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Centers for Medicare & Medicaid Services (CMS) November 2017 Local Coverage Determination (LCD) Updates

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

November 5th 2017 updates:

DOCUMENT ID DOCUMENT TITLE CONTRACTOR LAST UPDATED
L33982 (retired) Chiropractic Services CGS Administrators, LLC 11/5/2017
L36954 Noncovered Services other than CPT® Category III Noncovered Services Palmetto GBA 11/3/2017
L34555 Non-Covered Category III CPT Codes Palmetto GBA 11/3/2017
L35677 Infliximab Palmetto GBA 11/3/2017
L36471 Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy Palmetto GBA 11/3/2017
L34417 CT of the Head Palmetto GBA 11/3/2017
L33457 Cardiac Radionuclide Imaging Palmetto GBA 11/3/2017
L34556 Spinal Cord Stimulators for Chronic Pain Palmetto GBA 11/3/2017
L34416 Computerized Axial Tomography of the Chest/Thorax Palmetto GBA 11/3/2017
L34565 Home Health-Surface Electrical Stimulation in the Treatment of Dysphagia Palmetto GBA 11/3/2017
L36209 Cardiology – non-emergent outpatient testing: exercise stress test, stress echo, MPI SPECT, and cardiac PET First Coast Service Options, Inc. 11/3/2017
A55789 Cardiology— non-emergent outpatient testing: exercise stress test, stress echo, MPI SPECT, and cardiac PET revision to the Part A and B LCD First Coast Service Options, Inc. 11/3/2017
A53001 Wound Care Novitas Solutions, Inc. 11/3/2017
L35125 Wound Care Novitas Solutions, Inc. 11/3/2017
L34938 Removal of Benign Skin Lesions Novitas Solutions, Inc. 11/3/2017
L34999 Transoral Incisionless Fundoplication Novitas Solutions, Inc. 11/3/2017
L36920 Epidural Injections for Pain Management Novitas Solutions, Inc. 11/3/2017
L35093 Intravenous Immune Globulin (IVIG) Novitas Solutions, Inc. 11/3/2017
L34093 Chemotherapy and Biologicals CGS Administrators, LLC 11/3/2017
L35450 Spinal Cord Stimulation (Dorsal Column Stimulation) Novitas Solutions, Inc. 11/3/2017
L35094 Services That Are Not Reasonable and Necessary Novitas Solutions, Inc. 11/3/2017
A52986 Biomarkers for Oncology Novitas Solutions, Inc. 11/3/2017
L35396 Biomarkers for Oncology Novitas Solutions, Inc. 11/3/2017
A54862 Nivolumab (Opdivo®) – Related to LCD L33394 National Government Services, Inc. 11/3/2017
A55791 Corticotropin retired Part B LCD First Coast Service Options, Inc. 11/2/2017
A55790 Creatine Kinase (CK), (CPK) retired Part A and Part B LCD First Coast Service Options, Inc. 11/2/2017
L36174 MolDX: NSCLC, Comprehensive Genomic Profile Testing CGS Administrators, LLC 11/2/2017
L36113 MolDX: MGMT Promoter Methylation Analysis CGS Administrators, LLC 11/2/2017
L36117 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease CGS Administrators, LLC 11/2/2017
A54240 Bladder Tumor Marker FISH Billing and Coding Guidelines Update CGS Administrators, LLC 11/2/2017
A54242 MolDX: 9p21 Genotype Test Coding and Billing Guideline CGS Administrators, LLC 11/2/2017
A54242 MolDX: 9p21 Genotype Test Coding and Billing Guideline CGS Administrators, LLC 11/2/2017
A54272 MolDX: KIF6 Genotype Billing and Coding Guidelines CGS Administrators, LLC 11/2/2017
A54260 MolDX: CYP2B6 Test Coding and Billing Guidelines CGS Administrators, LLC 11/2/2017
A54269 MolDX: HTTLPR Gene Testing Coding and Billing Guidelines CGS Administrators, LLC 11/2/2017
A54275 MolDX: LPA-Aspirin Genotype Coding and Billing Guidelines CGS Administrators, LLC 11/2/2017
A54276 MolDX: LPA-Intron 25 Genotype Coding and Billing Guidelines CGS Administrators, LLC 11/2/2017
A54186 MolDX: AlloMap Billing and Coding Guidelines Update CGS Administrators, LLC 11/2/2017
A54241 MolDX: 4q25-AF Risk Genotype Coding and Billing Guidelines CGS Administrators, LLC 11/2/2017
L36675 MolDX- CDD: ProMark Risk Score CGS Administrators, LLC 11/2/2017
L36002 MolDX-CDD: Prolaris™ Prostate Cancer Genomic Assay CGS Administrators, LLC 11/2/2017
L36206 MolDX-CDD: Genomic Health™ Oncotype DX® Prostate Cancer Assay CGS Administrators, LLC 11/2/2017
A52885 (retired) Non-coverage of Transoral Incisionless Fundoplication Noridian Healthcare Solutions, LLC 11/1/2017
