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Centers for Medicare & Medicaid Services (CMS) January 15th 2018 Local Coverage Determination (LCD) Updates

Centers For Medicare & Medicaid Services (CMS) January 15th 2018 Local Coverage Determination (LCD) Updates
Centers for Medicare & Medicaid Services (CMS) Local Coverage Determination (LCD) Updates

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

January 15th 2018 Policy Updates:

DOCUMENT ID DOCUMENT TITLE
A52985 Acute Care: Inpatient, Observation and Treatment Room Services
L36241 Allergy Testing
L35041 Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds
A54117 Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds
A52687 Billing – Submission of Claims for Compounded Medications for Infusion Pumps for Treatment of Chronic Intractable Pain
A52688 Billing and Coding – Clarification of the Proper Use and Billing of Adenosine Injections
A52689 Billing and Coding – Removal of Impacted Cerumen and Evaluation and Management Services
A55352 Billing and Coding for Rezum® Procedure
L35396 Biomarkers for Oncology
A52986 Biomarkers for Oncology
L35062 Biomarkers Overview
L36715 BRCA1 and BRCA2 Genetic Testing
A52375 Category III CPT® Code Coverage
L34370 Category III CPT® Codes
L35006 Controlled Substance Monitoring and Drugs of Abuse Testing
L36393 Controlled Substance Monitoring and Drugs of Abuse Testing
A55878 Controlled substance monitoring and drugs of abuse testing revision to the Part A and Part B LCD
A52690 Drugs and Biologicals – Ziconotide Intrathecal Infusion (Prialt ®) (J2278)
L34253 Drugs and Biologicals: Botulinum Toxins
L34254 Drugs and Biologicals: Colony Stimulating Factors
L34256 Drugs and Biologicals: Immune Globulin Intravenous (IVIg)
L34257 Drugs and Biologicals: Infliximab (REMICADE ®)
L34258 Drugs and Biologicals: Octreotide Acetate for Injectable Suspension (Sandostatin LAR ® Depot)
L34258 Drugs and Biologicals: Octreotide Acetate for Injectable Suspension (Sandostatin LAR ® Depot)
L34260 Drugs and Biologicals: Zoledronic Acid
A52693 Educational Article – CPT 0171T and 0172T (Insertion of posterior spinous process distraction device)
A52694 Educational Article – Gastric Restrictive Procedures and Subsequent Visits
A52695 Educational Article – Guidelines for the Use of “Scribes” in Medical Record Documentation
A52696 Educational Article – Pulmonary Rehabilitation (PR) Services
A53124 Endovascular Repair of Aortic and/or Iliac Aneurysms
L36920 Epidural Injections for Pain Management
L35111 Hemophilia Factor Products
L35427 Hyaluronan Acid Therapies for Osteoarthritis of the Knee
A55036 Hyaluronan Acid Therapies for Osteoarthritis of the Knee
L35448 Independent Diagnostic Testing Facility (IDTF)
A53252 Independent Diagnostic Testing Facility (IDTF)
A55287 LCD – Comment/Response – Medicine: Home Sleep Testing (HST) (L36745)
A55303 LCD – Comment/Response – Pathology and Laboratory: BRCA1 and BRCA2 Genetic Testing (L36741)
A55015 LCD – Comment/Response – Pathology and Laboratory: KRAS Testing prior to Treatment of Colorectal Cancer (CRC) (L36582)
A55309 LCD – Comment/Response – Radiology: Intensity Modulated Radiotherapy (IMRT) (L36743)
A55733 Local Coverage Article: Ventricular Assist Device (VAD) Supply or Accessory (A55733)
A55733 Local Coverage Article: Ventricular Assist Device (VAD) Supply or Accessory (A55733)
L34500 Medicine: Autonomic Function Tests
L36945 Medicine: Bioimpedance Spectroscopy (BIS) Devices for the Detection and Management of Lymphedema
L36945 Medicine: Bioimpedance Spectroscopy (BIS) Devices for the Detection and Management of Lymphedema
L34262 Medicine: Health and Behavior Assessment/Intervention
L36745 Medicine: Home Sleep Testing (HST)
L36745 Medicine: Home Sleep Testing (HST)
L34263 Medicine: Hydration Therapy
L34263 Medicine: Hydration Therapy
L34264 Medicine: Long-Term Wearable Electrocardiographic Monitoring (WEM)
L34265 Medicine: Nerve Conduction Studies (NCS) and Electromyography (EMG)
L34266 Medicine: Neurophysiology Evoked Potentials (NEPs)
L34267 Medicine: Noninvasive Peripheral Arterial and Venous Studies
L35941 Medicine: Psychotherapy Services
L34269 Medicine: Repetitive Transcranial Magnetic Stimulation (rTMS) for Resistant Depression
L34270 Medicine: Wireless Capsule Imaging
L34270 Medicine: Wireless Capsule Imaging
L37305 MolDX: Oncotype DX® Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer
L37321 MolDX: Oncotype DX® Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer
L35000 Molecular Pathology Procedures
L35049 Monitored Anesthesia Care
A52698 NCD – Pharmacogenomic Testing for Warfarin Response
A52698 NCD – Pharmacogenomic Testing for Warfarin Response
A52699 NCD – Sterilization
A53134 NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions
A53132 NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions
L35456 Nerve Blockade for Treatment of Chronic Pain and Neuropathy
L35457 Nerve Blockade for Treatment of Chronic Pain and Neuropathy
L34975 Neurophysiology Evoked Potentials (NEPs)
L33777 Noncovered Services
A55880 Noncovered services (procedure codes 0449T and 0450T) – revision to the Part A and Part B local coverage article
L35409 Non-Vascular Extremity Ultrasound
