National Government Services Medicare Monthly
Review
Index of Articles
Article
Issue
Page
Jun-09
15
(A47181)
Mar-09
9
(A48211)
Mar-09
9
(L25271) (A44493)
Mar-09
9
(L26424) (A45917)
Mar-09
9
(L26426) (A45934)
Mar-09
9
(L26441) (A45936)
Mar-09
9
(L26851) (A46189)
Mar-09
9
(L26876) (A46192)
Mar-09
9
87641 CPT Code
(L26901) (A46201)
Mar-09
9
(NCS)/Electromyography (EMG) (NCS)/Electromyography (EMG)
Oct-08
14
(PTA) of the Carotid Artery Concurrent with Stenting
Apr-10
36
93930, 93931, 93965, 93970, and 93971
May-09
8
95992 Procedures
Feb-09
16
Abdominal Ultrasound L28073
Oct-08
20
Abdominal-Pelvic Ultrasound
Jan-09
10
Abdominal-Pelvic Ultrasound
Oct-10
4
ABN
Feb-10
32
ABNs
Apr-10
29
Acid Phosphatase – LCD & SIA
Mar-09
9
A
Acid Phosphatase L25879
Oct-08
12
Acupuncture
Aug-08
12
Acupuncture
Dec-07
41
Advance Beneficiary Notices
Dec-09
21
Advanced Beneficiary Notice of Noncoverage Revised
Oct-08
60
AdvanceMed's Role in the Medicare Program
Mar-09
8
Albuterol, Levalbuterol and Reclast
Jul-07
10
ALJ Hearings
Mar-09
25
ALJ Hearings
Apr-08
31
Allergy Immunotherapy
Jan-09
10
Ambulatory Surgical Centers
Mar-08
116
Ambulatory Surgical Centers and NPPs
Jun-09
65
Analogues in the Treatment of Prostate Cancer
Jan-08
32
Anesthesia Services by the Same Physician Providing Medical and
Oct-07
72
Anesthesiologists
Jan-10
71
Anti-Markup Rule - Purchased Diagnostic Test
Apr-10
64
Apheresis
May-08
8
Apheresis – LCD & SIA
Mar-09
9
Apheresis (36511-36514)
Sep-09
14
Apheresis L26865 (R2)
Oct-08
12
Apligraf
Oct-08
15
Apr-08
7
Surgical Services
‐
Related to LCD L26003
Apligraf Article- Dermagraph
Appeals
July 2010
44
Appeals Transition
Aug-07
38
Application rejections and denials for physician and certain nonphysician May-09
19
practitioner applications
Article for Dermagraft ® – Related to LCD L26003
Apr-09
7
Artificial Hearts
Oct-08
44
Astigmatism-Correcting Intraocular Lens
Jun-07
10
Astigmatism-Correcting Intraocular Lens
Mar-08
47
Astigmatism-Correcting Intraocular Lens
Aug-07
49
Audiologic and Vestibular Function Testing
Oct-08
6
Audiologic and Vestibular Function Testing
Mar-09
9
Audiologists Enrollment Requirement
May-08
73
Audiology Policies
July 2010
22
Audiology Policies
Apr-08
32
Audiology Policies
Sept-10
12
Audiology Policies
Oct-10
13
Average Sale Price (ASP) Updates
Jul-08
66
Azacitidine (e.g., Vidaza™)
Oct-08
16
Bariatric Surgery
Jan-09
11
Bariatric Surgery Billing
Jun-07
16
Bariatric Surgery L28202
Oct-08
20
Bariatric Surgery L28482
Oct-10
5
Beneficiary Signature Requirements.
Apr-09
25
B
Benign Skin Lesions, Removal of
Jan-08
32
Beta2 Microglobulin L28192
Oct-08
20
Beta Glucocerebrosidase
Oct-10
5
Bevacizumab
Nov-09
7
Bevacizumab
Feb-09
8
Bevacizumab (e.g., Avastin™)
Apr-08
4
Bevacizumab (e.g., Avastin™)
Jun-09
15
Biologic Products for Wound Treatment
Mar-08
10
Biologic Products for Wound Treatment and Surgical Interventions
Oct-07
5
Biologic Products for Wound Treatment and Surgical Interventions
Mar-09
9
Mar-09
9
‐
Related to LCD L25820 (A46095)
‐
Supplemental Instructions Article (SIA)
Blepharoplasty – LCD &SIA
Blood Glucose Monitors and Testing Supplies
May-10
50
Blood Glucose Monitors and Testing Supplies
June-10
49
BNP Natriuretic Peptide
Feb-09
8
Bone Mass Measurement – LCD & SIA
Mar-09
9
Bone Mass Measurement – LCD & SIA
Oct-07
15
Bone Mass Measurement –revised
Jul-07
6
Bortezomib (e.g., Velcade®)
Oct-08
17
Botulinum Toxins
Jan-08
29
Botulinum Toxins
Ocft-10
5
Botulinum Toxins Type A and Type B
May-08
8
Botulinum Toxins Type A and Type B
Oct-08
12
Botulinum Toxins Type A and Type B – LCD & SIA
Mar-09
9
Brachtherapy
Jan-09
11
Brachytherapy (L28433)
May-09
5
Brachytherapy L28149
Oct-08
20
Breast Imaging Mammography/Breast Echography (Sonography)/Breast Jun-09
7
MRI-Ductography
Breast Imaging: Mammography/Breast
Oct-08
13
Breast Imaging: Mammography/Breast Echography
Mar-09
9
Breast Imaging:Mammography/Breast Echography
May-08
9
Breast Mammography / Echography
Sep-09
15
Breast MRI/Ductography
Nov-09
8
BSIA
Nov-09
7
B-Type natriuretic Peptide (BNP) Testing
