173 SCHAUMBURG COOK 61344 MINERAL BUREAU 60055 PALATINE COOK 60176 SCHILLER PARK COOK

61345 NEPONSET BUREAU 60056 MOUNT PROSPECT COOK 60179 HOFFMAN ESTATES COOK

61346 NEW BEDFORD BUREAU 60062 NORTHBROOK COOK 60192 SCHAUMBURG COOK 61349 OHIO BUREAU 60065 NORTHBROOK COOK 60193 SCHAUMBURG COOK 61356 PRINCETON BUREAU 60067 PALATINE COOK 60194 SCHAUMBURG COOK 61359 SEATONVILLE BUREAU 60068 PARK RIDGE COOK 60195 SCHAUMBURG COOK 61361 SHEFFIELD BUREAU 60070 PROSPECT HEIGHTS COOK 60196 SCHAUMBURG COOK 61362 SPRING VALLEY BUREAU 60074 PALATINE COOK 60201 EVANSTON COOK 61368 TISKILWA BUREAU 60076 SKOKIE COOK 60202 EVANSTON COOK 61374 VAN ORIN BUREAU 60077 SKOKIE COOK 60203 EVANSTON COOK 61376 WALNUT BUREAU 60078 PALATINE COOK 60204 EVANSTON COOK 61379 WYANET BUREAU 60082 TECHNY COOK 60208 EVANSTON COOK 61014 CHADWICK CARROLL 60090 WHEELING COOK 60209 EVANSTON COOK 61046 LANARK CARROLL 60091 WILMETTE COOK 60296 MCHENRY COOK 61051 MILLEDGEVILLE CARROLL 60093 WINNETKA COOK 60297 MCHENRY COOK 61053 MOUNT CARROLL CARROLL 60094 PALATINE COOK 60301 OAK PARK COOK 61074 SAVANNA CARROLL 60095 PALATINE COOK 60302 OAK PARK COOK 61078 SHANNON CARROLL 60104 BELLWOOD COOK 60303 OAK PARK COOK 61285 THOMSON CARROLL 60107 STREAMWOOD COOK 60304 OAK PARK COOK

ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY

60305 RIVER FOREST COOK 60478 COUNTRY CLUB HILLS COOK 60631 CHICAGO COOK 60402 BERWYN COOK 60480 WILLOW SPRINGS COOK 60632 CHICAGO COOK 60406 BLUE ISLAND COOK 60482 WORTH COOK 60633 CHICAGO COOK 60409 CALUMET CITY COOK 60499 BEDFORD PARK COOK 60634 CHICAGO COOK 60411 CHICAGO HEIGHTS COOK 60501 SUMMIT ARGO COOK 60636 CHICAGO COOK 60412 CHICAGO HEIGHTS COOK 60513 BROOKFIELD COOK 60637 CHICAGO COOK 60415 CHICAGO RIDGE COOK 60525 LA GRANGE COOK 60638 CHICAGO COOK 60419 DOLTON COOK 60526 LA GRANGE PARK COOK 60639 CHICAGO COOK 60422 FLOSSMOOR COOK 60534 LYONS COOK 60640 CHICAGO COOK 60425 GLENWOOD COOK 60546 RIVERSIDE COOK 60641 CHICAGO COOK 60426 HARVEY COOK 60558 WESTERN SPRINGS COOK 60643 CHICAGO COOK 60428 MARKHAM COOK 60601 CHICAGO COOK 60644 CHICAGO COOK 60429 HAZEL CREST COOK 60602 CHICAGO COOK 60645 CHICAGO COOK 60430 HOMEWOOD COOK 60603 CHICAGO COOK 60646 CHICAGO COOK 60438 LANSING COOK 60604 CHICAGO COOK 60647 CHICAGO COOK 60439 LEMONT COOK 60605 CHICAGO COOK 60649 CHICAGO COOK 60443 MATTESON COOK 60606 CHICAGO COOK 60651 CHICAGO COOK 60445 MIDLOTHIAN COOK 60607 CHICAGO COOK 60652 CHICAGO COOK 60452 OAK FOREST COOK 60608 CHICAGO COOK 60653 CHICAGO COOK 60453 OAK LAWN COOK 60609 CHICAGO COOK 60654 CHICAGO COOK 60454 OAK LAWN COOK 60610 CHICAGO COOK 60655 CHICAGO COOK 60455 BRIDGEVIEW COOK 60611 CHICAGO COOK 60656 CHICAGO COOK 60456 HOMETOWN COOK 60612 CHICAGO COOK 60657 CHICAGO COOK 60457 HICKORY HILLS COOK 60613 CHICAGO COOK 60659 CHICAGO COOK 60458 JUSTICE COOK 60614 CHICAGO COOK 60660 CHICAGO COOK 60459 BURBANK COOK 60615 CHICAGO COOK 60661 CHICAGO COOK 60461 OLYMPIA FIELDS COOK 60616 CHICAGO COOK 60663 CHICAGO COOK 60462 ORLAND PARK COOK 60617 CHICAGO COOK 60664 CHICAGO COOK 60463 PALOS HEIGHTS COOK 60618 CHICAGO COOK 60666 AMF OHARE COOK 60464 PALOS PARK COOK 60619 CHICAGO COOK 60668 CHICAGO COOK 60465 PALOS HILLS COOK 60620 CHICAGO COOK 60669 CHICAGO COOK 60466 PARK FOREST COOK 60621 CHICAGO COOK 60670 CHICAGO COOK 60467 ORLAND PARK COOK 60622 CHICAGO COOK 60673 CHICAGO COOK 60469 POSEN COOK 60623 CHICAGO COOK 60674 CHICAGO COOK 60471 RICHTON PARK COOK 60624 CHICAGO COOK 60675 CHICAGO COOK 60472 ROBBINS COOK 60625 CHICAGO COOK 60677 CHICAGO COOK 60473 SOUTH HOLLAND COOK 60626 CHICAGO COOK 60678 CHICAGO COOK 60475 STEGER COOK 60628 CHICAGO COOK 60679 CHICAGO COOK 60476 THORNTON COOK 60629 CHICAGO COOK 60680 CHICAGO COOK 60477 TINLEY PARK COOK 60630 CHICAGO COOK 60681 CHICAGO COOK

ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY

60682 CHICAGO COOK 60106 BENSENVILLE DU PAGE 60532 LISLE DU PAGE 60684 CHICAGO COOK 60108 BLOOMINGDALE DU PAGE 60540 NAPERVILLE DU PAGE 60685 CHICAGO COOK 60116 CAROL STREAM DU PAGE 60555 WARRENVILLE DU PAGE 60686 CHICAGO COOK 60117 BLOOMINGDALE DU PAGE 60559 WESTMONT DU PAGE 60687 CHICAGO COOK 60122 CAROL STREAM DU PAGE 60561 DARIEN DU PAGE 60688 CHICAGO COOK 60125 CAROL STREAM DU PAGE 60563 NAPERVILLE DU PAGE 60689 CHICAGO COOK 60126 ELMHURST DU PAGE 60565 NAPERVILLE DU PAGE 60690 CHICAGO COOK 60128 CAROL STREAM DU PAGE 60566 NAPERVILLE DU PAGE 60691 CHICAGO COOK 60132 CAROL STREAM DU PAGE 60567 NAPERVILLE DU PAGE 60693 CHICAGO COOK 60137 GLEN ELLYN DU PAGE 60570 HINSDALE DU PAGE 60694 CHICAGO COOK 60138 GLEN ELLYN DU PAGE 60572 AURORA DU PAGE

60695 CHICAGO COOK 60139 GLENDALE HEIGHTS DU PAGE 60597 FOX VALLEY DU PAGE

60696 CHICAGO COOK 60143 ITASCA DU PAGE 60598 AURORA DU PAGE 60697 CHICAGO COOK 60148 LOMBARD DU PAGE 60599 FOX VALLEY DU PAGE 60699 CHICAGO COOK 60157 MEDINAH DU PAGE 60407 BRACEVILLE GRUNDY 60701 CHICAGO COOK 60172 ROSELLE DU PAGE 60416 COAL CITY GRUNDY

60706 HARWOOD HEIGHTS COOK 60181 VILLA PARK DU PAGE 60424 GARDNER GRUNDY

60707 ELMWOOD PARK COOK 60184 WAYNE DU PAGE 60437 KINSMAN GRUNDY 60712 LINCOLNWOOD COOK 60185 WEST CHICAGO DU PAGE 60444 MAZON GRUNDY 60714 NILES COOK 60186 WEST CHICAGO DU PAGE 60447 MINOOKA GRUNDY 60803 ALSIP COOK 60187 WHEATON DU PAGE 60450 MORRIS GRUNDY

60804 CICERO COOK 60188 CAROL STREAM DU PAGE 60474 SOUTH WILMINGTON GRUNDY

60805 EVERGREEN PARK COOK 60189 WHEATON DU PAGE 60479 VERONA GRUNDY 60827 RIVERDALE COOK 60190 WINFIELD DU PAGE 61233 ANDOVER HENRY 60111 CLARE DE KALB 60191 WOOD DALE DU PAGE 61234 ANNAWAN HENRY 60112 CORTLAND DE KALB 60197 CAROL STREAM DU PAGE 61235 ATKINSON HENRY 60115 DEKALB DE KALB 60199 CAROL STREAM DU PAGE 61238 CAMBRIDGE HENRY 60129 ESMOND DE KALB 60199 CAROL STREAM DU PAGE 61241 COLONA HENRY 60135 GENOA DE KALB 60398 FRANKLIN PARK DU PAGE 61254 GENESEO HENRY 60145 KINGSTON DE KALB 60399 BENSENVILLE DU PAGE 61258 HOOPPOLE HENRY 60146 KIRKLAND DE KALB 60504 AURORA DU PAGE 61262 LYNN CENTER HENRY 60150 MALTA DE KALB 60514 CLARENDON HILLS DU PAGE 61273 ORION HENRY 60178 SYCAMORE DE KALB 60515 DOWNERS GROVE DU PAGE 61274 OSCO HENRY 60520 HINCKLEY DE KALB 60516 DOWNERS GROVE DU PAGE 61413 ALPHA HENRY 60548 SANDWICH DE KALB 60517 WOODRIDGE DU PAGE 61419 BISHOP HILL HENRY 60550 SHABBONA DE KALB 60519 EOLA DU PAGE 61434 GALVA HENRY 60552 SOMONAUK DE KALB 60521 HINSDALE DU PAGE 61443 KEWANEE HENRY 60556 WATERMAN DE KALB 60522 HINSDALE DU PAGE 61468 OPHIEM HENRY 60101 ADDISON DU PAGE 60522 HINSDALE DU PAGE 61490 WOODHULL HENRY 60103 BARTLETT DU PAGE 60523 OAK BROOK DU PAGE 61001 APPLE RIVER JO DAVIESS 60105 BENSENVILLE DU PAGE 60527 WILLOWBROOK DU PAGE 61025 EAST DUBUQUE JO DAVIESS

ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY

61028 ELIZABETH JO DAVIESS 60922 CHEBANSE KANKAKEE 61372 TROY GROVE LA SALLE 61036 GALENA JO DAVIESS 60935 ESSEX KANKAKEE 61373 UTICA LA SALLE 61041 HANOVER JO DAVIESS 60940 GRANT PARK KANKAKEE 60002 ANTIOCH LAKE 61059 NORA JO DAVIESS 60941 HERSCHER KANKAKEE 60010 BARRINGTON LAKE 61075 SCALES MOUND JO DAVIESS 60944 HOPKINS PARK KANKAKEE 60011 BARRINGTON LAKE 61085 STOCKTON JO DAVIESS 60950 MANTENO KANKAKEE 60015 DEERFIELD LAKE 61087 WARREN JO DAVIESS 60954 MOMENCE KANKAKEE 60020 FOX LAKE LAKE 60109 BURLINGTON KANE 60961 REDDICK KANKAKEE 60030 GRAYSLAKE LAKE 60110 CARPENTERSVILLE KANE 60964 SAINT ANNE KANKAKEE 60031 GURNEE LAKE 60118 DUNDEE KANE 60969 UNION HILL KANKAKEE 60035 HIGHLAND PARK LAKE 60119 ELBURN KANE 60512 BRISTOL KENDALL 60037 FORT SHERIDAN LAKE 60120 ELGIN KANE 60536 MILLBROOK KENDALL 60040 HIGHWOOD LAKE 60121 ELGIN KANE 60537 MILLINGTON KENDALL 60041 INGLESIDE LAKE 60123 ELGIN KANE 60538 MONTGOMERY KENDALL 60042 ISLAND LAKE LAKE 60134 GENEVA KANE 60541 NEWARK KENDALL 60044 LAKE BLUFF LAKE 60136 GILBERTS KANE 60543 OSWEGO KENDALL 60045 LAKE FOREST LAKE 60140 HAMPSHIRE KANE 60545 PLANO KENDALL 60046 LAKE VILLA LAKE 60144 KANEVILLE KANE 60560 YORKVILLE KENDALL 60047 LAKE ZURICH LAKE 60147 LAFOX KANE 60470 RANSOM LA SALLE 60048 LIBERTYVILLE LAKE 60151 MAPLE PARK KANE 60518 EARLVILLE LA SALLE 60049 LONG GROVE LAKE 60170 PLATO CENTER KANE 60531 LELAND LA SALLE 60060 MUNDELEIN LAKE 60174 SAINT CHARLES KANE 60549 SERENA LA SALLE 60061 VERNON HILLS LAKE 60175 SAINT CHARLES KANE 60551 SHERIDAN LA SALLE 60064 NORTH CHICAGO LAKE 60177 SOUTH ELGIN KANE 60557 WEDRON LA SALLE 60069 LINCOLNSHIRE LAKE 60183 WASCO KANE 61301 LA SALLE LA SALLE 60073 ROUND LAKE LAKE 60505 AURORA KANE 61316 CEDAR POINT LA SALLE 60075 RUSSELL LAKE 60506 AURORA KANE 61321 DANA LA SALLE 60079 WAUKEGAN LAKE 60507 AURORA KANE 61325 GRAND RIDGE LA SALLE 60083 WADSWORTH LAKE 60510 BATAVIA KANE 61332 LEONORE LA SALLE 60084 WAUCONDA LAKE 60511 BIG ROCK KANE 61334 LOSTANT LA SALLE 60085 WAUKEGAN LAKE 60539 MOOSEHEART KANE 61341 MARSEILLES LA SALLE 60086 NORTH CHICAGO LAKE 60542 NORTH AURORA KANE 61342 MENDOTA LA SALLE 60087 WAUKEGAN LAKE 60554 SUGAR GROVE KANE 61348 OGLESBY LA SALLE 60088 GREAT LAKES LAKE 60568 AURORA KANE 61350 OTTAWA LA SALLE 60089 BUFFALO GROVE LAKE 60901 KANKAKEE KANKAKEE 61354 PERU LA SALLE 60092 LIBERTYVILLE LAKE

