NOTE: Should you have landed here as a result of a search engine … · 2016. 10. 26. · the MCS...

NOTE Should you have landed here as a result of a search engine (or other) link be advised that these files contain material that is copyrighted by the American Medical Association You are forbidden to download the files unless you read agree to and abide by the provisions of the copyright statement Read the copyright statement now and you will be linked back to here

PART B MEDICARE ADVISORY Latest Medicare News for Part B

Whatrsquos Inside Administration

CMS Quarterly Provider Update 3 Going Beyond Diagnosis 3 Get Your Medicare News Electronically 5 Notification of the 2017 Dollar Amount in Controversy Required to Sustain Appeal Rights

for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review 8 CMS Finalizes the New Medicare Quality Payment Program 9

Drugs and Biologicals Medicare Part B Drug Average Sales Price Reporting by Manufacturers ndash Blending

National Drug Codes 10 Implementation of New Influenza Virus Vaccine Code 12

Education Educational Events Now Available 15

Medicine Stem Cell Transplantation for Multiple Myeloma Myelofibrosis and Sickle Cell Disease

and Myelodysplastic Syndromes 16 Update to Hepatitis B Deductible and Coinsurance and Screening Pap Smears Claims Processing Information 20

Ambulance Ambulance Inflation Factor for CY 2017 and Productivity Adjustment 21

Laboratory Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2017 22

Continued gtgt

palmettogbacomJMB

The Part B Medicare Advisory contains coverage billing and other information for Part B This information is not intended to constitute legal advice It is our ofϐicial notice to those we serve concerning their responsibilities and obligations as mandated by Medicare regulations and guidelines This information is readily available at no cost on the Palmetto GBA website It is the responsibility of each facility to obtain this information and to follow the guidelines The Part B Medicare Advisory includes information provided by the Centers for Medicare amp Medicaid Services (CMS) and is current at the time of publication The information is subject to change at any time This bul-letin should be shared with all health care practitioners and managerial members of the provider staff Bulletins are available at no-cost from our website at httpwwwPalmettoGBAcomJMB

CPT only copyright 2015 American Medical Association All rights reserved CPT is a registered trademark of the American Medical Association Applicable FARSDFARS Restrictions Apply to Government Use Fee schedules relative value units conversion factors andor related components are not assigned by the AMA and are not part of CPTreg and the AMA is not recommending their use The AMA does not directly or indirectly practice medicine or dispense medical services The AMA assumes no liability for data contained or not contained herein The Code on Dental Procedures and Nomenclature is published in Current Dental Terminology (CDT) Copyright copy 2015 American Dental Association (ADA) All rights reserved

November 2016 Volume 2016 Issue 11

Skilled Nursing Facility Internet Only Manual Updates to Pub 100-01 100-02 and 100-04 to Correct Errors and Omissions (SNF) 23

Etcetera Medical Directorrsquos Desk 26 CMS e-News 47

CMS Provider Minute Videos The Medicare Learning Network has a series of CMS Provider Minute Videos (httpswwwcmsgovOutreach-and-EducationMedicareshyLearning-Network-MLNMLNProductsMLN-Multimediahtml) on a variety of topics such as psychiatry preventive services lumbar spinal infusion and much more The videos offer tips and guidelines to help you properly submit claims and maintain suffi cient supporting documentation Check the site often as CMS adds new videos periodically to further help you navigate the Medicare program

CPT codes descriptors and other data only are copyright 2015 American Medical Association (or such other date of publication of CPT) All Rights Reserved Applicable FARSDFARS apply Current Dental Terminology fourth edition (CDT) (including procedure codes nomenclature descriptors and other data contained therein) is copyright by the American Dental Association copy2015 American Dental Association All rights reserved Applicable FARSDFARS apply

2 112016

CMS Quarterly Provider Update

The Quarterly Provider Update is a comprehensive resource published by the Centers for Medicare amp Medicaid Services (CMS) on the first business day of each quarter It is a listing of all non-regulatory changes to Medicare including program memoranda manual changes and any other instructions that could affect providers Regulations and instructions published in the previous quarter are also included in the update The purpose of the Quarterly Provider Update is to

bull Inform providers about new developments in the Medicare program bull Assist providers in understanding CMS programs and complying with Medicare regulations and instructions bull Ensure that providers have time to react and prepare for new requirements bull Announce new or changing Medicare requirements on a predictable schedule bull Communicate the specific days that CMS business will be published in the lsquoFederal Registerrsquo

To receive notification when regulations and program instructions are added throughout the quarter sign up for the Quarterly Provider Update listserv (electronic mailing list) at httpspublicgovdeliverycomaccountsUSCMSsubscribernewpop=tampqsp=566

We encourage you to bookmark the Quarterly Provider Update Web site at wwwcmsgovRegulations-and-GuidanceRegulations-and-PoliciesQuarterlyProviderUpdatesindex html and visit it often for this valuable information

Going Beyond Diagnosis Preventing Payment Errors by

Improving Provider-Payer Communication A failure to communicate is the number one cause of Medicare claims denials Palmetto GBArsquos Going Beyond Diagnosis (GBD) process helps reduce Medicare denials by supporting the dissemination of best practices and process improvements The GBD Blog was established to provide a platform for discussing the challenges and complexities of communicating health care encounters and to provide potential solutions to identify the root causes for specific communication errors