Aug-07
12
(Sonography)/Breast MRI/Ductography
B
Apr-09
7
May-08
9
Mar-09
9
Apr-09
7
Oct-08
17
Jul-09
9
Cardiac Catheterization
Nov-09
9
Cardiac Catheterization and Coronary Angiography
May-08
10
‐
type Natriuretic Peptide (BNP) Testing
C
Capsule Opacification Following Cataract Surgery: Discission and YAG
Laser
Capsule Opacification Following Cataract Surgery: Discission and YAG
Laser Capsulotomy – LCD & SIA
Carboplatin (Paraplatin®, Paraplatin
‐
AQ®)
Carboplatin (Paraplatin®, Paraplatin
‐
AQ®)
Cardiac Catherization and Coronary Angiography Cor#1 (L26890)
(A48368)
Cardiac Catheterization and Coronary Angiography
Oct-08
15
Cardiac Catheterization and Coronary Angiography
Oct-10
6
Cardiac Catheterization and Coronary Angiography (R4)
Jun-09
8
Cardiac Catheterization and Coronary Angiography –LCD & SIA
Mar-09
9
Cardiac Catheterization and Coronary Angiography Revised
Dec-08
9
Cardiac Computed Tomography (CCT) and Coronary Computed
Oct-07
5
Mar-09
9
Cardiac Computed Tomography Angiography
Aug-08
31
Cardiac Output Measurement Thoracic Electrical Bioimpedance
Oct-07
6
Tomography
Cardiac Computed Tomography (CCT) and Coronary Computed
Tomography Angiography (CCTA) – Supplemental Instructions Article
(SIA)
Cardiac Output Measurement Thoracic Electrical Bioimpedance (L25447) Mar-09
10
Cardiac Rehabilitation
8
Dec-07
Cardiac Rehabilitation
Oct-07
15
Cardiac Rehabilitation
Feb-08
17
Cardiovascular Nuclear Medicine
May-08
9
Cardiovascular Nuclear Medicine (L26859)
Jul-09
9
Cardiovascular Nuclear Medicine L26859
Oct-08
13
Cataract Extraction
May-08
10
Cataract Extraction
Jan-08
32
Cataract Extraction – LCD & SIA
Mar-09
9
Category III CPT ® Codes (L25275)
Jan-08
5
Category III CPT ® Codes (L25275)
Dec-07
11
Category III CPT ® Codes (L25275)
Jun-09
15
Category III CPT® Codes
Oct-07
7
CERT Contacts and Web Sites
Sep-08
4
CERT Contacts and Web Sites
Mar-09
4
CERT Documentations Requirements
May-09
4
CERT Physician Orders for Labs and Diagnostics
Sep-08
4
CERT Requesting Physician Orders
Jun-08
5
Chiropractic Services
Oct-08
6
Clarification to Audiology Update Transmittal
Aug-08
96
Clinical Laboratory Service Competitive Bidding Demostration
Mar-08
55
Clinical Psychologist and Clinical Socialworker Fee Schedule 2008
Feb-08
32
Clinical Research Studies HCPCS Modifier
Feb-08
72
Clinical Review Judgement
July 2010
43
Clinical Socialworker and Psychologist Fee Schedule 2008
Feb-08
32
Clinical Trial
Feb-09
59
Clinical Trial Claims Registry Number
Feb-08
71
Clinical Trial Healthy control Group Volunteers
Oct-10
34
Clinical Trial Policy
Oct-07
44
Clinical Trial Routine Costs
Nov-08
43
Clinical Trial Services for Managed Care Beneficiaries
Nov-09
49
Clinical Trials (CR6431)
Jul-09
25
Clinical Trials (CR6431) revised
Aug-09
16
Clinical Trials and Medicare Payment
Mar-10
7
Clotting Factor
Mar-09
21
COB- SNF - Exceptionally Intensive Outpatient Hospital Services
Aug-10
25
COBA Provider Identifiers (qualifiers)
Dec-08
8
Collagen Meniscus Implant
July 2010
39
Colonography for Colorectal Cancer
Oct-09
31
Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy –
Oct-08
13
Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy – LCD & SIA
Mar-09
9
Colorectal Cancer Screening
Feb-09
8
Colorectal Cancer Screening
Jan-08
33
Comment Period for Draft LCD
June 07 Memo
6
Compendia as Auth Source for use of Med-accept indication of
Mar-10
29
Compounded Drugs (j3490)
Dec-07
41
Computed Tomographic (CT) Colongraphy
Oct-08
13
drugs/Biologicals Used off-label in Anti Cancer regimens
Computed Tomographic (CT) Colonography
Oct-07
7
Computed Tomographic (CT) Colonography (L25233)
May-09
6
Computed Tomography
Nov-09
9
Computed Tomography
Jan-09
12
Computed Tomography
Oct-10
6
Computed Tomography (L28516)
May-09
7
Computerized Corneal Topography L28201
Jun-09
9
Computerized Dynamic Posturography
Oct-08
20
Computerized Dynamic Posturography L28193
Jun-09
9
Consignment Closets
Sep-09
26
Consignment Closets
Oct-09
28
Consignment Closets and Stock and Bill Arrangements
Mar-10
24
Consultation Services Payment Policy 2010