60910 AROMA PARK KANKAKEE 61358 RUTLAND LA SALLE 60096 WINTHROP HARBOR LAKE

60913 BONFIELD KANKAKEE 61360 SENECA LA SALLE 60099 ZION LAKE 60914 BOURBONNAIS KANKAKEE 61364 STREATOR LA SALLE 60530 LEE LEE 60915 BRADLEY KANKAKEE 61370 TONICA LA SALLE 60553 STEWARD LEE 60917 BUCKINGHAM KANKAKEE 61371 TRIUMPH LA SALLE 61006 ASHTON LEE

ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY

61021 DIXON LEE 61263 MATHERVILLE MERCER 61256 HAMPTON ROCK ISLAND 61031 FRANKLIN GROVE LEE 61272 NEW BOSTON MERCER 61257 HILLSDALE ROCK ISLAND 61042 HARMON LEE 61276 PREEMPTION MERCER 61259 ILLINOIS CITY ROCK ISLAND 61057 NACHUSA LEE 61281 SHERRARD MERCER 61264 MILAN ROCK ISLAND 61058 NELSON LEE 61412 ALEXIS MERCER 61265 MOLINE ROCK ISLAND 61310 AMBOY LEE 61442 KEITHSBURG MERCER 61266 MOLINE ROCK ISLAND 61318 COMPTON LEE 61465 NEW WINDSOR MERCER 61275 PORT BYRON ROCK ISLAND 61324 ELDENA LEE 61466 NORTH HENDERSON MERCER 61278 RAPIDS CITY ROCK ISLAND 61331 LEE CENTER LEE 61476 SEATON MERCER 61279 REYNOLDS ROCK ISLAND 61353 PAW PAW LEE 61486 VIOLA MERCER 61282 SILVIS ROCK ISLAND

61367 SUBLETTE LEE 60113 CRESTON OGLE 61284 TAYLOR RIDGE ROCK ISLAND

61378 WEST BROOKLYN LEE 61007 BAILEYVILLE OGLE 61299 ROCK ISLAND ROCK ISLAND 61369 TOLUCA MARSHALL 61010 BYRON OGLE 61421 BRADFORD STARK 61375 VARNA MARSHALL 61015 CHANA OGLE 61426 CASTLETON STARK 61377 WENONA MARSHALL 61020 DAVIS JUNCTION OGLE 61449 LA FAYETTE STARK 61424 CAMP GROVE MARSHALL 61030 FORRESTON OGLE 61479 SPEER STARK 61537 HENRY MARSHALL 61043 HOLCOMB OGLE 61483 TOULON STARK 61540 LACON MARSHALL 61047 LEAF RIVER OGLE 61491 WYOMING STARK 61541 LA ROSE MARSHALL 61049 LINDENWOOD OGLE 61013 CEDARVILLE STEPHENSON 61565 SPARLAND MARSHALL 61052 MONROE CENTER OGLE 61018 DAKOTA STEPHENSON 60001 ALDEN MCHENRY 61054 MOUNT MORRIS OGLE 61019 DAVIS STEPHENSON 60012 CRYSTAL LAKE MCHENRY 61061 OREGON OGLE 61027 ELEROY STEPHENSON 60013 CARY MCHENRY 61064 POLO OGLE 61032 FREEPORT STEPHENSON

60014 CRYSTAL LAKE MCHENRY 61068 ROCHELLE OGLE 61039 GERMAN VALLEY STEPHENSON

60021 FOX RIVER GROVE MCHENRY 61084 STILLMAN VALLEY OGLE 61044 KENT STEPHENSON

60033 HARVARD MCHENRY 61091 WOOSUNG OGLE 61048 LENA STEPHENSON 60034 HEBRON MCHENRY 61326 GRANVILLE PUTNAM 61050 MC CONNELL STEPHENSON 60039 CRYSTAL LAKE MCHENRY 61327 HENNEPIN PUTNAM 61060 ORANGEVILLE STEPHENSON 60050 MCHENRY MCHENRY 61335 MC NABB PUTNAM 61062 PEARL CITY STEPHENSON 60051 MCHENRY MCHENRY 61336 MAGNOLIA PUTNAM 61067 RIDOTT STEPHENSON 60071 RICHMOND MCHENRY 61340 MARK PUTNAM 61070 ROCK CITY STEPHENSON 60072 RINGWOOD MCHENRY 61363 STANDARD PUTNAM 61089 WINSLOW STEPHENSON 60081 SPRING GROVE MCHENRY 61560 PUTNAM PUTNAM 61037 GALT WHITESIDE 60097 WONDER LAKE MCHENRY 61201 ROCK ISLAND ROCK ISLAND 61071 ROCK FALLS WHITESIDE 60098 WOODSTOCK MCHENRY 61204 ROCK ISLAND ROCK ISLAND 61081 STERLING WHITESIDE 60102 ALGONQUIN MCHENRY 61232 ANDALUSIA ROCK ISLAND 61230 ALBANY WHITESIDE 60142 HUNTLEY MCHENRY 61236 BARSTOW ROCK ISLAND 61243 DEER GROVE WHITESIDE 60152 MARENGO MCHENRY 61237 BUFFALO PRAIRIE ROCK ISLAND 61250 ERIE WHITESIDE