The GBD Blog and Twitter ID BeyondDx are part of Palmetto GBArsquos innovative strategy for increasing the capacity of Medicare providers to improve the quality of healthcare records and effectively decrease the claims payment error rate The success of this social media approach to communicating with healthcare stakeholders depends on your active participation

True innovation requires collaboration Please join the on-line GBD community by visiting the GBD Blog at httppalmgbacomgbd or signing-up to follow us on Twitter BeyondDx


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Palmetto GBA Advanced Clinical Editing System (P-ACE) Palmetto GBA Advanced Clinical Editing System (P-ACE) is available to all direct submitters as well as those who transmit claims via clearinghousesbilling services New CEM lsquoSmart editsrsquo will appear on claim rejection reports (277CA) as Palmetto GBA deploys P-ACE to the electronic claim submission process for professional claims

bull P-ACE returns pre-adjudicated claims information through claim acknowledgement transaction reports sent by your clearinghouse based on the Medicare 277CA

bull All direct submitters will receive the Medicare 277CA report with the new smart edits bull Claims failing the pre-adjudication editing process are not forwarded to the claims adjudication system bull P-ACE will work with your current clearinghousebilling service workflow so you can modify claims before

the MCS system receives them

After you have reviewed the Smart Edit if you choose not to change the claims you can resubmit in its original format and it will pass to the MCS claims adjudication system for processing P-ACE is available to you at no cost No downloads or software is required P-ACE is incorporated in your normal EDI stream

Unsure what the P-ACE Smart Edit means Smart Edits are not directives but rather considerations for appropriate claims processing based upon the information submitted on the claim Medicare will continue to require that all documentation and coverage requirements are met prior to providers making the claim change

To use the P-ACE Smart Edit Lookup tool enter the P-ACE Smart Edit fromfor the claim On the second screen you will see the P-ACE Smart Edit Message description and any additional information pertinent to your claim Only P-ACE Smart Edit rsquos listed in the Advance Clinical Editing page table will display


4 112016

Get Your Medicare News Electronically

The Palmetto GBA Medicare listserv is a wonderful communication tool that offers its members the opportunity to stay informed about

bull Medicare incentive programs bull Fee Schedule changes bull New legislation concerning Medicare bull And so much more

How to register to receive the Palmetto GBA Medicare Listserv Go to httptinyurlcomPalmettoGBAListserv and select ldquoRegister Nowrdquo Complete and submit the online form Be sure to select the specialties that interest you so information can be sent

Note Once the registration information is entered you will receive a confirmationwelcome message informing you that yoursquove been successfully added to our listserv You must acknowledge this confirmation within 3 days of your registration

CallBack Assist CallBack Assist was implemented to improve the wait times during peak calling periods of the day CallBack Assist allows providers to opt out for a same-day callback from a customer service representative (CSR) Typically the callback occurs within one hour This feature is a contact center best practice among the industry Providers are encouraged to try this new option when offered to avoid long wait times for assistance


5 112016

Now You Can Access Your Personal Data to See Who Has Been Using Your NPI

Electronic Utilization (eUtilization) reports are now available in the eServices online provider portal eUtilization reports provide rendering providers and ordering and referring providers access to their personal data This data can be reviewed to ensure providers are aware of when and by whom their NPI

is being used for billing Medicare services and when their NPI is entered on a Medicare claim as the ordering referring physician This will provide providers with the ability to identify possible misuse of their NPI Providers will be able to select a period from 1-12 months for the previous 12 months of data This data will be updated monthly so that providers can trend their data over time

Ordering and Referring This function enables an individual physician to view all Medicare claims billed where their NPI was entered as the ordering and referring provider for a beneficiary The report will also allow providers to click and see a summary by the type of code for the services billed

Rendering This will allow an individual provider who is part of a group practice or multiple groups to pull a data report for their NPI which will enable them to view their utilization for each associated provider ID for a specified time period

How to Sign Up to Receive This Data In order to access your data you will need to have an eServices account You can sign up at httpwwwpalmettogbacomeservices

eDelivery Reminder Are You Getting Your Greenmail

Palmetto GBA would like to remind providers that you have the option to receive letters electronically through eServices Gaining access to these letters is a simple process To start receiving your Medicare letters such as prior authorization or first level redeterminations decision letters electronically you must be signed up for our eServices online provider portal Once you

have signed into eServices select the Admin tab next you can choose your eDelivery preferences Just click the drop down box to choose eDelivery of the letters you would like to receive via greenmail You can also select lsquoUser Email Notificationrsquo to start receiving emails when your letters are available in eServices for you Selecting this choice is so easy and allows you to receive your letters faster

Once you have chosen the eDelivery option all of the letters you selected will come to you electronically even if you sent in your request via fax or mail


6 112016

Medicare Learning Networkreg (MLN) Want to stay informed about the latest changes to the Medicare Program Get connected with the Medicare Learning Networkreg (MLN) ndash the home for education information and resources for health care professionals

The Medicare Learning Networkreg is a registered trademark of the Centers for Medicare amp Medicaid Services (CMS) and the brand name for official CMS education and information for health care professionals It provides educational products on Medicare-related topics such as provider enrollment preventive services claims processing provider compliance and Medicare payment policies MLN products are offered in a variety of formats including training guides articles educational tools booklets fact sheets web-based training courses (many of which offer continuing education credits) ndash all available to you free of charge