Jan-10
39
Consultation Servicess Q & A
Apr-10
38
Corneal Pachymetry L28142
Jun-09
9
CPAP
Nov-08
35
CPAP Therapy
Aug-08
32
C-Reactive protein (hsCRP)
Aug-07
12
Critical Care Visits and Neonatal Intensive Care
Sep-08
83
Critical Care Visits and Neonatal Intensive Care
Aug-08
84
Critical Care Visits and Neonatal Intensive Care
Jul-08
101
Sep-07
31
D
Date Of Service for Laboratory and Pathology Specimens
Date Of Service for Laboratory and Pathology Specimens
Jul-08
51
Debridement Services
Oct-08
6
Debridement Services (L27373)
May-09
7
Deceased Providers
Aug-07
88
Decitabine (e.g., Dacogen™)
Oct-08
16
Deductible Coinsurance and Premium Rates for 2008
Feb-08
34
Deductible Coinsurance and Premium Rates for 2009
Dec-08
48
Denileukin Difitox (e.g., Ontak®)
Oct-08
17
Dental Services
May-09
12
Dermagraft®
Oct-08
17
Apr-09
7
‐
Related to LCD L26003
Dermal Regeneration Template, Integra ® Bilayer Matrix Wound
Dressing
Diabetes NCD Surgery
Jun-09
26
Diabetes Screening
Jul-08
57
Diabetes Self Management Training
June 07 Memo
7
Diabetes Self Management Training
Jul-07
23
Diabetes Supplies and Services
Dec-07
59
Diabetes Supplies and Services
Jan-08
67
Diagnostic Tests Anti-Markup Pricing
Apr-09
26
Difibrillator Modifier Services Provided in Clinical Study
June-10
31
Discarded Drugs
Jul-07
12
Discarded Drugs
Oct-10
24
Discarded Drugs and Biologicals
June 07 Memo
29
Discarded Drugs and Biologicals
June 10
28
Doxorubicin HCl - Related to LCD L25820
Oct-08
17
Doxorubicin, Liposomal (Doxil)
Oct-08
17
Drugs and Biologicals
Feb-08
8
Drugs and Biologicals
Jun-07
28
Drugs and Biologicals, Coverage for Label and Off Label Uses
Feb-09
8
Drugs and Biologicals, Coverage for Label and Off Label Uses
Jan-09
18
Drugs and Biologicals, Coverage for Labeled and Off
Oct-07
7
Drugs and Biologicals, Coverage for,
Mar-08
5
Drugs and Biologicals, Coverage for, Label and Off
Apr-08
4
May-09
7
‐
Labeled Indications
‐
Label Uses
‐
L25820
Drugs and Biologicals, Coverage of, for Label and Off
‐
Label Uses
DSMTCDE
Sep-09
24
Duplicate Claims
May-08
21
Electrocardiography (ECG or EKG) (L27427)
Mar-09
10
Electrocardiography (ECG/EKG)
Oct-08
6
Electronic Signatures
Feb-10
13
Electronic Signatures
Oct-10
3
End Stage Renal Disease 50/50 modifier
Dec-09
67
End Stage Renal Disease 50/50 rule modifier
May-10
63
Endoscopy by Capsule
Oct-07
8
Endoscopy by Capsule L25468
Jun-09
10
E
Endoscopy by Capsule L25468
Oct-08
13
Endoscopy by Capsule L25468
Oct-08
13
Endoscopy by Capsule LCD & SIA
Mar-09
9
Epidural/Intrathecal Injections L28117
Oct-08
20
Erectile Dysfunction, Evaluation and Treatment (L27371)
Oct-08
7
Erectile Dysfunction, Evaluation and Treatment (L27371)
Mar-09
10
Erythrocyte Sedimentation Rate (ESR)
Oct-07
8
Erythrocyte Sedimentation Rate (ESR)
Oct-08
14
Erythrocyte Sedimentation Rate (ESR) – Supplemental Instructions
Mar-09
9
Erythrocyte Sedimentation Rate (ESR) (L25639)
Jul-09
9
Erythropoiesis Stimulating Agents
Nov-07
14
Article (SIA)
Erythropoiesis Stimulating Agents (ESA) (L25211)
Apr-08
6
Erythropoiesis Stimulating Agents (ESA) (L25211)
Jun-09
6
Erythropoiesis Stimulating Agents in Neoplastic Conditions
Apr-08
35
Erythropoiesis Stimulting Agents in Cancer
Mar-08
49
Erythropoietin Stimulating Agents (ESA)
Jan-08
4
Erythropoietin Stimulating Agents (ESA)
Jun-08
4
Erythropoietin Stimulating Agents (ESA)
Feb-08
7
Erythropoietin Stimulating Agents (ESA)
Oct-07
8
Erythropoietin Stimulating Agents (ESA)
Oct-08
13
ESA in Cancer and Related Neoplastic Conditions
Jun-08
16
Esophagogastroduodenoscopy (EGD)
Oct-08
14
Esophagogastroduodenoscopy (EGD)
Jan-08
31
ESRD Clarification
Feb-09
46
ESRD Composite Rate Services
Nov-09
14
ESRD Diagnostic Tests
Aug-09
21
ESRD Facility Vaccine Administration
Nov-09
15
ESRD Related Services
Apr-08
91
ESWT
Jan-09
12
Etoposide - LCD L25820
Nov-08
5
Etoposide (Etopophos®, Toposar®, Vepesid®, VP 16
Oct-08
17
Evaluation and Management Services Resource
Oct-08
36
Exclusions
Jan-09
6
EXRD Monthly Capitation Payment Teaching Physician Requirements
Apr-08
89