60156 LAKE IN THE HILLS MCHENRY 61239 CARBON CLIFF ROCK ISLAND 61251 FENTON WHITESIDE

60180 UNION MCHENRY 61240 COAL VALLEY ROCK ISLAND 61252 FULTON WHITESIDE 61231 ALEDO MERCER 61242 CORDOVA ROCK ISLAND 61261 LYNDON WHITESIDE 61260 JOY MERCER 61244 EAST MOLINE ROCK ISLAND 61270 MORRISON WHITESIDE

ZIP_CODE CITY COUNTY ZIP_CODE CITY COUNTY

61277 PROPHETSTOWN WHITESIDE 61101 ROCKFORD WINNEBAGO 61283 TAMPICO WHITESIDE 61102 ROCKFORD WINNEBAGO 60401 BEECHER WILL 61103 ROCKFORD WINNEBAGO 60408 BRAIDWOOD WILL 61104 ROCKFORD WINNEBAGO 60410 CHANNAHON WILL 61105 ROCKFORD WINNEBAGO 60417 CRETE WILL 61106 ROCKFORD WINNEBAGO 60421 ELWOOD WILL 61107 ROCKFORD WINNEBAGO 60423 FRANKFORT WILL 61108 ROCKFORD WINNEBAGO 60431 JOLIET WILL 61109 ROCKFORD WINNEBAGO 60432 JOLIET WILL 61110 ROCKFORD WINNEBAGO 60433 JOLIET WILL 61111 LOVES PARK WINNEBAGO 60434 JOLIET WILL 61112 ROCKFORD WINNEBAGO 60435 JOLIET WILL 61114 ROCKFORD WINNEBAGO 60436 JOLIET WILL 61115 MACHESNEY PARK WINNEBAGO 60440 BOLINGBROOK WILL 61125 ROCKFORD WINNEBAGO 60441 LOCKPORT WILL 61126 ROCKFORD WINNEBAGO 60442 MANHATTAN WILL 61130 LOVES PARK WINNEBAGO 60446 ROMEOVILLE WILL 61131 LOVES PARK WINNEBAGO 60448 MOKENA WILL 61132 LOVES PARK WINNEBAGO 60449 MONEE WILL 60451 NEW LENOX WILL 60468 PEOTONE WILL 60481 WILMINGTON WILL 60490 BOLINGBROOK WILL 60491 LOCKPORT WILL 60544 PLAINFIELD WILL 60564 NAPERVILLE WILL 61016 CHERRY VALLEY WINNEBAGO 61024 DURAND WINNEBAGO 61063 PECATONICA WINNEBAGO 61072 ROCKTON WINNEBAGO 61073 ROSCOE WINNEBAGO 61077 SEWARD WINNEBAGO 61079 SHIRLAND WINNEBAGO 61080 SOUTH BELOIT WINNEBAGO 61088 WINNEBAGO WINNEBAGO

