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August and September 2022 LCD, Billing and Coding Article Updates

Routine Foot Care and Debridement of Nails – L33636

Under the Limitations section, the active care requirement for systemic conditions has been revised to remove “qualified non-physician practitioners” to conform with the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, section 290.D.

Billing and Coding: Routine Foot Care and Debridement of Nails – A57759

Clarifying information has been added to the Coding Guidelines and Documentation Requirements sections to reflect new testing technology and to specify clear medical documentation needed to justify services and for review of claims.

The active care requirement in ICD-10 coding sections for systemic conditions has been revised to remove “qualified non-physician practitioners” to conform with the CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, section 290.D.

Self-Administered Drug Exclusion List: Medical Policy Article (A53021 & A53022)

The article has been updated to remove Tezepelumab-ekko (Tezspire™) (C9399, J3490, J3590) effective for dates of service on or after 7/10/2022.

Posted 8/26/2022