Extended Opthalmoscopy L25466
Sep-09
15
Extracorporeal Shockwave Therapy for Muculoskeletal indications
Jan-09
12
Extremity Venous Evaluation
Nov-09
10
Family History Under IPPI
Oct-09
98
FDG
Oct-08
43
Filgrastim, Pegfilgrastim (e.g., Neupogen®, Neulasta TM)
Mar-09
11
Fixed Wing Air Ambulance
Apr-09
9
Flow Cytometry
Oct-08
7
Flow Cytometry (L27386)
Mar-09
11
Flow Cytometry L28123
Oct-08
21
F
‐
Related to LCD L25820
Flu Shot Frequency
Oct-10
31
Foot Care Coverage
Jul-07
65
Foot Care Services
May-09
23
Gemcitabine Hydrochloride (e.g., Gemzar®)
Apr-08
5
Gemcitabine Hydrochloride (e.g., Gemzar®)
Nov-09
9
G
Geriatric psychiatry
Aug -10
54
H
HCPCS DRUG CODES
Apr-09
8
Healthy Vision
Jun-07
26
Heartbreath Test for Heart Transplant Rejection
Mar-09
36
Heartsbreath Test for Heart Transplant Rejection Revised
Apr-09
63
Hematocrit and Hemoglobin for ESA
Jul-08
59
Hepatic Function Panel
Oct-08
7
Hepatic Function Panel
Nov-09
9
High Sensitivity C
Mar-09
9
Home Glucose Monitors
Jun-09
35
Homocysteine Level, Serum
Oct-07
9
Homocysteine Level, Serum – LCD & SIA
Mar-09
9
Hospice – Determining Terminal Status
Oct-07
14
Hospice
Jun-09
6
Hospice and Pallative Care Specialty Code
Jun-09
42
Hospice NPI
Jan-10
25
‐
Reactive Protein (hsCRP) Testing – LCD & SIA
‐
Determining Terminal Status (L25678)
Hospice Services
Mar-10
26
Human Papillomavirus (HPV) Testing L29508
Jun-09
11
Hyperbaric Oxygen Therapy (HBO)
Oct-07
9
I&D
Jan-09
13
ICD 10
Jun-09
20
ICD 10 Implementation Information
July 2010
61
ICD 10 CM/PCS
Nov-08
46
ICDs
Jan-09
17
Ifosfamide(Ifex)
Oct-08
17
Jul-07
13
I
‐
Related to LCD L25820
Immune Globulin
Immune Globulin
July 07 Memo
13
Immune Globulin
June 07 Memo
41
Immunohistochemistry
Oct-08
8
Immunohistochemistry (L27348)
Mar-09
11
Implantable Tissue Markers and Implantable Radiation Dosimeters
Sept-10
53
Implanted Catheter/Pump for Drug infusion
Oct-08
21
Incident to Policy Update Rescinded CR #52887
Jul-08
101
Incident To Policy Updated CR5288 revised
Jun-08
60
Incision and Drainage of Abscess of Skin, Subcutaneous and Accessory
Jan-09
13
Independent Diagnostic Testing Facilities,
May-09
8
Independent Lab Billing for Technical Component of Pathology
Mar-08
103
Structures
Independent Laboratory Billing
Sep-08
80
Indepentant Diagnostic testing Facilities
Jul-08
50
Indepentant Lab Billing for TC of Pathology
Apr-08
99
Infrared Coagulation (IRC) of Hemorrhoids
Oct-07
10
Infrared Coagulation (IRC) of Hemorrhoids – LCD & SIA
Jan-08
6
Infrared Coagulation (IRC) of Hemorrhoids – LCD & SIA
Mar-09
9
Infusion
Oct-08
21
Initial
Apr-08
96
Initial Preventive Physical Examination
Dec-08
44
Inpatient
Aug-08
77
Apr-08
95
Hospital
Care Services and Observation or Inpatient Service
Hospital
Visits
Inpatient
Hospital
Visits
Inpatient Rehabilitation Services Provided in an Inpatient Rehabilitation
Oct-07
11
Mar-09
9
Insulin Treatment (Therapy) IV
May-10
26
Integra® Bilayer Matrix Wound Dressing
Oct-08
17
Integra® Dermal Regeneration Template,
Oct-08
17
Interlaminar or Cadul Epidural and -or Intrathecal Injections
Apr-09
8
Intermittent Inotropic Infusion for the Treatment of Chronic Heart
May-08
10
Interventional Cardiology L28129
Oct-08
21
Intra-articular Inject of Hyaluronans, Hyalgan, Supartz, Eurlexxa
Feb-08
8
Intracranial Percutaneous Transluminal Angioplasty with Stenting
Aug-08
34
Facility (IRF)
Inpatient Rehabilitation Services Provided in an Inpatient Rehabilitation
Facility (IRF)
‐‐
LCD & SIA
Failure in an Outpatient Setting
Intravenous Immune Globulin (IVIG)
Oct-08
17
Investigational Device Exemption Requests
Dec-07
4
Investigational Device Exemption Requests
Oct-07
15
Ionized Calcium
Jun-09
11
IPPI Family History
Oct-09
98
Irinotecan Hydrochloride (e.g., Camptosar®)
Oct-08
17
Iron Dextran
Nov-08
90
Irridiated Blood Products
Jan-09
13
IVIG Preadmission Services
Aug-07
54
J
K
Kidney disease Patient Education Services
Feb-10
29
Laboratory - Diagnostic Test Medical Necessity
Apr-09
6
Laryngoscopy, Diagnostic
Jun-09
12
Laser Ablation of the Prostate
Oct-08
8
LCD Reconsiderations
