Medical policy news
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Modified: 5/11/2018
Change request (CR) 10622 makes coding and clarifying adjustments to NCDs 110.18, 150.3, 190.11, 220.6.16, 220.6.17, and 220.6.13. [MM10622]
Modified: 5/10/2018
The LCD was revised to assure consistency with the CMS sources.
Modified: 5/10/2018
LCD was revised to assure consistency with the CMS sources.
Modified: 5/10/2018
The LCD was revised to assure consistency with the CMS sources.
Modified: 5/4/2018
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 5/3/2018
The LCD was revised to assure consistency with the CMS sources.
Modified: 5/3/2018
The LCD was revised in the “Coverage Indications, Limitations, and/or Medical Necessity” section of the LCD to include the Food and Drug Administration (FDA) indications for Dysport® –the treatment of spasticity in adults and the treatment of lower limb spasticity in pediatric patients 2 years of age and older.
Modified: 5/3/2018
Based on CR 10515 (April 2018 Update of the Hospital Outpatient Prospective Payment System (OPPS) and CR 10445 (Quarterly update for Clinical Lab Fee Schedule and Lab Services subject to Reasonable Charge Payment), the LCD was revised to add procedure code 0028U.
Modified: 5/3/2018
Based on CR 10454, CR 10515 and CR 10530, the LCD was revised to reflect descriptor was changed for HCPCS code Q5101.
Modified: 5/3/2018
Based on CR 10488, CR 10454, CR 10515, and CR 10530, the LCD was revised to remove HCPCS code Q5102, and HCPCS codes Q5103 and Q5104.
Modified: 5/3/2018
The LCD was revised to assure consistency with the CMS sources.
Modified: 5/3/2018
The LCD was revised in the "Coverage Indications, Limitations, and/or Medical Necessity" section of the LCD to provide clarification for "Sclerotherapy", and also added clarification for CPT codes 36470, 36471, 36482, and 36483.
Modified: 4/26/2018
The LCD was revised to remove Current Procedural Terminology (CPT®) code 76380. The remaining procedure codes listed in the LCD are inclusive of all imaging guidance.
Modified: 4/19/2018
Based on data analysis, the LCD is no longer required, and will be retired.
Modified: 4/19/2018
The local coverage determination (LCD) for biofeedback has been updated to revise language in the “Limitations of Coverage” section of the LCD.
Modified: 4/19/2018
The italicized language in the “Indications and Limitations of Coverage and/or Medical Necessity” section of the LCD does not represent a quotation from a Centers for Medicare & Medicaid Services (CMS) source. Therefore, this LCD has been revised to remove the italics from the language.
Modified: 4/19/2018
The LCD was revised in the “CPT®/HCPCS Codes” section of the LCD to remove language referring to hospital outpatient prospective payment system (OPPS) and ambulatory surgical centers (ASCs). All the “C” procedure codes listed in the LCD are billable to hospital OPPS and ASCs. Therefore, the “CPT®/HCPCS Codes” section of the LCD was revised to consolidate the Part A and Part B groups that support medical necessity and groups that do not support medical necessity.
Modified: 4/19/2018
The noncovered services local coverage determination (LCD) “coding guidelines” article is revised to remove deleted Current Procedural Terminology (CPT®) code 35452 from the “Procedures for Part B” section of the coding guidelines.
Modified: 3/27/2018
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 3/25/2018
LCD was revised to remove ICD-10-CM diagnoses codes from the ICD-10 Codes that Support Medical Necessity section of the LCD.
Modified: 3/15/2018
LCD was revised to assure consistency with the CMS sources.
Modified: 3/15/2018
LCD was revised to update the dosage information for Healthcare Common Procedure Coding System (HCPCS) code J3315 (triptorelin pamoate).
Modified: 3/15/2018
LCD was revised to assure consistency with the CMS sources.
Modified: 3/15/2018
LCD was revised to assure consistency with the CMS sources.
Modified: 3/15/2018
LCD was revised to assure consistency with the CMS sources.
Modified: 2/7/2018
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 2/7/2018
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 2/7/2018
Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.
Modified: 2/2/2018
This calculator will assist you in determining when additional documentation requested by First Coast Service Options Inc. (First Coast) must be received.
Modified: 12/22/2017
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: 11/28/2017
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.
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