Chat with us, powered by LiveChat
skip to Main Content

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

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

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 »

 

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

Back To Top