The following items may be found on the CMS web page at httpswwwcmsgovOutreach-and-EducationMedicare-Learning-Network-MLNMLNProductsindexhtml bull MLN Catalog is a free interactive downloadable document that lists all MLN products by media format To

access the catalog scroll to the ldquoDownloadsrdquo section and select ldquoMLN Catalogrdquo Once you have opened the catalog you may either click on the title of a product or you can click on the type of ldquoFormats Availablerdquo This will link you to an online version of the product or the Product Ordering Page

bull MLN Product Ordering Page allows you to order hard copy versions of various products These products are available to you for free To access the MLN Product Ordering Page scroll to the ldquoRelated Linksrdquo and select ldquoMLN Product Ordering Pagerdquo

bull MLN Product of the Month highlights a Medicare provider education product or set of products each month along with some teaching aids such as crossword puzzles to help you learn more while having fun

Other resources bull MLN Publications List contains the electronic versions of the downloadable publications These products

are available to you for free To access the MLN Publications go to httpswwwcmsgovOutreach-andshyEducationMedicare-Learning-Network-MLNMLNProductsMLN-Publicationshtml You will then be able to use the ldquoFilter Onrdquo feature to search by topic or key word or you can sort by date topic title or format

MLN Educational Products Electronic Mailing List To stay up-to-date on the latest news about new and revised MLN products and services subscribe to the MLN Educational Products electronic mailing list This service is free of charge Once you subscribe you will receive an e-mail when new and revised MLN products are released

To subscribe to the service 1 Go to httpslistnihgovcgi-binwaexeA0=mln_education_products-l and select the lsquoSubscribe or

Unsubscribersquo link under the lsquoOptionsrsquo tab on the right side of the page 2 Follow the instructions to set up an account and start receiving updates immediately ndash itrsquos that easy

If you would like to contact the MLN please email CMS at MLNcmshhsgov


7 112016

Notification of the 2017 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law

Judge (ALJ) Hearing or Federal District Court Review

Section 1869(b)(1)(E) of the Social Security Act (the Act) as amended by Section 940 of the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) requires an annual reevaluation of the dollar amount in controversy required for an Administrative Law Judge (ALJ) hearing or Federal District Court review

The amount in controversy is adjusted by the percentage increase in the medical care component of the consumer price index for all urban consumers (US city average) for July 2003 to the July preceding the year involved Any amount that is not a multiple of $10 will be rounded to the nearest multiple of $10 bull ALJ Hearing Requests - The amount that must remain in controversy for ALJ hearing requests fi led on

or before December 31 2016 is $150 This amount will increase to $160 for ALJ hearing requests fi led on or after January 1 2017

bull Federal District Court - The amount that must remain in controversy for reviews in Federal District Court requested on or before December 31 2016 is $1500 This amount will increase to $1560 for appeals to Federal District Court filed on or after January 1 2017

eServices Makes Asking a Medicare Question Easier Palmetto GBA is pleased to announce the newest addition to our eService options-Secure eChat This innovative feature allows providers to interact with designated Palmetto GBA staff so they can receive real-time assistance locating information on any topics or specialties they are searching for on the Palmetto GBA website or within the eServices online portal The Secure eChat feature also allows users to dialogue with an online operator who can assist with patient or provider specifi c inqu ires or address questions that require the sharing of PHI information Using Secure eChat is simple This free portal is available to all Medicare providers as long as you have a signed Electronic Data Interchange (EDI) Enrollment Agreement on file with Palmetto GBA Once in the eServices portal from the bottom right corner select either Medicare Inquiries or eServices Help If you do not have an eServices account you can get started by clicking this eServices link httpswwwonlineproviderservicescomecx_improvev2The Secure eChat feature is available during business hours to assist providers


8 112016

CMS Finalizes the New Medicare Quality Payment Program On October 14 HHS finalized its policy implementing the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM) incentive payment provisions in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) collectively referred to as the Quality Payment Program The new Quality Payment Program will gradually transform Medicare payments for more than 600000 clinicians across the country and is a major step in improving care across the entire health care system

The final rule with comment period offers a fresh start for Medicare by centering payments around the care that is best for the patients providing more options to clinicians for innovative care and payment approaches and reducing administrative burden to give clinicians more time to spend with their patients instead of on paperwork

Accompanying the announcement is a new Quality Payment Program website at httpsqppcmsgov which will explain the new program and help clinicians easily identify the measures most meaningful to their practice or specialty

For More Information bull Final Rule (httpsqppcmsgovdocsCMS-5517-FCpdf) and

Executive Summary (httpsqppcmsgovdocsQPP_Executive_Summary_of_Final_Rulepdf) bull Press Release (httpwwwhhsgovaboutnews20161014hhs-finalizes-streamlined-medicare-paymentshy

system-rewards-clinicians-quality-patient-carehtml) bull Fact Sheet (httpsqppcmsgovdocsQuality_Payment_Program_Overview_Fact_Sheetpdf) bull Quality Payment Program website (httpsqppcmsgov)

Global Surgery Calculator Self-Service Tool This tool will allow you to calculate both 10 and 90 day global surgery periods You can also look up your 2016 procedure code global days requirement by using this tool Just enter the procedure code in the tool and the global surgery indicator information will appear Access the Global Surgery Calculator tool under Forms Tools on the home page


9 112016

Medicare Part B Drug Average Sales Price Reporting by Manufacturers ndash Blending National Drug Codes