Table 3: Virginia Zip Codes ZIP CODE COUNTY ZIP CODE COUNTY ZIP CODE COUNTY22427 CAROLINE 23105 AMELIA 23279 RICHMOND CITY22428 CAROLINE 23111 HANOVER 23280 HENRICO22446 CAROLINE 23116 HANOVER 23282 RICHMOND CITY22501 CAROLINE 23117 LOUISA 23284 RICHMOND CITY22514 CAROLINE 23123 BUCKINGHAM 23285 RICHMOND CITY22535 CAROLINE 23124 NEW KENT 23286 RICHMOND CITY22538 CAROLINE 23129 GOOCHLAND 23288 HENRICO22546 CAROLINE 23139 POWHATAN 23289 HENRICO22552 CAROLINE 23140 NEW KENT 23290 RICHMOND CITY22580 CAROLINE 23141 NEW KENT 23291 RICHMOND CITY22920 NELSON 23146 HANOVER 23292 RICHMOND CITY22922 NELSON 23150 HENRICO 23293 RICHMOND CITY22938 NELSON 23153 GOOCHLAND 23294 HENRICO22949 NELSON 23160 GOOCHLAND 23295 RICHMOND CITY22954 NELSON 23162 HANOVER 23298 RICHMOND CITY22958 NELSON 23170 LOUISA 23921 BUCKINGHAM22963 FLUVANNA 23173 RICHMOND CITY 23936 BUCKINGHAM22964 NELSON 23192 HANOVER 23939 APPOMATTOX22967 NELSON 23218 RICHMOND CITY 23958 APPOMATTOX22969 NELSON 23219 RICHMOND CITY 24069 PITTSYLVANIA22971 NELSON 23220 RICHMOND CITY 24139 PITTSYLVANIA22974 FLUVANNA 23221 RICHMOND CITY 24161 PITTSYLVANIA22976 NELSON 23222 RICHMOND CITY 24464 NELSON23002 AMELIA 23223 RICHMOND CITY 24502 CAMPBELL23004 BUCKINGHAM 23224 RICHMOND CITY 24517 CAMPBELL23005 HANOVER 23225 RICHMOND CITY 24522 APPOMATTOX23011 NEW KENT 23226 HENRICO 24527 PITTSYLVANIA23014 GOOCHLAND 23227 HENRICO 24528 CAMPBELL23015 HANOVER 23228 HENRICO 24530 PITTSYLVANIA23022 FLUVANNA 23229 HENRICO 24531 PITTSYLVANIA23024 LOUISA 23230 HENRICO 24538 CAMPBELL23027 CUMBERLAND 23231 HENRICO 24540 DANVILLE CITY23038 GOOCHLAND 23231 HENRICO 24541 DANVILLE CITY23039 GOOCHLAND 23232 RICHMOND CITY 24543 DANVILLE CITY23040 CUMBERLAND 23233 HENRICO 24544 DANVILLE CITY23047 HANOVER 23234 RICHMOND CITY 24549 PITTSYLVANIA23055 FLUVANNA 23238 HENRICO 24550 CAMPBELL23058 HENRICO 23240 RICHMOND CITY 24553 NELSON23059 HENRICO 23241 RICHMOND CITY 24554 CAMPBELL23060 HENRICO 23242 HENRICO 24557 PITTSYLVANIA23063 GOOCHLAND 23249 RICHMOND CITY 24562 BUCKINGHAM23065 GOOCHLAND 23250 HENRICO 24563 PITTSYLVANIA23067 GOOCHLAND 23255 HENRICO 24565 PITTSYLVANIA23069 HANOVER 23260 RICHMOND CITY 24566 PITTSYLVANIA23075 HENRICO 23261 RICHMOND CITY 24569 PITTSYLVANIA23083 AMELIA 23269 RICHMOND CITY 24571 CAMPBELL23084 FLUVANNA 23272 RICHMOND CITY 24576 CAMPBELL23089 NEW KENT 23273 RICHMOND CITY 24581 NELSON23093 LOUISA 23274 RICHMOND CITY 24586 PITTSYLVANIA23101 POWHATAN 23275 RICHMOND CITY 24588 CAMPBELL23102 GOOCHLAND 23276 RICHMOND CITY 24590 BUCKINGHAM/FLU23103 GOOCHLAND 23278 RICHMOND CITY 24593 APPOMATTOX

24594 PITTSYLVANIA24599 BUCKINGHAM

Table 4: Iowa Zip Codes

ZIP_CODE CITY COUNTY 52722 BETTENDORF SCOTT 52726 BLUE GRASS SCOTT 52728 BUFFALO SCOTT 52745 DIXON SCOTT 52746 DONAHUE SCOTT 52748 ELDRIDGE SCOTT 52753 LE CLAIRE SCOTT 52756 LONG GROVE SCOTT 52758 MC CAUSLAND SCOTT 52765 NEW LIBERTY SCOTT

52767 PLEASANT VALLEY SCOTT

52768 PRINCETON SCOTT 52773 WALCOTT SCOTT 52801 DAVENPORT SCOTT 52802 DAVENPORT SCOTT 52803 DAVENPORT SCOTT 52804 DAVENPORT SCOTT 52805 DAVENPORT SCOTT 52806 DAVENPORT SCOTT 52807 DAVENPORT SCOTT 52808 DAVENPORT SCOTT 52809 DAVENPORT SCOTT 52769 STOCKTON SCOTT

Table 5: 2005 Fee Schedule Amounts for CPT 98943

NonFacility

StFee Schedule ate Carrier

Du Ka l, IL $25.91

page, ne, Lake, Wil00952

Co $26.36ok, IL 00952 re g c L $23.62mainin ounties in I 00952 Cu nd $24.55mberla , York, ME 31142 re g c $23.57mainin ounties in ME 31142 IA $23.31 00826 NM $23.62 00521 VA $23.92 00904

Table 6: Procedure Codes Procedure Codes (CPT/H PCS):C Chiropractic manipulation codes

9894

3 extraspinal manip

ment Codes m m

3 New patient 30 m4 New patient 45 m

99205 New patient 60 minutes 99211 Established patient 5 minutes 99212 Established patient 10 minutes 99213 Established patient 15 minutes 99214 Established patient 25 minutes 99215 Established patient 40 minutes Test Codes 95831 Muscle testing, manual w/ report; extremity or trunk 95832 Hand, with or without comparison with normal side 95833 Total evaluation of body, excluding hands 95834 Total evaluation of body, including hands

95851 Range of motion measurements and report; each extremity or each trunk section

95852 Hand, with or without comparison with normal side 95857 Tensilon test for myasthenia gravis 95858 With electromyographic recording

95860 Needle electromyography; one extremity with or without related paraspinal areas

95861 Two extremities with or without related paraspinal areas

95863 Three extremities with or without related paraspinal areas

95864 Four extremities with or without related paraspinal areas95867 Cranial nerve supplied muscles, unilateral 95868 Cranial nerve supplied muscles, bilateral

