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Posting Date: 01/03/2025
12/12/2024 Part B POE Advisory Group Meeting
12/12/2024 Part B POE Advisory Group Meeting Meeting Minutes Meeting Time: 10:00 a.m.‒12:00 p.m. ET Member Attendees: Elizabeth Aldrich, Dawson Ballard, Doris Barnes, Sheila Bembeneck, Madelon Berger, Louise Bertrand, Kimberly Bischel, [...]
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Posting Date: 01/03/2025
Billing and Coding: Bevacizumab and Biosimilars
Billing and Coding: Bevacizumab and Biosimilars drug, retinal A52370 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52370 C9257, J3590, J9035, Q5107, Q5118, Q5126, Q5129, 67028
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Posting Date: 01/03/2025
Cardiac Catheterization and Coronary Angiography
Cardiac Catheterization and Coronary Angiography heart, circulatory L33557 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33557 A52850 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52850 36140, [...]
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Posting Date: 01/03/2025
Facet Joint Interventions for Pain Management
Facet Joint Interventions for Pain Management Radiofrequency, Neurotomy, pain, cervical, lumbar, thoracic L35936 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35936 A57826 [...]
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Posting Date: 01/03/2025
Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms
Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms N/A L37810 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37810 A56867 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=5686[...]
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Posting Date: 01/03/2025
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor N/A L37421 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37421 A57435 https://www.cms.gov/medicare-coverage-database/view/article.aspx?art[...]
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Posting Date: 01/03/2025
Molecular Pathology Procedures
Molecular Pathology Procedures genetic testing, genetic counseling, gene, Tier 1, Tier 2 L35000 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=35000 A56199 https://www.cms.gov/medicare-coverage-database/view/article.aspx?arti[...]
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Posting Date: 01/03/2025
Noninvasive Vascular Studies
Noninvasive Vascular Studies NonInvasive, leg, clot, plethysmography, duplex scan, Doppler, cerebrovascular, arterial, venous, hemodialysis L33627 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33627 A56758 [...]
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Posting Date: 01/03/2025
Off-Label Use of Intravenous Immune Globulin (IVIG)
Off-Label Use of Intravenous Immune Globulin (IVIG) L39314 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39314 A59105 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59105 A59251 [...]
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Posting Date: 01/03/2025
Outpatient Physical and Occupational Therapy Services
Outpatient Physical and Occupational Therapy Services maintenance, restorative, skilled, modality, therapeutic, exercise, manual, cast, splint, biofeedback L33631 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33631 A56566 [...]
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Posting Date: 01/03/2025
Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane)
Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™) drug A52450 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52450 J9264, J9267
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Posting Date: 01/03/2025
Psychiatric Partial Hospitalization Programs
Psychiatric Partial Hospitalization Programs mental illness, family counseling, vocational training L33626 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33626 A56850 [...]
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Posting Date: 01/03/2025
Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) ionizing, stereotactic guidance, robotic L35076 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35076 A56874 [...]
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Posting Date: 01/03/2025
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction 6 Only)
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction 6 Only) SAD A53022 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53022 C9399, J0129, J0139, J0270, J0364, J0593, J0599, J0630, J0801, [...]
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Posting Date: 01/03/2025
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction K Only)
Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction K Only) SAD A53021 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53021 C9399, J0129, J0139, J0270, J0364, J0593, J0599, J0630, J0801, [...]
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Posting Date: 01/06/2025
Time Requirements to Notify Medicare of Changes
Report Changes to Your Enrollment Records You must report changes of information in your Medicare enrollment records within 30 days for: Change(s) in ownership or control, including changes in authorized officials(s) All other changes to [...]
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Posting Date: 01/02/2025
Proper Submission of Reopening Requests
Proper Submission of Reopening Requests National Government Services has identified an issue where providers are submitting reopening requests to change or add diagnosis codes on paid claims. These reopening requests do not impact the outcome [...]
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Posting Date: 01/08/2025
Fourth Quarter Top Ten EDI Institutional Edits
Fourth Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the 2024 fourth quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits, their description and learn what you can [...]
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Posting Date: 01/07/2025
Using Nicotine Replacement Therapy for Smoking Cessation
Using Nicotine Replacement Therapy for Smoking Cessation Healthcare providers may choose to offer quit smoking medications to help reduce withdrawal symptoms and cigarette cravings, effectively doubling the chances of quitting successfully. [...]
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Posting Date: 05/06/2016
Inpatient Admission Prior to Medicare Entitlement Job Aid
Inpatient Admission Prior to Medicare Entitlement Job Aid Pre-Entitlement Quick Steps Pre-entitlement is when a beneficiary is admitted as an inpatient to an acute care hospital prior to the beneficiary's Medicare entitlement effective date [...]
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