news article details

January and February 2022 LCD and Billing and Coding Article Updates

Colon Capsule Endoscopy (CCE) (L38571)

LCD revised effective 2/15/2022: coverage criteria expanded to include blood-based biomarker colorectal cancer screening test, positive, in compliance with revised NCD 210.3, Colorectal Cancer Screening Tests.

Billing and Coding: Epidural Steroid Injections for Pain Management (A58745)

Effective 12/5/2021, removed M48.061 under Group 1 ICD-10-CM codes as this was included in error.

The language in the following Utilization guideline has been revised for clarity:
No more than four epidural injection sessions (CPT codes 62321, 62323, 64479, 64480, 64483, or 64484) may be reported per spinal region in a rolling 12-month period regardless of the number of levels involved.

Billing and Coding: Stem Cell Transplantation (A52879)

Based on Transmittal 11068, Change Request 12480 - ICD-10-CM April 2022, Allogeneic ICD-10-PCS 30230G2, 30230G3, 30230Y2, 30230Y3,30240G2, 30240G3, 30240Y2,30240Y3 and Autologous ICD-10 PCS 30230C0, 30230G0, 30230Y0, 30240C0, 30240G0, 30240Y0 have been end-dated effective 9/30/2021.

Retired LCDs and Billing and Coding Article

Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (DL37929)

National Government Services has decided not to move forward with finalizing the current Draft LCD and will also be retiring the Current (Final) LCD.

Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (L37929)

This LCD  will no longer be in effect for services performed after 1/27/2022. All local policy rules, requirements, and limitations within this policy will no longer be subject to automated edits, but as with any billed service, claims may be subject to medical review. All CMS national policy rules, requirements and limitations remain in effect.

Billing and Coding: Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea (A57548)

This article will no longer be in effect for services performed after 1/27/2022.  All local policy rules, requirements, and limitations within this article will no longer be subject to automated edits, but as with any billed service, claims will be subject to medical review. All CMS national policy rules, requirements and limitations remain in effect.

Posted 1/25/2022