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Medicare (CMS)

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

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

June 2019 Medicare (CMS) LCD Updates:

  • A56609             Billing and Coding: Biomarker Testing (Prior to Initial Biopsy) for Prostate Cancer Diagnosis
  • A56606             Billing and Coding: Cardiac Event Detection
  • A56606             Billing and Coding: Cardiac Event Detection
  • A56613             Billing and Coding: Cataract Surgery
  • A56607             Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
  • A56607             Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)
  • A56611             Billing and Coding: Corneal Pachymetry
  • A56611             Billing and Coding: Corneal Pachymetry
  • A56612             Billing and Coding: CT of the Head
  • A56612             Billing and Coding: CT of the Head
  • A56610             Billing and Coding: Hospice Cardiopulmonary Conditions
  • A56610             Billing and Coding: Hospice Cardiopulmonary Conditions
  • A56588             Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS)
  • A56178             Billing and Coding: Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)
  • A55336             Billing and Coding: Retroperitoneal Ultrasound
  • A56590             Billing and Coding: Water Vapor Thermal Therapy for LUTS/BPH
  • DL37733           Biomarker Testing (Prior to Initial Biopsy) for Prostate Cancer Diagnosis
  • L34573              Cardiac Event Detection
  • L37126              Coenzyme Q10 (CoQ10)
  • L37641              Continuous Peripheral Nerve Blocks (CPNB)
  • L33630              Corneal Pachymetry
  • L34512              Corneal Pachymetry
  • L34417              CT of the Head
  • L34548              Hospice Cardiopulmonary Conditions
  • A54953             Independent Diagnostic Testing Facilities- physician supervision and technician requirements
  • DL37244           Micro-Invasive Glaucoma Surgery (MIGS)
  • L37134              MolDX: BDX-XL2
  • L37818              MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Very Low and Low Risk Disease
  • L37820              MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Very Low and Low Risk Disease
  • L37130              MolDX: DecisionDx-UM (Uveal Melanoma)
  • L37130              MolDX: DecisionDx-UM (Uveal Melanoma)
  • L36206              MolDX: Genomic Health™ Oncotype DX® Prostate Cancer Assay
  • L36206              MolDX: Genomic Health™ Oncotype DX® Prostate Cancer Assay
  • L36048              MolDX: HLA-B*15:02 Genetic Testing
  • L36145              MolDX: HLA-B*15:02 Genetic Testing
  • L36149              MolDX: HLA-B*15:02 Genetic Testing
  • A54445             MolDX: MammaPrint Billing and Coding Guidelines
  • A54447             MolDX: MammaPrint Billing and Coding Guidelines
  • L36113              MolDX: MGMT Promoter Methylation Analysis
  • L37142              MolDX: Prolaris™ Prostate Cancer Genomic Assay for Men with Favorable Intermediate Risk Disease
  • L34171              Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation
  • L34175              Ophthalmic Angiography (Fluorescein and Indocyanine Green)
  • L34181              Ophthalmic Biometry for Intraocular Lens Power Calculation
  • L34399              Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
  • L34049              Outpatient Physical and Occupational Therapy Services
  • A52400             Outpatient Physical and Occupational Therapy Services Supplemental Instructions Article
  • L34353              Outpatient Psychiatry and Psychology Services
  • A52403             Outpatient Psychiatry and Psychology Services – Supplemental Instructions Article
  • DL33569           Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)
  • A52535             Process for Determining Self-Administered Drug Exclusions – Medical Policy Article
  • DL37808           Water Vapor Thermal Therapy for LUTS/BPH
  • L36690              Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities
  • A53387             Aflibercept (EYLEA®) Coding and Billing Guidelines
  • A56627             Billing and Coding Beleodaq (Belinostat)
  • A56628             Billing and Coding Fluocinolone Acetonide Intravitreal Implant
  • A56629             Billing and Coding Iron Sucrose, Iron Dextran and Ferumoxytol, (Intravenous Iron Therapy)
