Skip to Main Content
 
 
 
Web Content Viewer

News and Alerts

Web Content Viewer

Revised LCDs and Articles: October 2018

Prostate Rectal Spacers (L37485)

Based on the receipt of several Reconsideration Requests and the 8/15/2018 revision of NCCN guidelines, Indications and Limitations of Coverage have been updated, and references have been added to the Bibliography, effective for services rendered on or after 10/15/2018.

Bevacizumab - Related to LCD L33394 (A52370)

Based on compendia review, ICD-10-CM codes D32.0, D32.1, D42.0 and D42.1 have been added to the “Group 1 Covered ICD-10 Codes” section of the article effective for dates of service on and after 10/1/2018.

Botulinum Toxins (L33646)

LCD revised for annual ICD-10-CM code updates. ICD-10-CM code G51.3 has been deleted and replaced by ICD-10-CM codes G51.31, G51.32 and G51.33 in Group 5 in the “ICD-10 Codes that Support Medical Necessity” section of the LCD.

Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography – Supplemental Instructions Article (A52849)

Removed Bill Type Code 066X and added Bill Types Codes 012X, 013X, 022X, 023X, 071X, 073X, 077X, 085X in the “Coding Information” section.

Cardiac Catheterization and Coronary Angiography (L33557)

LCD revised for annual ICD-10 updates.

ICD-10 code G71.0 was deleted and replaced by G71.01, G71.02, and G71.09 for groups 1 and 2.

ICD-10 code R93.8 was deleted and replaced by R93.89 for groups 1, 2, 3 and 4.

ICD-10 codes I67.850 and I67.858 were added to group 6.

Computed Tomographic (CT) Colonography for Diagnostic Uses (L33562)

LCD revised for annual ICD-10-CM code updates. ICD-10 codes K35.89 and K83.0 were deleted from “ICD-10-CM Codes that Support Medical Necessity” section - Group 2 and ICD-10 codes K35.890, K35.891, K83.01 and K83.09 were added as replacement codes.

Health and Behavior Assessment/Intervention – Medical Policy Article (A52434)

Due to the annual ICD-10-CM update the following ICD-10 code descriptions were changed in the “Non-Covered ICD-10 Codes” section- Group 1: F68.10, F68.11, F68.12, and F68.13.

The following ICD-10 code was deleted from the “Non-Covered ICD-10 Codes” section - Group 1: F53.

The following ICD-10 codes were added to “Non-Covered ICD-10 Codes” section- Group 1: F12.23, F12.93.

Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures (L33563)

LCD revised for annual ICD-10-CM updates. ICD-10 codes T81.4XXA, T81.4XXD and T81.4XXS have been deleted from Group 1 and the following ICD-10 codes have been added as replacements; T81.41XA, T81.41XD, T81.41XS, T81.42XA, T81.42XD, T81.42XS, T81.43XA, T81.43XD, T81.43XS, T81.44XA, T81.44XD, T81.44XS, T81.49XA, T81.49XD and T81.49XS. In addition, ICD-10 codes K61.31, K61.39 and K61.5 have also been added to Group 1.

Laparoscopic Sleeve Gastrectomy (LSG) – Medical Policy Article (A52447)

The following ICD-10 code description was changed in the “Covered ICD-10 Codes” section- Group 2: Z68.43.

Magnetic Resonance Angiography (MRA) (L33633)

LCD revised for annual ICD-10 updates.

For Group 1, ICD-10 code I63.8 is deleted and replaced by I63.81 and I63.89 and ICD-10 codes I67.850 and I67.858 are being added.

For Group 4, ICD-10 code R93.8 is deleted and replaced by R93.811, R93.812, R93.813, R93.819 and R93.89.

Molecular Pathology Procedures (L35000)

Due to the annual ICD-10-CM update, diagnosis codes C43.11, C43.12, D03.11, and D03.12 were deleted from code ranges C43.0 - C43.9 and D03.0 - D03.9, and the following codes were added to code ranges C43.0 - C43.9 and D03.0 - D03.9 in the “ICD-10 Codes that Support Medical Necessity” section, Group 4 and Group 15: C43.111, C43.112, C43.121, C43.122, D03.111, D03.112, D03.121, D03.122.

Nerve Conduction Studies and Electromyography (L35098)

LCD revised for annual ICD-10 updates.

In Group 1, ICD-10 code G51.3 was deleted and replaced by G51.31, G51.32, and G51.33. ICD-10 code G71.0 was deleted and replaced by G71.01, G71.02 and G71.09. ICD-10 code M79.1 was deleted and replaced by M79.11, M79.12 and M79.18.