A55037 Non-Vascular Extremity Ultrasound
L36741 Pathology and Laboratory: BRCA1 and BRCA2 Genetic Testing
L36741 Pathology and Laboratory: BRCA1 and BRCA2 Genetic Testing
L34271 Pathology and Laboratory: B-type Natriuretic Peptide (BNP) Testing
L34273 Pathology and Laboratory: Circulating Tumor Cells (CTC) Assays
L34273 Pathology and Laboratory: Circulating Tumor Cells (CTC) Assays
L34272 Pathology and Laboratory: C-Reactive Protein; High Sensitivity (hsCRP)
L34272 Pathology and Laboratory: C-Reactive Protein; High Sensitivity (hsCRP)
L35660 Pathology and Laboratory: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing
L35660 Pathology and Laboratory: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing
L35553 Pathology and Laboratory: Genetic Testing for Lynch Syndrome
L35553 Pathology and Laboratory: Genetic Testing for Lynch Syndrome
L36582 Pathology and Laboratory: K-ras Testing prior to Treatment of Colorectal Cancer (CRC)
L34943 Pathology and Laboratory: Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing
L34943 Pathology and Laboratory: Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing
L36444 Pathology and Laboratory: Molecular RBC Phenotype
L36444 Pathology and Laboratory: Molecular RBC Phenotype
L36446 Pathology and Laboratory: Partial Genome Profiling in Non Small Cell Lung Cancer (NSCLC)
L36446 Pathology and Laboratory: Partial Genome Profiling in Non Small Cell Lung Cancer (NSCLC)
L34501 Pathology and Laboratory: Qualitative Drug Testing
L35920 Pathology and Laboratory: Quantitative Drug Testing
L35920 Pathology and Laboratory: Quantitative Drug Testing
L34274 Pathology and Laboratory: Vitamin D Assay Testing
L34274 Pathology and Laboratory: Vitamin D Assay Testing
L35679 Pharmacokinetic (PK) Testing for Chemotherapy Dosing
L34275 Radiology: Computed Tomographic (CT) Colonography
L34276 Radiology: Computed Tomographic Angiography of the Heart and Coronary Vessels
L34277 Radiology: Computed Tomography of the Abdomen and Pelvis
L36743 Radiology: Intensity Modulated Radiation Therapy (IMRT)
L34278 Radiology: Magnetic Resonance Imaging of the Brain
L34278 Radiology: Magnetic Resonance Imaging of the Brain
L34279 Radiology: Myocardial Perfusion Imaging (MPI)
L34279 Radiology: Myocardial Perfusion Imaging (MPI)
L34282 Radiology: Proton Beam Therapy
L34283 Radiology: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
L34938 Removal of Benign Skin Lesions
A55839 Response to Comments: MolDX: Oncotype DX® Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer
A55840 Response to Comments: MolDX: Oncotype DX® Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer
A55009 Response to Comments: Surgery: Implantable Pacemakers with Leads for Cardiac Rate, Dysrhythmia, Resynchronization, and Cardioversion/ Defibrillation (PM CRT AICD) (L36584)
A53127 Self-Administered Drug Exclusion List
A52700 Self-Administered Drug Exclusion List – JJ MAC
L35094 Services That Are Not Reasonable and Necessary
A54949 Single Chamber and Dual Chamber Permanent Cardiac Pacemakers – Coding and Billing
A52928 Sources of Information and Basis for Decision Noncovered Services LCD
L35070 Speech – Language Pathology (SLP) Services: Communication Disorders
A54111 Speech Language Pathology (SLP) Services: Communication Disorders
L34285 Surgery: Bioengineered Skin Substitutes (BSS) for the Treatment of Diabetic and Venous Stasis Ulcers of the Lower Extremities
L34286 Surgery: Blepharoplasty
L34286 Surgery: Blepharoplasty
L34288 Surgery: Colonoscopy (Diagnostic)
L34289 Surgery: Continuous Peripheral Nerve Blocks (CPNB)
L34290 Surgery: Debridement Services
L34290 Surgery: Debridement Services
L35942 Surgery: Fusion for Degenerative Joint Disease of the Lumbar Spine
L35658 Surgery: Implantable Hormone Pellets
L34291 Surgery: Injections of the Spinal Canal
L34291 Surgery: Injections of the Spinal Canal
L34292 Surgery: Interventional Renal Denervation (IRD) for Resistant Hypertension
L34292 Surgery: Interventional Renal Denervation (IRD) for Resistant Hypertension
L36084 Surgery: Leadless Cardiac Pacemaker
L36084 Surgery: Leadless Cardiac Pacemaker
L35889 Surgery: Left Atrial Appendage
L34293 Surgery: Lumbar Facet Blockade
L34294 Surgery: Major Joint Replacement (Hip and Knee)
L34294 Surgery: Major Joint Replacement (Hip and Knee)
L34295 Surgery: Nerve Blocks and Electrostimulation for Peripheral Neuropathy
L34296 Surgery: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control
L35554 Surgery: Reduction Mammaplasty
L35554 Surgery: Reduction Mammaplasty
L34944 Surgery: Routine Foot Care
L36879 Surgery: Spinal Cord Stimulators for Chronic Pain
L34298 Surgery: Transoral Incisionless Fundoplication (TIF)
L34300 Surgery: Vertebral Augmentation Procedures (VAPs)
L34300 Surgery: Vertebral Augmentation Procedures (VAPs)
L34301 Surgery: YAG Capsulotomy
L35036 Therapy and Rehabilitation Services (PT, OT)
L34302 Transportation Services: Ambulance
L34302 Transportation Services: Ambulance
L34924 Treatment of Varicose Veins and Venous Stasis Disease of the Lower Extremities
A55229 Treatment of Varicose Veins and Venous Stasis Disease of the Lower Extremitie

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

 

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