A52893 (retired) Non-coverage of Transoral Incisionless Fundoplication Noridian Healthcare Solutions, LLC 11/1/2017
L33617 Erythropoiesis Stimulating Agents (ESA) National Government Services, Inc. 11/1/2017
A52380 (retired) Hyperbaric Oxygen (HBO) Therapy – Medical Policy Article National Government Services, Inc. 10/31/2017
A54297 MolDX: PTCH1 Gene Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54296 MolDX: PreDx® Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54295 MolDX: PIK3CA Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54293 MolDX: PAX6 Gene Sequencing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54689 MolDX: Myriad’s BRACAnalysis CDx™ Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54688 MolDX: FDA-Approved KRAS Tests CGS Administrators, LLC 10/30/2017
A54598 MolDX: FDA Approved ALK Companion Diagnostic Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54687 MolDX: CYP2C9 and/or VKORC1 Gene Testing for Warfarin Response Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54238 MolDX: cobas® 4800 BRAF V600 Test Billing/Coding Guidelines CGS Administrators, LLC 10/30/2017
A54685 MolDX: Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54686 MolDX: BCR-ABL Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54201 MolDX: Vectra™ DA Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54280 MolDX: UGT1A1 Gene Analysis Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54281 MolDX: TP53 Gene Test Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54200 MolDX: therascreen® KRAS PCR Kit Billing/Coding Guidelines CGS Administrators, LLC 10/30/2017
A54199 MolDX: Therascreen® EGFR RGQ PCR Kit Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54282 MolDX: TERC Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54283 MolDX: SULT4A1 Genetic Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54284 MolDX: STAT3 Gene Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54285 MolDX: SMPD1 Genetic Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54286 MolDX: SLCO1B1 Genotype Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54300 MolDx: SEPT9 Gene Test Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54299 MolDX: RPS19 Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54198 MolDX: ResponseDX Tissue of Origin® Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54197 MolDX: Progensa® PCA3 Assay Coverage Update CGS Administrators, LLC 10/30/2017
A54196 MolDX: Oncotype DX® Colon Cancer Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54195 MolDX: Oncotype DX® Breast Cancer Assay Billing and Coding Guidelines CGS Administrators, LLC 10/30/2017
A54292 MolDX: OncoCee™ Billing and Coding Guidelines CGS Administrators, LLC 10/30/2017
A54291 MolDX: NSD1 Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54290 MolDX: myPap™ Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54288 MolDX: Mitochondrial Nuclear Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54278 MolDX: MECP2 Genetic Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54277 MolDX: MCOLN1 Genetic Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54194 MolDX: MammaPrint Billing and Coding Guidelines Update CGS Administrators, LLC 10/30/2017
A54276 MolDX: LPA-Intron 25 Genotype Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54275 MolDX: LPA-Aspirin Genotype Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54274 MolDX: L1CAM Gene Sequencing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54273 MolDX: know error® Billing and Coding Guidelines Update CGS Administrators, LLC 10/30/2017
A54272 MolDX: KIF6 Genotype Billing and Coding Guidelines CGS Administrators, LLC 10/30/2017
A54271 MolDX: Immunohistochemistry (IHC) Indications for Breast Pathology CGS Administrators, LLC 10/30/2017
A54270 MolDX: IKBKAP Genetic Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54269 MolDX: HTTLPR Gene Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54268 MolDX: HEXA Gene Analysis Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54193 MolDX: HERmark® Assay by Monogram Update CGS Administrators, LLC 10/30/2017