MLN Mattersreg Number SE1623 Related Change Request (CR) NA Related CR Release Date NA Effective Date NA Related CR Transmittal NA Implementation NA

Provider Types Affected This article is intended for drug manufacturers who submit Average Sales Price (ASP) data to the Centers for Medicare amp Medicaid Services (CMS)

Background Payment for many Medicare Part B drugs is based on ASP drug pricing data submitted to CMS by drug manufacturers In accordance with Section 1847A of the Social Security Act (the Act) manufacturers must submit ASP data including total sales and volume for their products 30 days after the current calendar quarter closes

What You Need to Know CMS is reminding manufacturers that ASP data must be reported for individual National Drug Codes (NDCs) As stated on page 45 of ldquoASP Data Collection (Addendum A) Userrsquos Guide ndash Revised 2012rdquo in the Downloads section at httpswwwcmsgovMedicareMedicare-Fee-for-Service-Part-B-DrugsMcrPartBDrugAvgSalesPrice indexhtml ldquomost ASP reporting is done at the NDC level where the ASP corresponds to the amount of drug represented by that NDChellip For these drugs and biologicals manufacturers will still submit ASP sales data for an NDC but will do so on an ASP unit level specified in this listrdquo Manufacturers should not blend the manufacturerrsquos ASP or the number of ASP Units sold for a single NDC with other NDCs

CMS also reminds manufacturers that misreporting of ASP sales data may result in civil monetary penalties as described in Section 1847A(d)(4) of the Act

Exceptions to ASP reporting by NDC are limited and are available in the document titled ldquoASP Report in Units other Than NDC ndash January 2016rdquo in the Related Links section at httpwwwcmsgovMcrPartBDrugAvgSalesPrice

Additional Information If you have questions about the information in this reminder please email them to the ASP mailbox at sec303aspdatacmshhsgov


10 112016

A list of current system-related claims payment issues is available on our website These issues were reported to the Centers for Medicare amp Medicaid Services (CMS) andor the Multi-Carrier System (MCS) Please check often for updates before contacting the provider contact center The issues are identified by stand alone articles and will be updated as needed

Be sure to sign-up to receive updates using the ldquoArticle Update Notifi cationrdquo feature

Appeals Calculator Self-Service Tool Did you know you can use the appeals calculator to determine the timely filing date of your appeals request All you have to do is select which level of appeal you are in and enter the date you received the response to your previous appeal After clicking ldquoFind Deadlinerdquo the timely filing limit date will appear This tool is very helpful to assure that you are filing your appeals on time Providers may appeal claims that are partially or fully denied as long as the claim has lsquoappeal rightsrsquo Different levels of appeals have different timelines in which the appeal rights are valid Access the Appeals Calculator tool under FormsTools on the home page to calculate the your claims appeal deadlines


11 112016

Implementation of New Influenza Virus Vaccine Code MLN Mattersreg Number MM9793 Revised Related Change Request (CR) CR 9793 Related CR Release Date September 30 2016 Effective Date August 1 2016 Related CR Transmittal R3617CP Implementation Date January 3 2017

Note This article was revised on October 21 2016 to correct a date on page 2 in bold The dates should have read ldquo from August 1 2016 through December 31 2016 All other information is unchanged

Provider Types Affected This MLN Mattersreg Article is intended for physicians and providers submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries

Provider Action Needed Change Request (CR) 9793 which informs MACs about the changes to instructions for payment and edits for the Common Working File (CWF) to include influenza virus vaccine code 90674 (Influenza virus vaccine quadrivalent (ccIIV4) derived from cell cultures subunit preservative and antibiotic free 05 mL dosage for intramuscular use) as payable for claims with dates of service on or after August 1 2016 processed on or after January 3 2017 Make sure that your billing staffs are aware of these changes

Background CR9793 provides instructions for payment and edits to include influenza virus vaccine code 90674 Medicare waives coinsurance and deductibles for code 90674 Medicare will pay for code 90674 based on reasonable cost when submitted by bull Hospitals on Type of Bill (TOB) 12X and 13X bull Skilled Nursing Facilities on TOB 22X and 23X bull Home Health Agencies on TOB 34X bull Hospital-Based Renal Dialysis facilities on 72X and bull Critical Access Hospitals (CAHs) on TOB 85X

MACs will pay for influenza virus vaccine code 90674 based on the lower of the actual charge or 95 percent of the Average Wholesale Price (AWP) to bull Indian Health Services (IHS) hospitals submitting claims on TOB 12X and 13X bull IHS CAHs submitting claims on TOB 85X bull Comprehensive Outpatient Rehabilitation Facilities using TOB 75X and bull Independent Renal Dialysis Facilities using TOB 72X

It is important to note that MACs will hold institutional claims with code 90674 with dates of service on or after January 1 2017 through February 20 2017 until the Fiscal Intermediary Shared System (FISS) chang es are implemented on February 20 2017 Medicare will issue further instructions on how to handle claims for code 90674 with dates of service from August 1 2016 through December 31 2016

Continued gtgt CPT codes descriptors and other data only are copyright 2015 American Medical Association (or such other date of publication of CPT) All Rights Reserved Applicable FARSDFARS apply Current Dental Terminology fourth edition (CDT) (including procedure codes nomenclature descriptors and other data contained therein) is copyright by the American Dental Association copy2015 American Dental Association All rights reserved Applicable FARSDFARS apply

