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Medical policy news

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Providers can now use First Coast’s website search bar to find the LCDs they need by searching by procedure code, keyword, or ICD-10 code.
Modified: 8/18/2017
Providers can now use First Coast’s website search bar to find the LCDs they need by searching by procedure code, keyword, or ICD-10 code.
Modified: 9/1/2017
This MAC JN LCD was revised to remove Current Procedural Terminology (CPT®) codes 90875 and 90876 from the “CPT/HCPCS Codes” section of the LCD as they are nationally noncovered by Medicare.
Modified: 8/31/2017
This MAC JN LCD was revised to add clarifying language to the “Indications and Limitations of Coverage and/or Medical Necessity” and the “Utilization Guidelines” sections of the LCD.
Modified: 8/18/2017
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: 8/17/2017
The local coverage determination (LCD) for chelation therapy is being retired based on data analysis.
Modified: 8/17/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 8/17/2017
The local coverage determination (LCD) for intraoperative neurophysiology monitoring is being retired based on data analysis review.
Modified: 8/17/2017
The local coverage determination (LCD) for low density lipoprotein (LDL) apheresis is being retired based on data analysis review.
Modified: 8/17/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 8/17/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 8/11/2017
Change request 10184 outlines maintenance updates of ICD-10 conversions and other coding updates specific to national coverage determinations (NCDs). These changes are the result of newly available codes, coding revisions to NCDs released separately, or coding feedback received. [MM10184]
Modified: 8/5/2017
This calculator will assist you in determining when additional documentation requested by First Coast Service Options Inc. (First Coast) must be received.
Modified: 8/3/2017
Change request 10117 provides information regarding the Centers for Medicare & Medicaid Services (CMS) coverage of leadless pacemakers through coverage with evidence development when performed in an approved study. [MM10117]
Modified: 7/28/2017
Change request (CR) 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. This article was revised July 26 to reflect the revised CR 10089 issued July 25. In the article, the transmittal numbers, CR release date, implementation date, and the web addresses for accessing the transmittals are revised. [MM10089]
Modified: 7/21/2017
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: 7/21/2017
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: 6/4/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
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.
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.