Nivolumab - Related to LCD L33394 (A54862)

Article revised for annual ICD-10-CM code updates. ICD-10-CM codes C43.11 and C43.12 have been deleted and replaced with ICD-10-CM codes: C43.111, C43.112, C43.121 and C43.122 in code range C43.0 - C43.9 in Group 1 and ICD-10-CM codes C4A.11 and C4A.12 have been deleted and replaced with C4A.111, C4A.112, C4A.121 and C4A.122 in Group 1.

Based on an FDA label update, the following has been added to the “Indications” section of the article:

Metastatic small cell lung cancer (SCLC) with progression after platinum-based chemotherapy and at least one other line of therapy (Effective 8/16/2018 based on [FDA] approval).

Non-covered Services (L33629)

Based on a reconsideration request for OVA1/MIA (Multi-Variate Index Assay) testing, sources reviewed have been added to the Sources of Information section of the LCD. No change was made to coverage.

Non-Invasive Vascular Studies (L33627)

Due to the annual ICD-10-CM update, ICD-10 code I63.8 was deleted from the “ICD-10-CM "Codes that Support Medical Necessity” section- Group1 and Group 2 and was replaced by I63.81 and I63.89.

Based on a provider request, ICD-10-CM codes I82.591, I82.592 and I82.593 have been added to the “ICD-10 Codes that Support Medical Necessity” section- Group 4, effective for dates of service on or after 10/1/2017.

Outpatient Physical and Occupational Therapy Services (L33631)

LCD updated for annual ICD-10 updates to revise descriptors for ICD-10 codes L98.495, L98.496, L98.498.

Paclitaxel (e.g., Taxol®/Abraxane ™) - Related to LCD L33394 (A52450)

Article revised for annual ICD-10-CM code updates. ICD-10-CM codes C43.11 and C43.12 have been deleted and replaced with C43.111, C43.112, C43.121 and C43.122 in code range C43.0 - C43.9 in Groups 1 and 2 for albumin-bound paclitaxel and paclitaxel. ICD-10-CM codes D03.11 and D03.12 have been deleted and replaced with ICD-10-CM codes D03.111, D03.112, D03.121 and D03.122 in code range D03.0-D03.9 in Groups 1 and 2 for albumin-bound paclitaxel and paclitaxel. ICD-10-CM codes C44.102. C44.109, C44.112, C44.119, C44.122, C44.129, C44.192 and C44.199 have been deleted and replaced with ICD-10-CM codes C44.1021 C44.1022, C44.1091, C44.1092, C44.1121, C44.1122, C44.1191, C44.1192, C44.1221, C44.1222, C44.1291 and C44.1292 in code range C44.00-C44.1292 in Group 2 for paclitaxel and ICD-10-CM codes C44.1321, C44.1322, C44.1391, C44.1392, C44.1921, C44.1922, C44.1991 and C44.1992 have been added to code range C44.1321 – C44.99 in Group 2 for paclitaxel.

Pain Management (L33622)

LCD revised for annual ICD-10-CM code updates. ICD-10-CM code M79.1 has been deleted and replaced with ICD-10-CM codes M79.11, M79.12 and M79.18 in Group 1 in the “ICD-10 Codes that Support Medical Necessity” section of the LCD.

Peripheral Nerve Blocks (L36850)

LCD revised for annual ICD-10-CM updates. ICD-10 codes C43.11, C43.12, C4A.11, C4A.12, C44.102, C44.109, C44.112, C44.119, C44.122, C44.129, C44.192, C44.199, D22.11, D22.12, D23.11, and D23.12 have been deleted from Group 1 and Group 2 and the following ICD-10 codes have been added as replacements; C43.111, C43.112, C43.121, C43.122, C4A.111, C4A.112, C4A.121, C4A122, C44.1021, C44.1022, C44.1091, C44.1092, C44.1121, C44.1122, C44.1191, C44.1192, C44.1221, C44.1222, C44.1291, C44.1292, C44.1921, C44.1922. C44.1991, C44.1992, D22.111, D22.112, D22.121, D22.122, D23.111, D23.112, D23.121, and D23.122. In addition, ICD-10 codes C44.1321, C44.1322, C44.1391, C44.1392, D03.111, D03.112, D03.121, D03.122, D04.111, D04.112, D04.121 and D04.122 have also been added to Group 1 and Group 2.

