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Medical policy news

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Take advantage of the LCD and procedure to diagnosis lookup to find information in current and draft LCDs.
Modified: 5/19/2017
Payment will be considered for unused and discarded portions of a single-use drug/biological product. The JW modifier is not permitted when the actual dose of the drug or biological administered is less than the billing unit.
Modified: 5/18/2017
Based on data analysis multiple MAC JN local coverage determinations (LCDs) are being retired.
Modified: 5/18/2017
Based on data analysis multiple LCDs were retired.
Modified: 5/18/2017
Based on data analysis this MAC JN LCD was retired
Modified: 5/7/2017
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within the following 20 calendar days. [CR 6698]
Modified: 4/27/2017
Based on the Centers for Medicare & Medicaid Services (CMS) change request (CR) 9977 (Quarterly update to the MPFSDB – April CY 2017 update), the “coding guideline” attachment to the local coverage determination (LCD) for optical coherence biometry was revised
Modified: 4/27/2017
Based on change request (CR) 10005 (April 2017 Update of the Hospital Outpatient Prospective Payment System [OPPS]). the LCD was revised to add additional HCPCS code and diagnoses.
Modified: 4/21/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 4/12/2017
Medicare pays for clinical laboratory services that are medically reasonable and necessary, ordered by a physician, and used by the physician in the treatment of the patient. When a physician documents an order for a complete blood count (CBC) in a patient’s medical record, Medicare will not pay for a CBC with automated differential.
Modified: 4/6/2017
This MAC JN LCD was revised to include additional ICD-CM-10 diagnosis codes.
Modified: 4/6/2017
Based on data analysis this MAC JN local coverage determination (LCD) is being retired.
Modified: 4/6/2017
Based on change request (CR) 9861 (ICD-10 Coding Revisions to National Coverage Determination [NCDs]), the LCD was revised to add additional diagnoses.
Modified: 3/31/2017
The following LCDs were revised to include ICD-10-CM diagnosis code range T85.22XA-T85.22XS in the “ICD-10 Codes that Support Medical Necessity” sections of LCD L34017 for Current Procedural Terminology (CPT®) codes 92225, 92226 and LCD L33670 for CPT® code 92250.
Modified: 3/31/2017
The following LCDs were revised to include ICD-10-CM diagnosis code Z01.810 in the “ICD-10 Codes that Support Medical Necessity” sections of LCD L33282 for CPT® codes 75571, 75572, 75573, 75574 and LCD L36209 for CPT® codes 78451, 78452, 78453 and 78454.
Modified: 3/31/2017
The local coverage determination (LCD) for B-Scan was revised to include additional ICD-10-CM diagnosis codes.
Modified: 2/16/2017
This calculator will assist you in determining when additional documentation requested by FIrst Coast Service Options Inc. (First Coast) must be received.
Modified: 2/16/2017
The Centers for Medicare & Medicaid Services (CMS) requires that any Medicare service provided or ordered must be authenticated by the author -- the one who provided or ordered that service. This article outlines acceptable forms of authentication.
Modified: 1/13/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 1/1/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 1/1/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 12/23/2016
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.