Part A Updates for April 1, 2008

Note: All updates apply to Illinois, Indiana, Kentucky, and Ohio.

Diagnostic Mammography R13Cor (effective March 1, 2008): Source of revision: External – CPT code 70551 was listed in the CPT\HCPCS section in error. CPT code 70551 has been removed. No comment and notice periods required and none given.

The following Local Coverage Determinations (LCDs) will no longer be in effect for services performed after March 31, 2008. All local policy rules, requirements, and limitations within this policy will no longer be applied on a prepay basis, but as with any billed service, will be subject to postpay review. All Centers for Medicare & Medicaid Services (CMS) national policy rules, requirements and limitations remain in effect.

B-type Natriuretic Peptide ( BNP) Testing (R5)

Colorectal Cancer Screening (R13)

Dental Services (R1)

Diagnostic and Therapeutic Colonoscopy/ Sigmoidoscopy/Proctosigmoidoscopy (R13)

Diagnostic and Therapeutic Esophagogastroduodenoscopy (EGD) (R15)

High Sensitivity C-Reactive Protein (hsCRP) (R1)

Intravenous Immune Globulin (IVIG) (R18)

Intravenous Nesiritide Therapy in the Outpatient Setting (R7)

Overnight Sleep Studies (R5)

Long-term Electrocardiographic Monitoring (Holter Monitoring) (R9)

Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (formerly Leuprolide acetate (Lupron) and Goserelin acetate (Zoladex) (R9)

Percutaneous Vertebroplasty and Kyphoplasty (formerly) Percutaneous Vertebroplasty (R7) (cor#1)

Psychiatric Partial Hospitalization Programs (R14)

The following articles will also be posted under the “ Medical Policy Articles ” Current link on the National Government Services (fiscal intermediary) Web site ( www.NGSMedicare.com) on April 1, 2008:

Policy Consolidation in National Government Services, Inc.

Retired Local Coverage Determination (LCD) – Dental Services

Retired Local Coverage Determination (LCD) – Intravenous Immune Globulin (IVIG)

Local Coverage Determination (LCD) Reconsideration Process - Medical Policy Article – Newly Revised Article

The following article has also been revised and will be posted under the “ Part A (Intermediary) Usually Self-Administered Drug Exclusion List ” link on the National Government Services (fiscal intermediary) Web site ( www.NGSMedicare.com) on April 1, 2008:

“Process for Determining Payment for Drugs and Biologicals Furnished Incident to a Physician’s Service”