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Medicare (CMS) Local Coverage Determination (LCD) Updates – May 2019

Medicare (CMS) Local Coverage Determination (LCD) Updates – May 2019
Centers for Medicare & Medicaid Services (CMS) Local Coverage Determination (LCD) Updates

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

March 2019 Medicare (CMS) LCD Updates:

  • L34549                Ambulance Services
  • A52422               Billing and Codeing for Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer
  • A52422               Billing and Codeing for Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer
  • A52530               Billing and Coding for Capsaicin 8% patch (Qutenza®)
  • A52530               Billing and Coding for Capsaicin 8% patch (Qutenza®)
  • A56534               Billing and Coding for Denosumab (Prolia™, Xgeva™)
  • A56543               Billing and Coding for Durvalumab (Imfinzi)
  • A56514               Billing and Coding for Pathology Services on the Same Date of Service (DOS) as Mohs Surgery
  • A56515               Billing and Coding for Pathology Services on the Same Date of Service (DOS) as Mohs Surgery
  • A56468               Billing and Coding: Ambulance Services
  • A56476               Billing and Coding: Cardiac Radionuclide Imaging
  • A56545               Billing and Coding: Hospice – Renal Care
  • A56545               Billing and Coding: Hospice – Renal Care
  • A56506               Billing and Coding: Noncovered Services other than CPT® Category III Noncovered Services
  • A56531               Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin LAR® depot)
  • A56531               Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin LAR® depot)
  • A56389               Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
  • L33457                Cardiac Radionuclide Imaging
  • L34093                Chemotherapy and Biologicals
  • A52424 (retired)  Denosumab (Prolia ™, Xgeva ™)
  • L34559                Hospice – Renal Care
  • L34422                Infrared Coagulation (IRC) of Hemorrhoids
  • A53101               MolDX: bioTheranostics Cancer TYPE ID® Update
  • L37785                MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Very Low and Low Risk Disease
  • L35868                MolDX: Decipher® Prostate Cancer Classifier Assay
  • L33438                Octreotide Acetate for Injectable Suspension (Sandostatin LAR® depot)
  • A56172 (retired)  Response to Comments: Micro-Invasive Glaucoma Surgery (MIGS)
  • A56150 (retired)  Response to Comments: MolDX: Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification (NAATs)
  • A56174 (retired)  Response to Comments: MolDX: Oncotype DX AR-V7 Nucleus Detect for Men with Metastatic Castrate Resistant Prostate Cancer (MCRPC)
  • L35080                Select Minimally Invasive GERD Procedures
  • L34578                Surface Electrical Stimulation in the Treatment of Dysphagia
  • DL34823             Tumor Treatment Field Therapy (TTFT)
  • L34434                Upper Gastrointestinal Endoscopy and Visualization
  • L35408        3D Interpretation and Reporting of Imaging Studies
  • L36240        Allergen Immunotherapy
  • L33417        Allergy Skin Testing
  • L36241        Allergy Testing
  • L34977        Anorectal Manometry, Anal Electromyography, and Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters
  • A56577       Billing and Coding for Docetaxel; Taxotere
  • A56577       Billing and Coding for Docetaxel; Taxotere
  • A56578       Billing and Coding for Infliximab; Remicade
  • A56578       Billing and Coding for Infliximab; Remicade
  • A56579       Billing and Coding for Paclitaxel; Taxol
  • A56579       Billing and Coding for Paclitaxel; Taxol
  • A56526       Billing and Coding: 3D Interpretation and Reporting of Imaging Studies
  • A56538       Billing and Coding: Allergen Immunotherapy
  • A56559       Billing and Coding: Allergy Skin Testing
  • A56559       Billing and Coding: Allergy Skin Testing
  • A56558       Billing and Coding: Allergy Testing
  • A56530       Billing and Coding: Anorectal Manometry, Anal Electromyography, and Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters
  • A56580       Billing and Coding: Computerized Axial Tomography (CT), Thorax
  • A56580       Billing and Coding: Computerized Axial Tomography (CT), Thorax
  • A56562       Billing and Coding: Health and Behavior Assessment/Intervention
  • A56562       Billing and Coding: Health and Behavior Assessment/Intervention
  • A56365       Billing and Coding: Non-Coronary Vascular Stents
  • A56434 (retired)            Billing and Coding: Remote Perimetric or Microperimetric Patient Monitoring Systems
  • A56497       Billing and Coding: Vestibular Function Testing
  • A56419       Billing and Coding: Voretigene Neparvovec-rzyl (Luxturna™)
  • L34093        Chemotherapy and Biologicals
  • L34093        Chemotherapy and Biologicals
  • L34093        Chemotherapy and Biologicals
  • L33459        Computerized Axial Tomography (CT), Thorax
  • L36029        Controlled Substance Monitoring and Drugs of Abuse Testing
  • L37638        Health and Behavior Assessment/Intervention
  • L34559        Hospice – Renal Care
  • DL38139     Lab: Drug Interaction Testing
  • DL38155     Lab: Drug Interaction Testing
  • L35702        Mohs Micrographic Surgery
  • L35704        Mohs Micrographic Surgery
  • A54185       MolDX: Afirma™ Assay by Veracyte Update
  • A54188       MolDX: bioTheranostics Cancer TYPE ID® Update
  • DL38143     MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Favorable Intermediate Risk Disease
  • DL38145     MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Favorable Intermediate Risk Disease
  • DL38147     MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Unfavorable Intermediate Risk Disease
  • DL38149     MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Unfavorable Intermediate Risk Disease
  • L37130        MolDX: DecisionDx-UM (Uveal Melanoma)
  • L37295        MolDX: EndoPredict® Breast Cancer Gene Expression Test
  • L37311        MolDX: EndoPredict® Breast Cancer Gene Expression Test
  • DL38127     MolDX: Guardant360® Plasma-Based Comprehensive Genomic Profiling in Solid Tumors
  • DL38129     MolDX: Guardant360® Plasma-Based Comprehensive Genomic Profiling in Solid Tumors
  • A54194       MolDX: MammaPrint Billing and Coding Guidelines Update
  • DL38119     MolDX: Next-Generation Sequencing for Solid Tumors
  • DL38121     MolDX: Next-Generation Sequencing for Solid Tumors
  • DL38123     MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
  • DL38125     MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
  • DL38151     MolDX: Pigmented Lesion Assay
  • DL38153     MolDX: Pigmented Lesion Assay
  • DL38131     MolDX: Prospera
  • DL38133     MolDX: Prospera
  • A54901       MolDX: Targeted and Comprehensive Genomic Profile Next Generation Sequencing Testing in Cancer
  • A54281       MolDX: TP53 Gene Test Coding and Billing Guidelines
  • DL38135     MolDX: TruGraf Blood Gene Expression Test
  • DL38137     MolDX: TruGraf Blood Gene Expression Test
  • L35084        Non-Coronary Vascular Stents
  • A52395       Ophthalmic Angiography (Fluorescein and Indocyanine Green) – Supplemental Instructions
  • L34181        Ophthalmic Biometry for Intraocular Lens Power Calculation
  • A52397       Ophthalmic Biometry for Intraocular Lens Power Calculation – Supplemental Instructions Article
  • A52398       Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) – Supplemental Instructions Article
  • L37814 (retired) Remote Perimetric or Microperimetric Patient Monitoring Systems
  • A56408 (retired)            Response to Comments: Remote Perimetric or Microperimetric Patient Monitoring Systems
  • A53066       Self-Administered Drug Exclusion List:
  • L34537        Vestibular Function Testing

 

 

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

 

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