12 112016

Medicare will use the Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing webpage at httpswwwcmsgovMedicareMedicare-Fee-for-Service-Part-B-Drugs McrPartBDrugAvgSalesPriceVaccinesPricinghtml to determine the payment rate for influenza virus vaccine code 90674 This applies to professional claims with dates of service on or after August 1 2016

Coinsurance and deductible do not apply

Additional Information The official instruction CR9793 issued to your MAC regarding this change is available at httpwwwcmshhsgovRegulations-and-GuidanceGuidanceTransmittalsDownloadsR3617CPpdf

Document History Date of Change Description October 21 2016 The article was revised to correct a date on page 2 in bold The dates should have read

ldquo from August 1 2016 through December 31 2016 September 302016 Initial article post

eServices EligibilityeServices by Palmetto GBA allows you to search for patient eligibility which is a functionality of HETS HETS requires you to enter beneficiary last name and HICN in addition to either the birth date or first name See options below

bull HICN Last Name First Name Birth Date bull HICN Last Name Birth Date bull HICN Last Name First Name

For more information about eServices and the many services it offers please visit our website at httpwwwPalmettoGBAcomeServices


13 112016

b

Review and Print Electronic Remittances ndash via eRemits

Palmetto GBA is pleased to offer eRemits through our eServices a free web-based provider self-service tool You can view or print remittances which are available for approximately one year In addition eServices will let you store remittances and utilize search features to fi nd specific information on the notices eRemits are available to be accessed every day between the hours of

8 am and 7 pm ET

To use eServices you must have an Electronic Data Interchange (EDI) Agreement on file with Palmetto GBA If you are already submitting claims electronically you do not have to submit a new EDI Enrollment Agreement For more information on EDI please visit our website at wwwPalmettoGBAcomEDI

Denial Resolution Tool The Palmetto GBA Denial Resolution tool located on the home page under FormsTools includes resources for resolving the top claim rejections and denial reasons Save time and resources by looking here before you pick up the phone

bull Access denial reasons in plain language bull Scroll through the titles to locate your procedure bull Use the Palmetto GBA search engine to search by remark code


14 112016

Educational Events Now AvailablehellipDonrsquot Miss this Wonderful Opportunity

Join the Provider Outreach and Education event listed below to learn about the Medicare program

Event Title Ask the Contractor Teleconference

eServices Open House ndash (Registration Required)

DateTime November 10 2016 10 am ET

January 3 2017 - various times available

Access Teleconference number 866-745-0425 Passcode 87679707

httpwwwpalmettogbacomeventpgbaeventnsf SeriesDetailsxspEventID=AB8PAH5576

Managing Multiple eService Accounts Just Got Easier with Account Linking

Palmetto GBA is excited to announce the highly anticipated eService enhancement- Account Linking No longer will providers need a separate login for each PTAN and NPI combination Palmetto GBA now gives users the ability to link their previously assigned eServices user IDs under one default ID Getting started is simple Users should log into eServices with the user ID that they wish to designate as their default login ID This is the user ID that will be used to access the linked accounts Once the user has successfully logged into eServices they will select the My Account Tab and then access the Account Linking sub-tab This will allow the provider to choose the accounts they wish to link

Note Providers are only able to link active eServices accounts

Once your accounts are linked you will be able to log in click a drop down menu that lists all your linked NPI and PTAN combinations attached to your ID and select the individual account yoursquod like to view For complete step-by-step instructions please view the eServices User Guide at httpwwwpalmettogbacomeServicesuserguide


15 112016

Stem Cell Transplantation for Multiple Myeloma Myelofibrosis and Sickle Cell Disease and Myelodysplastic

Syndromes MLN Mattersreg Number MM9620 Revised Related Change Request (CR) CR 9620 Related CR Release Date July 1 2016 Effective Date January 27 2016 Related CR Transmittal R193NCD and R3556CP Implementation Date October 3 2016

Note This article was revised on September 26 2016 to correct the language regarding the submission of professional claims on page 4 of the article All other information remains the same

Provider Types Affected This MLN Mattersreg Article is intended for physicians and providers submitting stem cell transplantation claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries

Provider Action Needed Change Request (CR) 9620 from which this article was developed notifies providers that effective for claims with dates of service on and after January 27 2016 for the use of allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for treatment of Multiple Myeloma Myelofibrosis and Sickle Cell Disease is covered by Medicare but only if provided in the context of a Medicare-approved clinical study meeting specifi c criteria under the Coverage with Evidence Development (CED) paradigm

CR9620 also clarifies the ICD-9 and ICD-10 diagnosis codes for allogeneic HSCT for treatment of Myelodysplastic Syndromes (MDS) in the context of a Medicare-approved prospective clinical study under CED Specifically for dates of service on or after August 4 2010 through September 30 2015 the ICD-9-CM diagnosis codes are 23872 23873 23874 or 23875 AND clinical trial ICD-9-CM diagnosis code V707 For dates of service on or after October 1 2015 the ICD-10-CM diagnosis codes are D46A D46B D46C D460 D461 D4620 D4621 D4622 D464 D469 or D46Z AND clinical trial ICD-10-CM diagnosis code Z006 Make sure your billing staff is aware of these determinations

Background HSCT is a process that includes mobilization harvesting and transplant of stem cells and the administration of high-dose chemotherapy andor ra diotherapy prior to the actual transplant During the process stem cells are harvested from either the patient (autologous) or a donor (allogeneic) and subsequently administered by intravenous infusion to the patient