Apr-08
7
LCD Retired Coverage New York, New Jersey
Jul-08
15
Lipid Profile/Cholesterol Testing
Oct-08
9
Lipid Profile/Cholesterol Testing (L27352)
Jul-09
10
Lipid Profile/Cholesterol Testing L27352
Apr-09
7
Local Coverage Determination (LCD) Reconsideration Process
Mar-09
11
L
‐
Medical Policy Article (A47355)
Lumbar Artificial Disc Replacement
Nov-07
38
Luteinizing Hormone
Jan-08
31
Mar-09
12
Magnetic Resonance Angiography
Aug-07
15
Magnetic Resonance Angiography (MRA)
Aug-10
Magnetic Resonance Angiography (MRA)
Oct-07
11
Magnetic Resonance Angiography (MRA) LCD & SIA
Mar-09
9
Magnetic Resonance Angiography Zostavax - revised
Aug-07
12
Magnetic Resonance Imaging
Jan-09
13
Magnetic Resonance Imaging
Jan-08
28
‐
Releasing Hormone (LHRH
Luteinizing Hormone
‐
Releasing Hormone (LHRH) Analogs (L26369)
M
20
Mammography
Jan-08
75
Mammography Claims, Self Referred
Jul-08
72
Mammography/Breast Echography
Nov-09
8
Mammography/Breast Echography
May-08
9
Mammography/Breast Echography SIA
Nov-09
8
Medical Nutrition Therapy
Jan-08
4
Medical Nutrition Therapy (MNT) Services
Mar-09
9
Medical reasonableness
Apr-09
25
Medically Necessary Removal of Impacted Cerumen
Jun-09
12
Medical Record Retention
Sept-10
30
Medical Review Judgement
Jun-10
43
Mental Health Outpatient Treatment Limitation
Dec-09
35
‐‐
Medical Policy Article
Mental Health Services
Apr-10
28
Mental Health Services, Payments for
Dec-08
30
Mentl Health Services
Feb-09
33
Mepivacaine Reimbursement
Dec-07
41
Missed Appointments
Aug-07
56
Missing or Illegible Signatures continued
Sep-09
10
Mitomycin (Mutamycin®, Mitomycin
Oct-08
17
Modifier 25, Misuse of
Nov-08
7
Modifier 50
Sep-09
25
Modifier 59
Jul-07
56
Modifier HCPCS Clinical Research Studies
Feb-08
72
‐
C)
MOHS Micrographic Surgery – Supplemental Instructions Article (SIA)
Mar-09
9
Morphometric Analysis L28132
Oct-08
21
MRI
Jan-09
13
MRI
Nov-09
44
MRI Procedures
Nov-07
36
MUE Medically Unlikely Edits
Mar-10
23
Myocardial Perfusion Imaging
Aug-07
14
Myocardial Perfusion Imaging
Sep-07
16
Myocardial Perfusion Imaging
Jan-08
33
Apr-09
6
N
Nail Debridement
Nail Debridement Reminder
Apr-09
9
Nasal Punctum
May-08
11
Mar-09
9
National Drug Codes
Mar-09
51
National Drug Codes
May-08
69
National Provider Identifier
June 07 Memo
10
National Provider Identifier
Dec-07
104
Natriuretic Peptide
Oct-07
29
Nebulized Beta Adrenergic Agonist Therapy
Feb-08
51
‐
Nasolacrimal Duct Dilation and Probing with or without Irrigation
Nasal Punctum
‐
Nasolacrimal Duct Dilation and Probing with or without Irrigation
‐‐
LCD & SIA
National Government Services-Medicare Monthly Review -
Nerve Conduction Studies
Oct-08
14
Nerve Conduction Studies (NCS)/Electromyography (EMG)
Mar-09
9
Nerve Conduction Studies (NCS)/Electromyography (EMG)
May-08
12
Neuromuscular Junction Testing
Jan-08
7
Neuromuscular Junction Testing
Oct-07
12
Neuromuscular Junction Testing
Oct-08
14
Neuromuscular Junction Testing
Jan-09
18
Neuromuscular Junction Testing – LCD & SIA
Mar-09
9
New Contractor Numbers for J13
Jul-08
77
New Waived Tests
Mar-09
61
New Waived Tests
Mar-10
64
New Waived Tests
Apr-09
84
New Waived Tests
Nov-07
103
New Waived Tests (CR6459)
Jul-09
64
New Waived Tests MM6287
Apr-09
86
Non- ESRD Anemia
Sep-07
14
Non-ESRD Indications Modifiers for
Feb-08
65
Noninvasive Vascular Diagnostic Studies
Oct-08
21
Noninvasive Vascular Studies (L27355)
May-09
8
Noninvasive Vascular Studies (L27355)
Oct-08
9
Nonvascular Extremity Ultrasound
Jun-09
12
NP and CNS Services
Sep-07
64
NPI and Enrollment Information
Nov-07
82
NPI Final Implementation
Nov-07
46
NPI for Ordering/Referring and Attending/Operating/Other Service
Jan-08
56
NPI for Ordering/Referring and Attending/Operating/Other Service
Dec-07
72
NPI for Ordering/Referring and Attending/Operating/Other Service
Feb-08
74
NPI for Secondary Providers
Nov-08
37
NPI for Secondary Providers
Oct-08
38
NPI Purchased Diagnostic Services
Apr-09
87
OASIS® Wound Matrix and Oasis® Burn Matrix
May-08
4
OASIS® Wound Matrix and Oasis® Burn Matrix
Jul-09
10
