Centers for Medicare & Medicaid Services (CMS) February 25th 2018 Local Coverage Determination (LCD) Updates

Centers for Medicare & Medicaid Services (CMS) Local Coverage Determination (LCD) Updates »

February 25th 2018 LCD Updates:

• A54923                  Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
• A52370                  Bevacizumab – Related to LCD L33394
• A54829                  Clinical Social Worker Services
• A55913                  Correct Billing and Coding for Hospital Outpatient Drugs and Biologicals Under the Outpatient Prospective Payment System (OPPS)
• L34253 (retired)      Drugs and Biologicals: Botulinum Toxins
• L34254 (retired)      Drugs and Biologicals: Colony Stimulating Factors
• L34256 (retired)      Drugs and Biologicals: Immune Globulin Intravenous (IVIg)
• L34257 (retired)      Drugs and Biologicals: Infliximab (REMICADE ^®)
• L34258 (retired)      Drugs and Biologicals: Octreotide Acetate for Injectable Suspension (Sandostatin LAR ^® Depot)
• L34260 (retired)      Drugs and Biologicals: Zoledronic Acid
• L34636                   Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)
• L33670                   Fundus Photography
• A55905                  Fundus photography revision to the Part A and Part B LCD
• L34596                   Immunizations
• L34500 (retired)      Medicine: Autonomic Function Tests
• L36945 (retired)      Medicine: Bioimpedance Spectroscopy (BIS) Devices for the Detection and Management of Lymphedema
• L34261 (retired)      Medicine: Chiropractic Services
• L34262 (retired)      Medicine: Health and Behavior Assessment/Intervention
• L36745 (retired)      Medicine: Home Sleep Testing (HST)
• L34263 (retired)      Medicine: Hydration Therapy
• L34264 (retired)      Medicine: Long-Term Wearable Electrocardiographic Monitoring (WEM)
• L34265 (retired)      Medicine: Nerve Conduction Studies (NCS) and Electromyography (EMG)
• L34266 (retired)      Medicine: Neurophysiology Evoked Potentials (NEPs)
• L34267 (retired)      Medicine: Noninvasive Peripheral Arterial and Venous Studies
• L35941 (retired)      Medicine: Psychotherapy Services
• L34269 (retired)      Medicine: Repetitive Transcranial Magnetic Stimulation (rTMS) for Resistant Depression
• L34270 (retired)      Medicine: Wireless Capsule Imaging
• L36791                   MolDX: Decipher® Prostate Cancer Classifier Assay
• L36398                   MolDX: Genetic Testing for CYP2C19, CYP2D6, CYP2C9, and VKORC1
• A55846                  MolDX: ThermoFisher Oncomine Dx Target Test For Non-Small Cell Lung Cancer, Coding and Billing Guidelines
• A55911                  MolDX: ThermoFisher Oncomine Dx Target Test For Non-Small Cell Lung Cancer, Coding and Billing Guidelines
• A54862                  Nivolumab – Related to LCD L33394
• A52450                  Paclitaxel (e.g., Taxol®/Abraxane ™) – Related to LCD L33394
• L33930                   Paravertebral Facet Joint Blocks
• A55906                  Paravertebral facet joint blocks revision to the Part B LCD
• L34271 (retired)      Pathology and Laboratory: B-type Natriuretic Peptide (BNP) Testing
• L34273 (retired)      Pathology and Laboratory: Circulating Tumor Cells (CTC) Assays
• L34272 (retired)      Pathology and Laboratory: C-Reactive Protein; High Sensitivity (hsCRP)
• L35660 (retired)      Pathology and Laboratory: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing
• L35553 (retired)      Pathology and Laboratory: Genetic Testing for Lynch Syndrome
• L36582 (retired)      Pathology and Laboratory: K-ras Testing prior to Treatment of Colorectal Cancer (CRC)
• L34943 (retired)      Pathology and Laboratory: Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing
• L36444 (retired)      Pathology and Laboratory: Molecular RBC Phenotype
• L36446 (retired)      Pathology and Laboratory: Partial Genome Profiling in Non Small Cell Lung Cancer (NSCLC)
• L34501 (retired)      Pathology and Laboratory: Qualitative Drug Testing
• L35920 (retired)      Pathology and Laboratory: Quantitative Drug Testing
• L34274 (retired)      Pathology and Laboratory: Vitamin D Assay Testing
• L34761                   Percutaneous Coronary Interventions
• A54666                  Positron Emission Tomography Scans Coverage
• A54668                  Positron Emission Tomography Scans Coverage