Multiple myeloma is a neoplastic plasma-cell disorder Myelofibrosis is a stem cell-derived hematologic disorder Sickle cell disease is a group of inherited red blood cell disorders created by the presence of abnormal hemoglobin genes On April 30 2015 the Centers for Medicare amp Medicaid Services (CMS) accepted a formal request from the American Society for Blood and Marrow Transplantation (ASBMT) to reconsider its policy and expand coverage of allogeneic HSCT for sickle cell disease Myelofibrosis multiple myeloma and rare diseases


16 112016

Myelodysplastic Syndrome (MDS) refers to a group of diverse blood disorders in which the bone marrow does not produce enough healthy functioning blood cells On August 4 2010 CMS issued a final decision stating that allogeneic HSCT for MDS is covered by Medicare only if provided pursuant to a Medicare-approved clinical study under CED CR 7137 (see the article MM7137 at httpwwwcmsgovOutreach-and-Education Medicare Learning-Network-MLNMLNMattersArticlesDownloadsMM7137pdf) provides specifi c ICD-9 related coding and claims processing requirements regarding this particular coverage decision and CRs 8197 and 8691 (see MM8197 at httpwwwcmsgovOutreach-and-EducationMedicare-Learning-Network MLN MLNMattersArticlesDownloadsMM8197pdf and MM8691 at httpwwwcmsgovOutreach-and-Education Medicare-Learning-Network MLNMLNMattersArticlesDownloadsMM8691pdf) provide ICD-10 related coding requirements On November 30 2015 CMS accepted a formal request from the National Marrow Donor Program (NMDP) to clarify the list of ICD-9-CM and ICD-10-CM diagnosis codes covered for allogeneic HSCT for the treatment of MDS in the context of a Medicare-approved clinical study under CED

On January 27 2016 CMS issued a final decision to expand national coverage of items and services necessary for research in an approved clinical study via Coverage with Evidence Development (CED) under Section 1862(a)(1)(E) of the Social Security Act (the Act) for allogeneic HSCT for the following indications bull Multiple Myeloma bull Myelofibrosis bull Sickle Cell Disease

Refer to the following Medicare manual sections for more information regarding this NCD and further billing instructions specific to this NCD and the business requirements specific to CR9620 bull Chapter 1 Section 11023 of the ldquoMedicare NCD Manualrdquo which is attached to the CR9620 NCD transmittal

at httpwwwcmsgovRegulations-and GuidanceGuidanceTransmittalsDownloadsR191NCDpdf bull Chapter 1 Section 3101 of the ldquoMedicare NCD Manualrdquo available at

httpswwwcmsgovRegulations-and GuidanceGuidanceManualsDownloadsncd103c1_Part4pdf and

bull Chapter 32 Sections 69 and 90 of the ldquoMedicare Claims Processing Manualrdquo available at httpswwwcmsgovRegulations-and GuidanceGuidanceManualsDownloadsclm104c32pdf

Please note Chapter 1 Section 11081 has been removed from the ldquoNCD Manualrdquo and incorporated into Chapter 1 Section 11023

In addition to the diagnosis codes detailed at the beginning of this article providers need to be aware of the other billing requirements as follows

Inpatient Claims For claims submitted on type of bill 11X for discharges on or after January 27 2016 for HSCT for the treatment of Multiple Myeloma Myelofibrosis or Sickle Cell Disease the claim must show bull An ICD-10-PCS procedure code of 30230G1 30230Y1 30233G1 30233Y1 30240G1 30240Y1 30243G1

30243Y1 30250G130250Y1 30253G1 30253Y1 30260G1 30260Y1 30263G1 or 30263Y1 AND bull The clinical trial ICD-10-CM code of Z006 AND bull Condition code 30 denoting qualifying clinical trial AND bull Value code D4 showing the Clinical Trial Number (assigned by NLMNIH with an 8-digit clinicaltrials

gov identifier number listed on the CMS website) along with the appropriate ICD-10-diagnosis code of


17 112016

bull Multiple Myeloma-ICD-10-CM diagnosis code C9000 C9001 or C9002 OR bull Myelofibrosis-ICD-10-CM diagnosis code C9440 C9441 C9442 D474 or D7581 OR bull Sickle Cell Disease-ICD-10-CM diagnosis code D5700 D5701 D5702 D571 D5720 D57211

D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819

Outpatient Claims For claims submitted on type of bill 13X or 85X for dates of service on or after January 27 2016 for HSCT for the treatment of Multiple Myeloma Myelofibrosis or Sickle Cell Disease the claim must show bull An HSCT CPT code of 38240 AND bull The clinical trial ICD-10-CM code of Z006 AND bull Condition code 30 denoting qualifying clinical trial AND bull Value code D4 showing the Clinical Trial Number (assigned by NLMNIH with an 8-digit clinicaltrials

gov identifier number listed on the CMS website) along with the appropriate ICD-10-diagnosis code of bull Multiple Myeloma-ICD-10-CM diagnosis code C9000 C9001 or C9002 OR bull Myelofibrosis-ICD-10-CM diagnosis code C9440 C9441 C9442 D474 or D7581 OR bull Sickle Cell Disease-ICD-10-CM diagnosis code D5700 D5701 D5702 D571 D5720 D57211