OASIS® Wound Matrix and Oasis® Burn Matrix
Oct-08
18
Observation Services and Inpatient Care Services
Apr-08
93
O
Observation Services Billing – CERT Alert
Sept-10
3
Ocular Blood Flow Tests – LCD & SIA
Mar-09
9
Ocular Photography
Oct-08
9
Off Label Compendia
Dec-08
40
Off Label Use of Drugs
Mar-08
98
Off Label Uses
Apr-08
5
On-Call Physicians
Feb-10
14
Ophthalmic A and B Scans
Jun-09
13
Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Oct-07
12
Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Oct-08
14
Ophthalmic Angiography (Fluorescein and Indocyanine Green) (L25347)
Mar-09
12
‐
External
Ophthalmic Biometry for Intraocular Lens Power Calculation – LCD &
Mar-09
9
Oct-08
14
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy Oct-07
13
SIA
Ophthalmology: Posterior Segment Imaging
and Fundus Photography)
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy Mar-09
12
and Fundus Photography) (L25466)
Oprelvekin (e.g., Neumega®)
Oct-08
18
Opting Out of Medicare
Aug-08
75
Ordering/Referring Providers
Nov-09
76
Ordering/Referring Providers
May-10
61
Ordering/Referring Providers -Edits
May-10
70
Ordering/Referring Providers Who are not enrolled in Medicare
May-10
65
Ordering/Referring Providers for claims processed by Medicare carriers
Feb-10
93
and Part B Medicare contractors
Orders for Labs and Diagnostics
Jul-09
8
Outpatient ESRD Related Services Visit Requirements
Oct-09
99
Outpatient Physical and Occupational Therapy Services (L26884)
May-08
12
Outpatient Physical and Occupational Therapy Services (L26884)
Mar-09
12
Outpatient Psychiatry and Psychology Services (L26895)
May-08
12
Outpatient Psychiatry and Psychology Services (L26895)
Mar-09
13
Outpatient Pulmonary Rehabilitaion
Jan-09
14
Outpatient Services
July 07 Memo
8
Outpatient Therapy Services
May-08
5
Feb-09
8
P
Paclitaxel
Paclitaxel (e.g., Taxol®/Abraxane™)
Oct-08
18
Pain Management
Apr-09
8
Pain Management
Jan-09
14
Pain Management – Supplemental Instructions Article (A48042)
May-09
9
Pamidronate Disodium for Injection (e.g., Aredia
Oct-08
18
Pamidronate Disodium for Injection (e.g.,
Apr-08
5
Panitumumab
Feb-08
8
Panretinal (Scatter) Laser Photocoagulation
Jan-09
15
Panretinal (Scatter) Laser Photocoagulation
Oct-08
22
Parathormone (Parathyroid Hormone, PTH, Immunoreactive PTH)
Jan-09
15
Parathormone (Parathyroid Hormone, PTH, Immunoreactive PTH)
Mar-09
13
Aredia®)
(L28443)
Parathormone (Parathyroid Hormone, PTH,Immunoreactive PTH)
Oct-08
22
Pathology Services (CR6457) Global Billing
Jul-09
63
Pathology Services (CR6457) Global Billing
Sep-09
66
Pathology Services- Independent Lab Billing
Mar-08
103
Pelvic and Transvaginal Ultrasound Procedures L28134
Oct-08
22
Percuaneous Coronary Intervention
Jan-09
15
Percutaneous Transluminal Angioplasty
Oct-07
32
Percutaneous Transluminal Angioplasty
Jul-08
74
PET for Cervical Cancer
Feb-10
47
PET for Cervical Cancer
Jan-10
75
PET for Solid Tumors and Myeloma
Nov-09
38
PET for Solid Tumors and Myeloma
June-10
22
PET Imaging for Infection and Inflammation
Oct-08
43
PET Scan Coding
Sep-07
19
PET to Identify Bone Metastasis of Cancer
May-10
33
Physical Medicine and Rehabilitation (PM&R) Services
Jan-08
33
Physician Ownership in Hospitals
Apr-09
57
Physician Pathology Services
Aug-08
97
Place of Service Code
Jan-08
113
Place of Service Reminder
Apr-08
22
Polypectomy Performed During Screening Colonoscopy
Dec-07
54
Polysomnography and Sleep Studies
Jun-08
7
Polysomnography and Sleep Studies
Jun-09
13
Polysomnography and Sleep Studies Correction
Apr-08
7
POS Hospice
Aug - 10
43
POS and DOS for Interpretation of Diagnostic Tests
Mar-10
24
POS and DOS for Interpretation of Diagnostic Tests
Feb-10
26
Post
May-08
12
Oct-08
14
PQRI
Jan-09
97
PQRI 2007
Sep-08
66
PQRI 2007 Feedback
Sep-08
68
PQRI 2008
Aug-08
78
PQRI 2008
Jul-08
111
‐
Void Residual Urine and/or Bladder Capacity by Ultrasound
Post
‐
Void Residual Urine and/or Bladder Capacity by Ultrasound
PQRI 2009
May-09
36
Pre
May-09
8
Preventing Services and Screenings
Jan-08
63
Preventive Services SNF
Jan-08