• L35075                   Proton Beam Therapy
• L33538                   Radiation Therapy for T1 Basal Cell and Squamous Cell Carcinomas of the Skin
• A55907                  Radiation therapy for T1 basal cell and squamous cell carcinomas of the skin revision to the Part A and Part B LCD
• L34275 (retired)      Radiology: Computed Tomographic (CT) Colonography
• L34276 (retired)      Radiology: Computed Tomographic Angiography of the Heart and Coronary Vessels
• L34277 (retired)      Radiology: Computed Tomography of the Abdomen and Pelvis
• L36743 (retired)      Radiology: Intensity Modulated Radiation Therapy (IMRT)
• L34278 (retired)      Radiology: Magnetic Resonance Imaging of the Brain
• L34279 (retired)      Radiology: Myocardial Perfusion Imaging (MPI)
• L34280 (retired)      Radiology: Nonobstetric Pelvic Ultrasound
• L34282 (retired)      Radiology: Proton Beam Therapy
• L34283 (retired)      Radiology: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
• A55419 (retired)     Response to Comments: Medicine: Bioimpedance Spectroscopy (BIS) Devices for the Detection and Management of Lymphedema (L36945)
• A55692 (retired)     Response to Comments: MolDX: EndoPredict Breast Cancer Gene Expression Test
• A54833 (retired)     Response to Comments: Pathology and Laboratory: Molecular RBC Phenotyping (L36444)
• A54834 (retired)     Response to Comments: Pathology and Laboratory: Partial Genome Profiling in Non Small Cell Lung Cancer (NSCLC) (L36446)
• A55009 (retired)     Response to Comments: Surgery: Implantable Pacemakers with Leads for Cardiac Rate, Dysrhythmia, Resynchronization, and Cardioversion/ Defibrillation (PM CRT AICD) (L36584)
• A55417 (retired)     Response to Comments: Surgery: Spinal Cord Stimulators (SCS) for Chronic Pain (L36879)
• A55910                  Response to Comments: Wound Care (DL37228)
• A54846                  Screening and Diagnostic Mammography – coding guidelines
• A55914                  Screening and diagnostic mammography revision to the Part A and Part B coding guidelines article (A54846)
• L34556 (retired)      Spinal Cord Stimulators for Chronic Pain
• L35076                   Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
• L34284 (retired)      Surgery: Arthrocentesis, Aspiration, and/or Injection; Major Joint or Bursa
• L34285 (retired)      Surgery: Bioengineered Skin Substitutes (BSS) for the Treatment of Diabetic and Venous Stasis Ulcers of the Lower Extremities
• L34286 (retired)      Surgery: Blepharoplasty
• L34287 (retired)      Surgery: Cataract Extraction
• L34288 (retired)      Surgery: Colonoscopy (Diagnostic)
• L34289 (retired)      Surgery: Continuous Peripheral Nerve Blocks (CPNB)
• L34290 (retired)      Surgery: Debridement Services
• L35942 (retired)      Surgery: Fusion for Degenerative Joint Disease of the Lumbar Spine
• L35658 (retired)      Surgery: Implantable Hormone Pellets
• L34291 (retired)      Surgery: Injections of the Spinal Canal
• L34292 (retired)      Surgery: Interventional Renal Denervation (IRD) for Resistant Hypertension
• L36084 (retired)      Surgery: Leadless Cardiac Pacemaker
• L35889 (retired)      Surgery: Left Atrial Appendage
• L34293 (retired)      Surgery: Lumbar Facet Blockade
• L34294 (retired)      Surgery: Major Joint Replacement (Hip and Knee)
• L34295 (retired)      Surgery: Nerve Blocks and Electrostimulation for Peripheral Neuropathy
• L34296 (retired)      Surgery: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control
• L35554 (retired)      Surgery: Reduction Mammaplasty
• L34297 (retired)      Surgery: Removal of Benign or Premalignant Skin Lesions
• L34944 (retired)      Surgery: Routine Foot Care
• L36879 (retired)      Surgery: Spinal Cord Stimulators for Chronic Pain
• L34298 (retired)      Surgery: Transoral Incisionless Fundoplication (TIF)
• L34299 (retired)      Surgery: Trigger Point Injections
• L34300 (retired)      Surgery: Vertebral Augmentation Procedures (VAPs)
• L34301 (retired)      Surgery: YAG Capsulotomy
• L34302 (retired)      Transportation Services: Ambulance
• A55892                  Viscosupplementation therapy for knee revision to the Part A and Part B LCD

Centers for Medicare & Medicaid Services (CMS) Local Coverage Determination (LCD) Updates »

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