  • A56630             Billing and Coding Sodium Ferric Gluconate, (Intravenous Iron Therapy)
  • A52986             Billing and Coding: Biomarkers for Oncology
  • A56591             Billing and Coding: Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)
  • A56600             Billing and Coding: Cardiac Event Detection Monitoring
  • A56602             Billing and Coding: Cardiac Rhythm Device Evaluation
  • A56615             Billing and Coding: Cataract Extraction (including Complex Cataract Surgery)
  • A56613             Billing and Coding: Cataract Surgery
  • A56616             Billing and Coding: Chiropractic Services
  • A56616             Billing and Coding: Chiropractic Services
  • A56248             Billing and Coding: Corneal Hysteresis
  • A56608             Billing and Coding: Corus® CAD Test
  • A56625             Billing and Coding: Echocardiography
  • A56625             Billing and Coding: Echocardiography
  • A56619             Billing and Coding: Nerve Conduction Studies and Electromyography
  • A56619             Billing and Coding: Nerve Conduction Studies and Electromyography
  • A56614             Billing and Coding: Pyschiatric Inpatient Hospitalization
  • L35396              Biomarkers for Oncology
  • L34834              Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)
  • L34953              Cardiac Event Detection Monitoring
  • L34833              Cardiac Rhythm Device Evaluation
  • L35091              Cataract Extraction (including Complex Cataract Surgery)
  • L34413              Cataract Surgery
  • L34093              Chemotherapy and Biologicals
  • L37387              Chiropractic Services
  • L38014              Corneal Hysteresis
  • L36713              Corus® CAD Test
  • L37379              Echocardiography
  • A54689             MolDX: Myriad’s BRACAnalysis CDx™ Coding and Billing Guidelines
  • A55597             MolDX: PIK3CA Gene Tests Billing and Coding Guidelines
  • A55602             MolDX: PIK3CA Gene Tests Billing and Coding Guidelines
  • A53558             MolDX: PIK3CA Gene Tests Coding and Billing Guidelines
  • A54295             MolDX: PIK3CA Gene Tests Coding and Billing Guidelines
  • L35048              Nerve Conduction Studies and Electromyography
  • A52479             Oral Anticancer Drugs – Policy Article
  • L34570              Psychiatric Inpatient Hospitalization
  • A56529             Response to Comments: Corneal Hysteresis
  • L34577              Retroperitoneal Ultrasound
  • A53066             Self-Administered Drug Exclusion List:
  • A52505             Wheelchair Seating – Policy Article
  • A56632             Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
  • A56632             Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
  • A56639             Billing and Coding: Hospice Alzheimer’s Disease & Related Disorders
  • A56639             Billing and Coding: Hospice Alzheimer’s Disease & Related Disorders
  • A56621             Billing and Coding: Swallowing Studies for Dysphagia
  • A56621             Billing and Coding: Swallowing Studies for Dysphagia
  • L35091              Cataract Extraction (including Complex Cataract Surgery)
  • L37126              Coenzyme Q10 (CoQ10)
  • L34454              Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
  • L34741 (retired) Drugs and Biologics (Non-chemotherapy)
  • A52531 (retired)        Fluocinolone acetonide intravitreal implant
  • L35132              Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus
  • L34566              Hospice – HIV Disease
  • L34567              Hospice Alzheimer’s Disease & Related Disorders
  • L34558              Hospice The Adult Failure To Thrive Syndrome
  • A52427 (retired)        Iron Sucrose, Iron Dextran and Ferumoxytol, (Intravenous Iron Therapy)
  • A53101             MolDX: bioTheranostics Cancer TYPE ID® Update
  • L36117              MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
  • L36011              MolDX: Molecular RBC Phenotyping
  • L34045              Non-Invasive Vascular Studies
  • A56212 (retired)        Response to Comments: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
  • A52429 (retired)        Sodium Ferric Gluconate, (Intravenous Iron Therapy)
  • L35986              Special Histochemical Stains and Immunohistochemical Stains
  • L33449              Swallowing Studies for Dysphagia

 

 

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

 

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