60
Prison Medicare Beneficiaries
Oct-09
28
Prison Medicare Beneficiaries
Oct-09
41
Private Fee for Service Plans
Mar-09
41
Private Fee for Service Plans Revised
Apr-09
49
Procedures L28134
Oct-08
22
Prolonged Services Codes 99354-99359
Jun-08
54
Prostate laser Ablation
Nov-09
9
‐
surgical Conduit Mapping for Coronary Artery Bypass Graft Procedures
Prostate Specific Antigen (PSA)
Oct-08
10
Prostate Specific Antigen (PSA) (L27357)
Mar-09
13
Psychiatric Inpatient Hospitalization
Oct-07
13
Psychiatric Partial Hospitalization Programs (L26398)
May-09
10
Psychiatry and Psychology Services (R12)
Aug-07
13
Psychiatry and Psychology Services (R12)
Jan-08
31
Psychological and Neuropsychological Tests
Apr-08
40
Psychological Services Coverage under the “Incident to” Provision for
Aug-07
13
May-08
13
Sep-07
15
Physicians and Non
‐
physicians
Psychological Services Coverage under the “Incident to” Provision for
Physicians and Non
‐
physicians
Psychological Services Coverage under the “Incident to” Provision for
Physicians and Non
‐
physicians
PT/ INR Monitoring
Sep-08
31
PTA Billing Requirements
Oct-07
35
PTA Percutaneous Transluminal Angioplasty
Aug-07
43
PTAN
Apr-08
101
PTH
Jan-09
15
PT-INR Monitoring
Feb-09
41
Pulmonary Rehabilitation Services
Jan-08
74
Pulse Oximetry L28180
Oct-08
22
Purchased Diagnostic Test and Anti-Markup Rule
Apr-10
64
Q
Q0 Modifier Common Procedure Coding
June-10
31
Q0 Modifier ICD Provided in Clinical Study
May-10
37
Qualitative Drug Screen LCD (L28145)
Jun-09
4
Qualitative Drug Screening
Jun-09
14
Radiation Therapy L28199
Oct-08
22
Radiologic Examination of the Chest
May-08
12
Radiologic Examination of the Chest
Oct-08
14
Radiologic Examination of the Chest – LCD & SIA
Mar-09
9
Ranibizumab
Feb-08
9
RAST Type Tests
Jan-09
16
Reassigned Services Payment Jurisdiction
July 2010
99
R
Recoupment
Oct-08
52
Regadenoson (Lexiscan)
Nov-08
4
Removal of Benign Skin Lesions (L27362)
Oct-08
10
Removal of Benign Skin Lesions (L27362)
Mar-09
14
Removal of Benign Skin Lesions (L27362) (A47397)
Jul-09
10
Respiratory Therapy Services L28124
Oct-08
22
Revocation effective dates
May-09
18
Rituximab (Rituxan®)
Oct-08
18
Roster Billing
Aug-09
27
Roster Billing
Sep-08
40
Rotary Wing Air Ambulance
Apr-09
25
Routine Foot Care
Jul-09
29
Routine Foot Care
Jan-08
32
Routine Foot Care and Debridement of Nails
Oct-08
15
Routine Foot Care and Debridement of Nails – LCD & SIA
Mar-09
9
Routine Foot Care Services
Jun-09
37
Safeguard Services LLC
Dec-08
9
Scanning Computerized Ophthalmic Diagnositic Imaging
Jan-09
16
SCODI
Jan-09
16
Screening DNA Stool Test for Colorectal Cancer
Oct-08
40
Screening DNA Stool Test for Colorectal Cancer
Sep-08
47
Screening Mammography, Diagnosis codes for
Sep-07
18
S
Screening Pelvic Examination
Aug-08
27
Self Administered Drugs
Jul-08
4
Sentinel Lymph Node Biopsy –
Apr-08
7
Sentinel Lymph Node Biopsy – Medical Policy Article
Mar-09
9
Serum Magnesium Testing
Oct-08
10
Serum Magnesium Testing L28136
Oct-08
23
Signature Guidelines for Medical Review Purposes
July 2010
26
Signature Guidelines for Medical Review Purposes
May-10
23
Signature Guidelines for Medical Review Purposes
Sept-10
17
Signature Requirements
May-08
47
Signature Requirements
Sep-08
5
Signature Requirements CR 5971
Sep-08
29
Signature Requirements for Diagnostic Tests
Mar-09
18
Signature Requirements for Diagnostic Tests
Oct-08
42
Signatures, Missing or Illegible
Aug-09
4
Signatures, Missing or Illegible
Sep-09
10
Sleep Testing for OSA
Aug-09
25
Smoking and Tobacco use Cessation Counseling Billing Code
Mar-08
38
SNF Consolidated Billing
Sep-07
30
SNF Consolidated Billing
Aug-07
41
SNF Consolidated Billing
Aug-08
66
SNF Consolidated Billing and Preventative/Screening Services
Nov-07
55
Somatosensory Testing
Jun-09
14
Somatosensory Testing L28204
Oct-08
23
Specialty Codes
Jun-09
64
Specialty Codes for Hospice and Pallative Care
Jun-09
42
Speech Language Pathologists Specialty Code
Apr-09
6
Speech Language Pathology (L27404)& (A47407)
Jul-09
10
Speech Language Pathology Private Practice Payment
