Articles

Link to the CMS Medicare Coverage Database. The following results include only documents currently in effect.

The 2009 update to the ICD-9-CM diagnosis coding structure is effective October 1, 2008. This article contains a table that lists the affected Part A LCDs and the specific conditions revised as a result of the 2009 ICD-9-CM update.

The LCD and the coding guidelines attachment were revised to extend the therapy cap exception process through December 31, 2009, based on the Medicare Improvements for Patients and Providers Act of 2008.

The LCD for Bortezomib (Velcade®) was revised to delete the requirement for at least one prior therapy for treatment of patients with multiple myeloma in the “Indications and Limitations of Coverage and/or Medical Necessity” section of the LCD.

The LCD for Hemophilia Clotting Factors was revised to add CPT code Q4096 to the "CPT/HCPCS Codes" section of the LCD.

This article provides clarification on how to bill aqueous drainage devices for the treatment of glaucoma.

Have you received a request from Medicare for medical records, or do you have questions regarding medical record review? Read this article for more information.

The LCD has been revised to include HCPCS codes descriptor changes based on Change Request 6094 (July 2008 Update of the Hospital Outpatient Prospective Payment System [OPPS]), Transmittal 1536, dated June 19, 2008.

The "coding guidelines" attachment for Therapy and Rehabilitation Services (ATHERSVCS) has been revised to add language listing applicable revenue codes for 75x type of bill (TOB).

This LCD was revised to add CPT codes 0190T and 0191T under the ‘CPT/HCPCS Codes’, ‘Local Noncoverage Decisions, Procedures’ section of the LCD, as these procedures are considered investigational.

The LCD has been revised to add HCPCS code C9727/CPT code 42299 (Palatal implants [Pillar™]) to the list of procedures under the “local noncoverage” decisions section of the LCD. Palatal implants (Pillar™) are considered experimental and investigational.

The LCD has been revised to include HCPCS codes descriptor changes based on Change Request 6094 (July 2008 Update of the Hospital Outpatient Prospective Payment System [OPPS]), Transmittal 1536, dated June 19, 2008.

The LCD was revised to clarify the frequency of courses of treatment allowed, documentation guidelines to support frequency of courses of treatment, conservative treatment, and the use of imaging when administering viscosupplementation.

This new local coverage determination (LCD) was written to outline when FCSO will consider the application of gene expression profiling using Oncotype DXTM as medically reasonable and necessary.

The LCD for Trastuzumab (Herceptin®) was revised to update language for additional approved indications based on the Food and Drug Administration (FDA) drug label.

This LCD was revised to update the list of applicable revenue codes based on Change Request 5898. Revenue codes 0410, 0412 and 0419 were also added to the "coding guidelines" attachment for the LCD.