D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819

Method II Critical Access Hospital (CAH) Claims For claims submitted on type of bill 85X with Revenue Codes 96X 97X or 98X for dates of service on or after January 27 2016 for HSCT for the treatment of Multiple Myeloma Myelofibrosis or Sickle Cell Disease the claim must show bull An HSCT CPT code of 38240 AND bull The clinical trial ICD-10-CM code of Z006 AND bull Condition code 30 denoting qualifying clinical trial AND bull Value code D4 showing the Clinical Trial Number (assigned by NLMNIH with an 8-digit clinicaltrials


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819

Professional Claims For professional claims submitted for dates of service on or after January 27 2016 for HSCT for the treatment of Multiple Myeloma Myelofibrosis or Sickle Cell Disease the claim must show bull An HSCT CPT code of 38240 AND bull The clinical trial ICD-10-CM code of Z006 AND bull The Q0 modifi er AND bull A Place of Service Code of 19 21 or 22 along with the appropriate ICD-10-CM diagnosis code of


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819

For all of the above claims types submitted without the requisite coding MACs will deny the claims using the following messages


18 112016

bull Claim Adjustment Reason Code (CARC) 50 - These are non-covered services because this is not deemed a lsquomedical necessityrsquo by the payer Note Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF) if present

bull Remittance Advice Remarks Code (RARC) N386 - This decision was based on a National Coverage Determination (NCD) An NCD provides a coverage determination as to whether a particular item or service is covered A copy of this policy is available at httpwwwcmshhsgovmcdsearchasp If you do not have web access you may contact the contractor to request a copy of the NCD

bull Group Code - Patient Responsibility (PR) if an Advance Beneficiary Notice (ABN)Hospital Notice on Non-Coverage (HINN) otherwise Contractual Obligation (CO)

For claims with dates of service prior to the implementation date of CR9620 MACs shall perform necessary adjustments only when the provider brings such claims to the attention of their MAC

Additional Information The official instruction CR9620 consists of two transmittals The first updates the ldquoMedicare Claims Processing Manualrdquo at httpwwwcmsgovRegulations-and GuidanceGuidanceTransmittalsDownloadsR3556CPpdf The second transmittal updates the ldquoMedicare NCD Manualrdquo at httpwwwcmsgovRegulations-and GuidanceGuidanceTransmittalsDownloadsR193NCDpdf

Document History Date of Change Description September 26 2016 The article was revised to correct the language on page 4 regarding professional claims July 5 2016 The article was revised due to an updated Change Request (CR) That CR revised

Shared System Maintainer (SSM) responsibility The transmittal number CR release date and link to the transmittal also changed

May 9 2016 Initial article release

Global Surgery Denial Tool If the procedure code was denied with remittance message CO-B15CO-97 (claimservice deniedreduced because this procedureservice is not paid separately OR payment is included in the allowance for another serviceprocedure) then use the following worksheet to see what if any corrections you can make to your claim Just answer a few questions and the tool will provide you with information to help you with your service Access the Global Surgery Denial tool under FormsTools on the home page


19 112016

Update to Hepatitis B Deductible and Coinsurance and Screening Pap Smears Claims Processing Information

MLN Mattersreg Number MM9778 Related Change Request (CR) CR 9778 Related CR Release Date September 23 2016 Effective Date December 27 2016 Related CR Transmittal R3615CP Implementation Date December 27 2016

Provider Types Affected This MLN Mattersreg Article is intended for physicians providers and suppliers submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

What You Need to Know Change Request (CR) 9778 informs MACs about the updates to language regarding coinsurance and deductible for hepatitis B in the Chapter 18 Section 10 of the ldquoMedicare Claims Processing Manualrdquo to show that coinsurance and deductible for hepatitis B virus vaccine are waived This is not a change in current policy and the CR only updates the manual to show current policy CR9778 also removes subsection D from Sections 308 and 309 of Chapter 18 of the manual which contained incorrect claims processing instructions regarding processing claims with HCPCS code G0476 HPV screening when submitted on a Type of Bill other than 12X 13X 14X 22X 23x and 85X

Additional Information The official instruction CR9778 issued to your MAC regarding this change is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittalsDownloadsR3615CPpdf

Medicare Physician Fees Lookup Tool Use the Medicare Physician Fee Lookup Tool located on our home page The Physician Fee Schedule tool saves our customers time and money by providing a lsquoone stop shoprsquo Customers can locate fees for the 2013 through 2016 throughout the United States The tool can search up to five codes and each code shows the allowance all of the indicator rules such as the Global Surgery modifiers and Multiple Surgery rules This tool helps customers research more than a fee they can determine if the wrong modifier was appended to a service or if the service was subject to multiple surgery rules The fees and indicator files are downloadable and customers can easily save the data to their systems for future use


20 112016

Ambulance Inflation Factor for CY 2017 and Productivity Adjustment

MLN Mattersreg Number MM9811 Related Change Request (CR) CR 9811 Related CR Release Date October 14 2016 Effective Date January 1 2017 Related CR Transmittal R3625CP Implementation Date January 3 2017

Provider Types Affected This MLN Mattersreg Article is intended for ambulance providers and suppliers submitting claims to Medicare Administrative Contractors (MACs) for Medicare Part B ambulance services provided to Medicare beneficiaries

Provider Action Needed Change Request (CR) 9811 furnishes the Calendar Year (CY) 2017 Ambulance Inflation Factor (AIF) for determining the payment limit for ambulance services Make sure that your billing staffs are aware of the change

