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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: 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: 3/22/2017
Multiple services have been added to the "Noncovered services" LCD.
Modified: 3/22/2017
Change request (CR) 10036 announces the changes that will be included in the July 2017 quarterly release of the edit module for clinical diagnostic laboratory services. [MM10036]
Modified: 3/17/2017
This article provides clarification regarding system technology and correct billing for Rezum®.
Modified: 3/16/2017
Based on the 2017 HCPCS Update (CR9752), HCPCS codes G0477-G0479 were deleted and replaced with CPT® codes 80305-80307 in the “CPT®/HCPCS Codes” section of this local coverage determination (LCD).
Modified: 3/16/2017
This MAC JN revision was based on a reconsideration request to add CPT code 81479.
Modified: 3/16/2017
This local coverage determination (LCD) was revised based on a reconsideration request to add additional indications, as well as additional ICD-10-CM diagnosis codes.
Modified: 3/16/2017
The local coverage determination (LCD) for viscosupplementation therapy for knee was revised based on a reconsideration request to correct the dosage and duration of treatment for GenVisc 850®.
Modified: 3/9/2017
Coverage determinations for gender reassignment surgery continue to be made by the local MACs on a case-by-case basis. [MM9981]
Modified: 3/8/2017
It has come to the attention of First Coast Service Options Inc. that the dosage for Gel-Syn (Healthcare Common Procedure Coding System [HCPCS] code J7328) is being submitted incorrectly on Part B claims.
Modified: 2/28/2017
The Centers for Medicare & Medicaid Services (CMS) recently released change request (CR) 9982 which updates diagnosis codes specific to nine national coverage determinations (NCD) including those covering mammograms and covering cardiac rehabilitation. [MM9982]
Modified: 2/28/2017
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: 2/27/2017
The Centers for Medicare & Medicaid Services (CMS) recently released change request (CR) 9861 which updates diagnosis codes specific to16 national coverage determinations (NCDs). [MM9861]
Modified: 2/16/2017
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: 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: 1/19/2017
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
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.