95900 Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study

95903 Motor, with F-wave study 95904 Sensory Therapy codes

64550 Application of surface (transcutaneous) neurostimulator 97012 traction, mechanical 97018 parafin bath 97020 Microwave 97024 Diathermy 97026 Infrared 97028 Ultraviolet

ulation

eEvaluation and Manag99201 New patient 10

02 New patient 20inutes

992 inutes 9920 inutes 9920 inutes

97032 electrical stimulation, constant attendance

97035 Ultrasound

97110 therapeutic exercise

e

116124139 edure

140

150

504

530 erapeutic activities--dynamic activities to improve

97703

750 asurement, with written

97799

G0283

0 20

040 s

spine cervical 4+ views

mplete,

tanding for thoracolumbar

oracic 2 views

97034 contrast baths

97039 unlisted modality

97112 neuromuscular reducation

97113 aquatic therapy with exercis

97 gait training 97 Massage 97 unlisted therapeutic proc

97 Manual therapy techniques

97 therapeutic procedures, group

97 orthotic fitting and training

97Thfunctional performance

check out for orthotics and prosthetic use physical performance test or me

97 report

unlisted physical medicine/rehabilitation service

unattended electrical stimulation for other than wound care

X rays

7201720

x-ray spine entire x-ray spine, 1 view

72 xray spine cervical 2-3 view

72050 x-ray,

72052 x-ray spine cervical co

72069 x-ray spine s

72070 x-ray spine th

72072 x-ray spine thoracic 3 views

thoracic 4+ views

bar 2 views

72090 x-ray spine thoracolumbar supine and standing

mbosacral 2-3 views

s

plete

g only

72170

72200 x-ray sacroiliac joints, up to 3 views

72202 x-sacroiliac joints 3+ views

72220

73000 x-ray clavicle complete 73010 x-ray scapula compete

73030 x-ray shoulder 2+ views

50 acromioclavicular joint, bilateral

73060 x-ray humerus, 2+ views

70 -ray elbow 2 views s s

73110 x-ray wrist, 3+ views

73130 x-ray hand 3+ views

72074 x-ray, spine

72080 x-ray spine thoracolum

72100 x-ray spine lu

72110 x-ray spine lumbosacral 4+ view

72114 x-ray spine lumbosacral com

72120 x-ray spine lumbosacral bendin

x-ray pelvis, 1-2 views x-ray pelvis complete 72190

x-ray sacrum and coccyx 2+ views

73020 x-ray shoulder 1 view

730 x-ray

730 x73080 x-ray elbow 3+ view73090 x-ray forearm 2 view73100 x-ray wrist, 2 views

73120 x-ray hand 2 views

73140 x-ray finger(s) 2+ views

73500 x-ray hip unilateral 1 view

73510 x-ray hip unilateral 2+ views

73520 x-ray hip bilateral 2+ views

73550 x-ray femur 2 views 73560 x-ray knee 1-2 views

73564 x-ray knee 4+ views

73590 x-ray tibia fibula 2 views

73600 x-ray ankle 2 views

73620 x-ray foot, two views

73650 x-ray heel 2+ views

ews

71120 x-ray sternum, 2+ views

71130 x-ray, sternum+sc joint

73562 x-ray knee 3 views

73565 x-ray bilateral knees standing

73610 x-ray ankle 3+ views

73630 x-ray foot, 3+ views

73660 x-ray toe--2 or more views

71100 xray ribs, unilateral; 2 views

71110 x-ray ribs, bilateral 3 vi

Table 7: Diagnosis Codes Diagnosis (ICD-9) Codes:

Co Specific codes within the range 307.81

elitis

346 Migraine 346.00-.01, 346.10-.11, 346.20-.21, 346.80-.81, 346.90-.91 350.1, 350.2

352 disorder cranial nerve 352.4 nd

353.0, 353.1, 353.2, 353.4, 353.6 b and

354.0, 354.1, 354.2, 354.3, 354.4, 354.8, 354.9 mb 355.0, 355.1, 355.2, 355.3, 355.4, 355.5, 355.6, 355.71, 355.79, 355.8, 355.9

356 idoiopathic 356.1, 356.4, 356.8, 356.9 358.00, 358.01

715 Arthritis, osteoarthritis* 715.0x, 715.1x, 715.2x, 715.3x, 715.8x, 715.9x 716.1x, 716.2x, 716.3x, 716.4x, 716.5x, 716.6x, 716.8x, 716.9x

717 derangement, knee internal 717.0-3, 717.40-43, 717.49, 717.5-7, 717.81-84, 717.85, 717.89, 717.9 718.0x, 718.1x, 718.6x, 718.8x, 718.9x, 718.48

719 disorder, joint NEC/NOS* 719.0x, 719.1x, 719.2x, 719.3x, 719.4x, 719.5x, 719.6x, 719.7, 719.8x, 719.9x

720

nd he inflammatory

spondylopathies 720.0, 720.1, 720.2, 720.81, 720.89, 720.9

721 Spondylosis and allied disorders 721.0, 721.1, 721.2, 721.3, 721.41, 721.42, 721.5, 721.6, 721.7, 721.8, 721.90, 721.91