Jun-09
66
Speech
Oct-08
11
Stretta Procedure
May-08
12
Subsequent Hospital Visits and Hospital Discharge Day Management
Apr-08
98
Surgical Decompression for Peripheral Neuropathy
Nov-08
6
Surgical Decompression for Peripheral Neuropathy
Jan-09
18
‐
Language Pathology
Surgical Decompression for Peripheral Polyneuropathy
Oct-07
14
Surgical Decompression for Peripheral Polyneuropathy
Oct-08
15
Surgical Decompression for Peripheral Polyneuropathy – LCD & SIA
Mar-09
9
Surgical Treatment of Nails – LCD & SIA
Mar-09
9
Surveillance of Implantable Cardioverter Defibrillators
Jul-09
11
Surveillance of Implantable or Wearable Cardioverter Defibrillators
Jan-09
17
Swallow Evaluation and Dysphagia Treatment
Oct-08
11
Swallow Evaluation and Dysphagia Treatment LCD (L27364) and SIA
Jul-09
11
Jan-09
17
Sep-07
66
(ICDs) Office
(A47391)
Syphillis Tests
T
Tamper-Resistant Prescription Pads for Outpatient Drugs Prescribed
Tamper-Resistant Prescription Pads for Outpatient Drugs Prescribed
Nov-07
105
Taxonomy Codes
Apr-09
35
Taxonomy Codes
Oct-07
47
Taxonomy Codes
Apr-08
52
Taxonomy Codes (HPTC)
Nov-08
6
T C Multiple Procedure Payment Reduction
June -10
80
Teaching Physician Requirements for EXRD Monthly Capitation Payment
Apr-08
89
Technical Component, Purchased Diagnostic Services
Oct-08
84
Telehealth Originating Site
Mar-08
42
Telehealth Services
Jun-09
42
Telehealth Services
Feb-09
44
Telehealth Services
Jan-08
58
Temporary Lodging
Jan-08
113
Temsirolimus
Nov-07
15
Temsirolimus (Torisel ™)
Apr-08
5
Temsirolimus (Torisel)
Feb-09
8
Temsirolimus (Torisel™)
Oct-08
18
Tetanus Immunization
Mar-10
18
Therapeutic shoes for Diabetics
Feb-09
20
Therapy Caps
Jul-08
75
Therapy Caps
Aug-08
97
Therapy Code List (CR#6254)
Dec-08
47
Therapy Personnel Qualifications and Policies
Jun-08
28
Therma Intradiscal Procedures
Jan-09
47
Thyrotropin Alfa (Thyrogen®)
Apr-09
7
Thyrotropin Alfa (Thyrogen®)
Mar-09
9
Timeframes for reporting changes of information
May-09
18
Topotecan Hydrochloride (Hycamtin®)
Oct-08
18
Tracheo-Esophageal Voice Prostheses
June-10
49
Transcatheter Infusion Therapy (L26849)
Mar-09
14
Transesophageal Echocardiography
Oct-08
12
Transesophageal Echocardiography (TEE)
Jun-09
14
Transplant Centers
Nov-07
30
Transrectal Ultrasound – LCD & SIA
Mar-09
9
‐‐
Related to LCD L25820
Transrectal Ultrasound L26876
Oct-08
23
Transthoracic Echocardiography (TTE)
Oct-08
12
Ultrasound Diagnostic Procedures CR #5608
Oct-07
37
Ultrasound Diagnostic Procedures CR #5608
Nov-07
39
Unlabeled Use for Anti-Cancer Drugs
Nov-07
100
Unsolicited/voluntary Refund Information
Sep-07
37
UPIN Registry Discontinuance
Oct-07
45
Urodynamics – LCD & SIA
Mar-09
9
Vaccine Administrations
Sep-07
61
Vagus Nerve Stimulation for Resistant Depression
Aug-07
46
U
V
Varicose Veins of the Lower Extremity, Treatment of
Oct-07
14
Varicose Veins of the Lower Extremity, Treatment of – LCD & SIA
Mar-09
9
Varicose Veins of the Lower Extremity, Treatment of (L25519)
May-09
9
Venipuncture Necessitating Physician's Skill for Specimen Collection
Jan-09
17
Venipuncture Necessitating Physicians’ Skill for Specimen Collection
Jul-09
12
Verification of Legalized Status
Mar-10
61
Vertebral Axial Decompression (VAX-D)
May-08
21
Vertebroplasty and Kyphoplasty
Oct-08
15
Vertebroplasty and Kyphoplasty (Percutaneous) (L26439)
Nov-08
6
Vertebroplasty and Kyphoplasty (Percutaneous) (L26439)
Mar-09
14
Viral Hepatitis Serology Tests
Jan-09
18
(L28459) & (48001)
Viral Hepatitis Serology Tests L28197
Oct-08
23
Visual Fields Testing L26367
Nov-09
10
Visual Fields Testing L26367
Oct-08
15
Vitamin B
Oct-08
23
Oct-08
4
Waived Tests
Jan-10
70
Waived Tests
Apr-08
84
Waived Tests
Oct-08
85
Wavied Tests
Aug-08
67
‐
12 Injections L28218
Voluntary Refund Information
W
X
X-rays - LCD
Jun-08
14
Jan-08
30
Zoledronic Acid (e.g., Zometa ®, Reclast® )
Jul-09
12
Zoledronic Acid (e.g., Zometa®, Reclast®)
Aug-08
6
Zoledronic Acid (e.g., Zometa®, Reclast®)
Feb-08
9
Zoledronic Acid (e.g., Zometa®, Reclast®)
Oct-08
19
Y
YAG Laser Capsulotomy
Z