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Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter
IssueMonthyear

Policy Consolidation in National Government Services

 

As National Government Services evolves into an integrated company that serves beneficiaries and providers under Medicare Part A and Part B in many states, the local policies that guide payment criteria for Medicare services are being consolidated into uniform local coverage determinations (LCDs).

To arrive at the goal of having one set of uniform LCDs within the National Government Services contracts, some LCDs from former local contractors will be retired, and many new LCDs will be created as National Government Services consolidated LCDs.

On March 31, 2008, the following LCDs will be retired for New Jersey and New York Medicare Part B. These will be replaced by the consolidated National Government Services LCDs listed next to them, effective April 1, 2008.

LCD Being Retired

Consolidated NGS LCD Replacing Retired LCD

Ambulatory Electrocardiographic Monitoring (Holter Monitor)

L5321 - New Jersey
L3029 - New York

L26409 - Dynamic Electrocardiography (EKG, ECG)

Blepharoplasty

L24215 - New Jersey
L24014 - New York

L26448 - Blepharoplasty

 

Bone Mass Measurement

L3792 - New Jersey
L3141 - New York

L26385 - Bone Mass Measurement

B-Type Natriuretic Peptide (BNP)

L13054 - New Jersey
L13097 - New York

L26375 - B-type Natriuretic Peptide (BNP)

LCD Being Retired

Consolidated NGS LCD Replacing Retired LCD

Cardiac Event Detection

L3848 - New Jersey
L3629 - New York -

L26415 - Cardiac Event Detection

Colonoscopy

L4017 - New Jersey
L8257 - New York

L26404 - Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

Debridement of Mycotic Nails

L3509 - New Jersey
L9009 - New York

L26426 - Routine Foot Care and Debridement of Mycotic Nails

High Sensitivity C-Reactive Protein (hsCRP)

L20464 - New Jersey
L20503 - New York

L26445 - High Sensitivity C-Reactive Protein (hsCRP) Testing

Kyphoplasty

L3779 - New Jersey
L3101 - New York

L26439 - Vertebroplasty and Kyphoplasty (Percutaneous)

Luteinizing Hormone-Releasing Hormone (LHRH) Analogs

L3751 - New Jersey
L3602 - New York

L26369 - Luteinizing Hormone-Releasing Hormone (LHRH) Analogs

Mohs’ Micrographic Surgery

L3521 - New Jersey
L9424 - New York

L26371 - MOHS Micrographic Surgery

Nesiritide Infusion for Heart Failure

L16971 - New Jersey
L16974 - New York

L26418 - Nesiritide Infusion for Heart Failure

Ocular Blood Flow Tests

L15640 - New Jersey

L15635 - New York

L26422 - Ocular Blood Flow Tests

Ophthalmic Biometry for Intraocular Lens (IOL) Power Calculation

L19519 - New Jersey

L3756 - New York -

L26441 - Ophthalmic Biometry for Intraocular Lens Power Calculation

Percutaneous Vertebroplasty

L3552 - New Jersey

L3819 - New York

L26439 - Vertebroplasty and Kyphoplasty (Percutaneous)

Polysomnography / Sleep Testing

L4067 - New Jersey

L8201 - New York -

L26428 - Polysomnography and Sleep Studies

Routine Foot Care

L3854 - New Jersey

L3107 - New York -

L26426 - Routine Foot Care and Debridement of Mycotic Nails

Surgical Treatment of Nails

L5291 - New Jersey

L18645 - New York -

L26424 - Surgical Treatment of Nails

Visual Field Testing

L5305 - New Jersey

L6986 - New York -

L26367 - Visual Fields Testing

 


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