Coverage: Medical Policy Update Part A and Part B Cardiac Catherization and Coronary Angiography

Cardiac Catheterization and Coronary Angiography (L26880) R (#2) (effective 12/01/2008)

(A) This LCD was revised in response to reconsideration requests to correct the section on extra-cardiac angiography to: (1) clarify that the LCD applied only to extra-cardiac angiography performed during the same encounter as cardiac catheterization; (2) clarify the difference between the selective and nonselective cardiac angiography services; and (3) include additional ICD-9-CM diagnosis codes that support the medical necessity of the selective extra-cardiac catheterization.

(B) The ICD-9-CM Codes that Support Medical Necessity subsection for left ventricular catheterization was revised to exclude the reference to coronary/bypass angiography since the specific CPT codes for these services were not identified.

(C) ICD-9-CM code V67.09 was added to the diagnoses supporting medical necessity for right and left heart catheterization and endomyocardial biopsy.

(D) This revision is retroactive to the original date of implementation of this LCD (July 1, 2008 for all of National Government Services jurisdictions, including contracts 00803 and 00308; or the specific transition date for each region into J-13, as noted above).

No additional comment or notice periods required and none given.

Cardiac Catheterization and Coronary Angiography SIA (A46193) article will be published December 1, 2008.

Revision (#3):
(A) This article was revised in response to reconsideration requests to correct the section on extra-cardiac angiography to: (1) clarify that the LCD applied only to extra-cardiac angiography performed during the same encounter as cardiac catheterization; (2) clarify the difference between the selective and non-selective extra-cardiac angiography services; and (3) include additional ICD-9-CM diagnosis codes that support the medical necessity of the selective extra-cardiac catheterization.

(B) This revision is retroactive to the original date of implementation of this LCD (July 1, 2008 for all of National Government Services jurisdictions, including contracts 00803 and 00308; or the specific transition date for each region into J-13, as noted above).