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: 7/20/2017
Correct the information previously published regarding dosage for Gel-Syn HCPCS Code J7328.
Modified: 7/14/2017
This MAC JN LCD was revised to add ICD-10-CM diagnosis codes C16.1-C16.9. The Utilization Guidelines were updated to the current FDA label dosage forms and strengths.
Modified: 7/6/2017
This MAC JN LCD was revised to add the indication "non hodgkins's lymphoma (NHL) Adult T-cell Leukemia/Lymphoma"; and add ICD-10 CM codes, and update the sources of information and basis for decision sections.
Modified: 7/6/2017
Based on data analysis this MAC JN LCD was retired
Modified: 7/3/2017
This MAC JN LCD was revised to add ICD-10-CM diagnosis code Z86.000.
Modified: 6/29/2017
This MAC JN LCD was revised to update language related to direct supervision.
Modified: 6/27/2017
Multiple services have been added to the Noncovered Services LCD
Modified: 6/22/2017
The Centers for Medicare & Medicaid Services (CMS) recently released instructions for Medicare administrative contractors regarding changes in the laboratory national coverage determination (NCD). [MM10156]
Modified: 6/22/2017
This MAC JN LCD was revised to remove conflicting language regarding coverage of interlaminar injections and add CPT® codes 62320 and 62322 to the “CPT®/HCPCS Codes” section.
Modified: 6/14/2017
Change request 10086 requires a maintenance update of numerous national coverage determinations (NCDs), resulting from newly available codes, coding revisions to NCDs released separately, or coding feedback received. Any related policy changes will continue to be implemented via the current, long-standing NCD process. [MM10086]
Modified: 6/13/2017
The Centers for Medicare & Medicaid Services has been authorized to add coverage of screening for lung cancer as an "additional preventive services." The service must meet all of the criteria outlined within the national coverage determination. This article was revised June 12 to clarify that independent diagnostic testing facilities (IDTF) may be eligible facilities. All other information is unchanged. [MM9246]
Modified: 6/9/2017
Based on data analysis this MAC JN LCD was retired
Modified: 6/9/2017
Based on annual review and data analysis the LCD for Vinorelbine tartrate (Navelbine) was retired.
Modified: 6/9/2017
Coding guidance related to the Eclipse system and CPT code 58999
Modified: 6/9/2017
Based on a reconsideration request, this LCD was revised to add multiple indications and the corresponding ICD-10-CM diagnoses codes
Modified: 6/8/2017
Based on change request (CR) 8776 multiple LCDs have been revised to remove language related to lab services and type of bill 13X
Modified: 6/8/2017
Based on change request (CR) 8776 this LCD was revised to remove language related to lab services and type of bill 13X
Modified: 6/8/2017
This is a new MAC JN local coverage determination (LCD).
Modified: 6/6/2017
Change request 10089 announces that Medicare will cover percutaneous image-guided lumbar decompression under coverage with evidence development for beneficiaries with lumbar spinal stenosis (LSS) enrolled in an approved prospective longitudinal study. [MM10089]
Modified: 6/4/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 6/2/2017
This MAC JN LCD was revised to include two new FDA approved indications and the corresponding ICD-10-CM diagnosis codes.
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: 5/7/2017
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: 5/7/2017
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: 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: 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: 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.
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