Proton Beam Therapy (L35075)

Due to the annual ICD-10-CM update, the following ICD-10 codes were deleted from the “ICD-10 Codes that Support Medical Necessity” section –Group 2: C43.11 and C43.12. The following ICD-10 codes were added to “ICD-10 Codes that Support Medical Necessity” section-Group 2: C43.111, C43.112, C43.121, and C43.122. ICD-10-CM codes C44.1021, C44.1022, C44.1091, C44.1092, C44.1121, C44.1122, C44.1191, C44.1192, C44.1221, C44.1222, and C44.1291. C44.1292 has been inserted into code range C44.00 - C44.1292 in the “Codes that Support Medical Necessity” section-Group 2. ICD-10-CM codes C44.1321, C44.1322, C44.1391, C44.1392, C44.1921, C44.1922, C44.1991 and C44.1992 were inserted into code range C44.1321- C44.99 in the “Codes that Support Medical Necessity” section Group 2.

Psychiatric Inpatient Hospitalization (L33624)

Due to the annual ICD-10-CM update, the following ICD-10 code was deleted from the “CD-10 Codes that Support Medical Necessity” Group 1: F53. The following ICD-10 codes were added to the "ICD-10 Codes that Support Medical Necessity" section-Group 1: F53.0 and F53.1.

Psychiatric Partial Hospitalization Programs (L33626)

Due to the annual ICD-10-CM update, the following ICD-10 codes were added to the “ICD-10 Codes that Support Medical Necessity” section Group 1: F53.0, F53.1

Psychiatry and Psychology Services (L33632)

Due to the annual ICD-10-CM update, ICD-10 code F53 was deleted from the “ICD-10 Codes that Support Medical Necessity” section Group 1 and replaced by codes F53.0, and F53.1

Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (L35076)

LCD revised for annual ICD-10-CM updates. ICD-10 code G51.3 has been deleted from “ICD-10 Codes that Support Medical Necessity” section - Group 1 and replaced by G51.31, G51.32, G51.33 and G51.39.

Transesophageal Echocardiography (TEE) (L33579)

LCD revised for annual ICD-10 updates to make these changes to Group 1:

ICD-10 code I63.8 was deleted and replaced by I63.81 and I63.89.

ICD.10 code R93.8 was deleted and replaced by R93.89.

ICD-10 codes T81.4XXA, T81.4XXD, and T81.4XXS were deleted and replaced by T81.44XA, T81.44XD and T81.44XS.

Transrectal Ultrasound (L33578)

LCD revised for annual ICD-10-CM code update. ICD-10 code K61.3 was deleted from “ICD-10 Codes that Support Medical Necessity” section - Group 1 and ICD-10 codes K61.31 and K61.39 were added as replacement codes.

Transthoracic Echocardiography (TTE) (L33577)

LCD revised for annual ICD-10 updates.

ICD-10 code I63.8 was deleted and replaced by I63.81 and I63.89 in Group 1.

ICD-10 codes T81.4XXA, T81.4XXD and T81.4XXS were deleted and replaced by T8140XA, T8141XA, T8142XA, T8143XA, T8144XA, T8140XD, T8141XD, T8142XD, T8143XD, T8144XD, T8140XS, T8141XS, T8142XS, T8143XS, and T8144XS in Group 1.

Urine Drug Testing (L36037)

Due to the annual ICD-10-CM update the following ICD-10 codes were deleted from the “ICD-10 Codes that Support Medical Necessity” section Group 1: M79.1.The following ICD-10 Codes have been added to the “Support Medical Necessity” section in Group 1: M79.10, M79.11, M79.12, M79.18, T43.641A, T43.641D, T43.641S, T43.642A, T43.642D, T43.642S, T43.643A, T43.643D, T43.643S, T43.644A, T43.644D and T43.644S.

Urodynamics (L33576)

LCD revised for annual ICD-10-CM code update for 2019 ICD-10 code N35.8 was deleted and replaced by N35.811, N35.812, N35.813, N35.814, N35.816, N35.819, N35.82.

Visual Fields Testing (L33574)

Due to the annual ICD-10-CM diagnosis code update, code I63.8 has been deleted from the “ICD-10 Codes that Support Medical Necessity” section - Group 1.

Vitamin D Assay Testing (L37535)

LCD revised for annual ICD-10-CM code updates. The descriptor for ICD-10-CM code Z68.43 was changed in Group 1.

[Return to Medicare Monthly Review Index]

1018 MMR: Revised LCDs and Articles: October 2018
Web Content Viewer
Complementary Content