A54267 MolDX: HBB Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54266 MolDX: HAX1 Gene Sequencing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54265 MolDX: GBA Genetic Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54264 MolDX: Fragile X Coding and Billing Guidelines Update CGS Administrators, LLC 10/30/2017
A54192 MolDX: FDA-Approved EGFR Tests CGS Administrators, LLC 10/30/2017
A54191 MolDX: FDA-Approved BRAF Tests CGS Administrators, LLC 10/30/2017
A54263 MolDX: FANCC Genetic Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54262 MolDX: ENG and ACVRL1 Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54260 MolDX: CYP2B6 Test Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54189 MolDX: cobas® EGFR Mutation Test Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54258 MolDX: CFTR Gene Analysis Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54257 MolDX: BluePrint® Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54256 MolDX: BLM Gene Analysis Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54188 MolDX: bioTheranostics Cancer TYPE ID® Update CGS Administrators, LLC 10/30/2017
A54255 MolDX: BCKDHB Gene Test Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54187 MolDX: Avise PG Assay Billing/Coding Update CGS Administrators, LLC 10/30/2017
A54254 MolDX: ATP7B Gene Tests Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54253 MolDX: Aspartoacyclase 2 Deficiency(ASPA) Testing Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54244 MolDX: ApoE Genotype Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
L34416 Computerized Axial Tomography of the Chest/Thorax Palmetto GBA 10/30/2017
A54186 MolDX: AlloMap Billing and Coding Guidelines Update CGS Administrators, LLC 10/30/2017
A54185 MolDX: Afirma™ Assay by Veracyte Update CGS Administrators, LLC 10/30/2017
A54242 MolDX: 9p21 Genotype Test Coding and Billing Guideline CGS Administrators, LLC 10/30/2017
L34556 Spinal Cord Stimulators for Chronic Pain Palmetto GBA 10/30/2017
A54241 MolDX: 4q25-AF Risk Genotype Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
L33445 Removal of Benign and Malignant Skin Lesions Palmetto GBA 10/30/2017
A54243 MolDX: CHD7 Gene Analysis Coding and Billing Guidelines CGS Administrators, LLC 10/30/2017
A54240 Bladder Tumor Marker FISH Billing and Coding Guidelines Update CGS Administrators, LLC 10/30/2017
L36954 Noncovered Services other than CPT® Category III Noncovered Services Palmetto GBA 10/30/2017
L34555 Non-Covered Category III CPT Codes Palmetto GBA 10/30/2017
L34045 Non-Invasive Vascular Studies CGS Administrators, LLC 10/30/2017
L36675 MolDX- CDD: ProMark Risk Score CGS Administrators, LLC 10/30/2017
L35443 MolDX: GeneSight ® Assay for Refractory Depression CGS Administrators, LLC 10/30/2017
L36656 MolDX-CDD: Decipher® Prostate Cancer Classifier Assay CGS Administrators, LLC 10/30/2017
L36021 Molecular Diagnostic Tests (MDT) CGS Administrators, LLC 10/30/2017
L35349 MolDX: Genetic Testing for Lynch Syndrome CGS Administrators, LLC 10/30/2017
A52437 Sentinel Lymph Node Biopsy – Medical Policy Article CGS Administrators, LLC 10/30/2017
A52435 Osteopathic Manipulative Treatment CGS Administrators, LLC 10/30/2017
A52528 Allergen Immunotherapy CGS Administrators, LLC 10/30/2017
A54812 Antibacterial Drugs Palmetto GBA 10/30/2017
L33952 Cardiac Event Detection CGS Administrators, LLC 10/30/2017
L33947 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) CGS Administrators, LLC 10/30/2017
L33959 Cardiac Catheterization and Coronary Angiography CGS Administrators, LLC 10/30/2017
L33946 Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy CGS Administrators, LLC 10/30/2017
L33944 Blepharoplasty CGS Administrators, LLC 10/30/2017
L32553 Allergy Immunotherapy CGS Administrators, LLC 10/30/2017
A55521 (retired) Response to Comments: White Cell Colony Stimulating Factors Palmetto GBA 10/30/2017
A55517 (retired) Response to Comments: CT of the Head Palmetto GBA 10/30/2017

 

 

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

 

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