722 disorder, intervertebral disc 722.0, 722.10-.11, 722.2, 722.30-.32, 722.39-.4, 722.51-.52, 722.6, 722.70-.73, 722.81-.83, 722.91-.93

723 disorder cervical spine 723.0, 723.1, 723.2, 723.3, 723.4, 723.5, 723.6, 723.7, 723.8, 723.9 724 disorders, back NEC/NOS 724.00-02, 724.1-6, 724.70, 724.71, 724.79, 724.8, 724.9 725 Polymyalgia rheumatica

726 enthesopathies, peripheral and allied syndromes

726.0, 726.10-.12, .19, 726.2, 726.30-.32, .39, 726.4, .5, 726.60-.65, .69, 726.70-.73,.79, 726.8, .90, .91

727 disorders, synovium tendon and bursa

727.00-.06, 727.09,.1, .2, .3, 727.40-.43, 727.49, 727.50-.51, 727.59, 727.60-.69, 727.81-.83, 727.89-.9

728 disorders, muscle, ligament and fascia

728.10-.12, 728.2, .3, .4, .5, .6, 728.71, 728.79, 728.81, 728.83, 728.85, 728.87, 728.89, 728.9

729 Other disorders of soft tissues 729.0-.2, 729.5, 729.8-.9

733 Other disorders of bone and cartilage 733.6, 733.92

735 deformity, toe acquired 735.0, 735.1, 735.2, 735.4, 735.5, 735.8, 735.9

736 Deformity, limbs acquired 736.00-.07, 736.09-.1, 736.20-.22, 736.29-.32, 736.39, 736.41-.42, 736.6, .70-.76, 736.79, 736.81, 736.89

737 Curvature spine 737.0, 737.10, 737.11, 737.12, 737.19, 737.20-22, 737.29, 737.30-34, 737.40-43, 737.8, 737.9

de Description 307 Special symptoms 138 Late effects of poliomy340 Multiple sclerosis

350 Trigeminal neuralgia

353 plexus disorder, nerve root a

354 multiple Mononeuritis, upper lim

355 Mononeuritis, lower liNeuropathy, hereditary and

358 disorders myoneural

716 Arthropathies, NEC/NOS*

718 derangement, other joint*

Spondylitis, ankylosing aot

738 deformity, acquired 738.2-9 739 Lesions, nonallopathic NEC 739.0-9

754 loskeletal

deformities 754.1, 754.2, 754.40-44, 754.50-53, 754.59, 754.60-62, 754.69, 754.70, 754.71, 754.79

other co

56.10-15, 756.17, 756.19, 756.2, 756.3 756.4, 756.82, 756.83, 756.89 s of

nd upper arm elbow

3, ist

844 e

844.0-844.3, 844.8, 844.9 strains of ankle

9-13, 845.19 e

sues

907 s, injuries to the

nervous system .33, 922.8

) of

and lower limb

s d

* = "x" atomic site, and an be appropriate

Congenital muscu

756

ngenital musculoskeletal abnormalities 7 ,

840 Sprains and strainshoulder a 840.1-9

841 Sprains and strains ofand forearm 841.0-.

842 Sprains and strains of wrand hand 842.00-02, 842.09-13, 842.19

843 Sprains and strains of hip and thigh 843.0, 843.1, 843.8, 843.9 Sprains and strains of kneand leg Sprains and

845 and foot 845.00-03, 845.0

846 Sprains and strains of thsacroiliac region 846.0-3, 846.8, 846.9

847 Sprains and strains of back NEC/NOS 847.0-4, 847.9

848 Sprains and strains, ill-defined, NEC Late effects, musculoskeletal and connective tis

848.3, 848.40-42, 848.49, 848.8, 848.9

905 injuries Late effect

905.1-9

907.0, 907.1-5, 907.9 922 Contusion, trunk 922.1, 922.31, 922.32, 922923 Contusion, upper limb 923.00-03, 923.09-11, 923.20-21, 923.3, 923.8, 923.9 924 Contusion, lower limb 924.00, 924.01, 924.10-11, 924.20-21, 924.3-5, 924.8, 924.9

955

Injury, peripheral nerve(sshoulder girdle and upper limb 955.0-9

956 Injury, peripheral nerve(s) of pelvic girdle 956.0-5, 956.8, 956.9

958 Certain traumatic complication 958.6

784 Symptoms involving heaand neck 784.0 cifies an spe y value would

Table 8: MSN Message Text English Beginning April 1, 2005 through Mar ll cover additional chiropractic services. For more to your chiropractor, call 1-800-MEDICARE, or go to http://ww esearchers/demos/eccs/default.asp . Spanish Come 5 ha de marzo de 2007, Medicare cubrirá má serviciosquirop con su quiropráctico, llame al 1-800-MEDICARE o visite el sitio de Internet http://www.c v/researchers/demos/eccs/ fault.asp.

ch 31, 2007, Medicare wiinformation, talkw.cms.hhs.gov/r

nzando el 1 de abril de 200 sta el 31 s rácticos. Para más información, comuníquese

ms.hhs.go de