Background CR9811 furnishes the CY 2017 Ambulance Inflation Factor (AIF) for determining the payment limit for ambulance services required by Section 1834(l)(3)(B) of the Social Security Act (the Act)

Section 1834(l)(3)(B) of the Act provides the basis for an update to the payment limits for ambulance services that is equal to the percentage increase in the Consumer Price Index for all urban consumers (CPI-U) for the 12-month period ending with June of the previous year Section 3401 of the Affordable Care Act amended Section 1834(l)(3) of the Act to apply a productivity adjustment to this update equal to the 10-year moving average of changes in economy-wide private nonfarm business multi-factor productivity beginning January 1 2011 The resulting update percentage is referred to as the AIF

Section 3401 of the Affordable Care Act requires that specific Prospective Payment System (PPS) and Fee Schedule (FS) update factors be adjusted by changes in economy-wide productivity The statute defi nes the productivity adjustment to be equal to the 10-year moving average of changes in annual economy-wide private nonfarm business Multi-Factor Productivity (MFP) (as projected by the Secretary of Health and Human Services (the Secretary) for the 10-year period ending with the applicable fiscal year cost reporting period or other annual period)

The MFP for CY 2017 is 03 percent and the CPI-U for 2017 is 10 percent According to the Affordable Care Act the CPI-U is reduced by the MFP even if this reduction results in a negative AIF update Therefore the AIF for CY 2017 is 07 percent

Part B coinsurance and deductible requirements apply to payments under the ambulance fee schedule



21 112016

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2017

MLN Mattersreg Number MM9806 Related Change Request (CR) CR 9806 Related CR Release Date September 23 2016 Effective Date October 1 2016 Related CR Transmittal R3614CP Implementation Date January 3 2017

Provider Types Affected This MLN Mattersreg Article is intended for physicians other providers and suppliers submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

Provider Action Needed Change Request (CR) 9806 announces changes that will be included in the January 2017 quarterly release of the edit module for clinical diagnosis laboratory services Make sure your billing staffs are aware of these changes to ensure proper billing to Medicare

Background The National Coverage Determinations (NCDs) for clinical diagnostic laboratory services were developed by the laboratory negotiated rulemaking committee and the final rule was published on November 23 2001 Medicare developed nationally uniform software that was incorporated in the Medicare shared systems so that laboratory claims subject to one of the 23 NCDs (Publication 100-03 Sections 19012-19034) were processed uniformly throughout the United States effective April 1 2003

CR9806 communicates requirements to Medicare system maintainers and the MACs regarding changes to the NCD code lists used for laboratory claims edit software for January 2017 The changes are a result of coding analysis decisions developed under the procedures for maintenance of codes in the negotiated NCDs and biannual updates of the ICD-10-CM codes Please see Section II (Business Requirements Table) of CR9806 for the lengthy list of codes added or deleted Note that where codes are deleted the effective date of deletion is September 30 2016 and the effective date for codes added is October 1 2016



22 112016

Internet Only Manual Updates to Pub 100-01 100-02 and 100-04 to Correct Errors and Omissions (SNF)

MLN Mattersreg Number MM9748 Revised Related Change Request (CR ) CR 9748 Related CR Release Date October 13 2016 Effective Date October 18 2016 Related CR Transmittal R101GI R228BP and R3612CP Implementation Date October 18 2016

Note This article was revised on October 17 2016 to reflect a new Change Request (CR) That CR revised Chapter 8 to correct minor omissions in Sections 102 and 70 Additionally Section 20 was removed from the CR in order to rescind unclear wording (page 2 in bold below) The transmittal number CR release date and link to the transmittal were also changed All other information remains the same

Provider Types Affected This MLN Mattersreg Article is intended for physicians and other providers submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

Provider Action Needed CR 9748 revises the following Medicare manuals to correct various minor technical errors and omissions bull ldquoMedicare General Information Eligibility and Entitlement Manualrdquo bull ldquoMedicare Benefit Policy Manualrdquo and bull ldquoMedicare Claims Processing Manualrdquo

The revisions of these manuals are intended to clarify the existing content and no policy processing or system changes are anticipated

Key Points of CR9748 CR9748 includes all revisions as attachments and selected extracts from these attachments are as follows

ldquoMedicare General Information Eligibility and Entitlement Manualrdquo Revision Summary bull Chapters 4 and 5 of this manual are revised to include references to another manual with related information

and a reference to a related regulation

ldquoMedicare Benefit Policy Manualrdquo Summary of Key Revisions bull In several sections references to related material in other manuals are included bull Language is added to refer providers to a list of exclusions from consolidated billing (CB the SNF ldquobundlingrdquo

requirement) which is available at httpwwwcmsgovMedicareBillingSNFConsolidatedBillingindexhtml

bull Language that was initially added by CR9748 in Transmittal R227BP to sect20 of Chapter 8 regarding the scope and purpose of Medicarersquos post-hospital extended care benefit inadvertently included unclear wording and has been rescinded by Transmittal R228BP As a result the original version of this sectionrsquos text as it read prior to that revision is now restored


23 112016

b

b

ldquoMedicare Claims Processing Manualrdquo Key Revision Summary bull In several sections references to related material in other manuals are included

Additional Information The official instruction CR9748 issued to your MAC regarding this change is available via three transmittals bull The first updates the ldquoMedicare General Information Eligibility and Entitlementrdquo manual at

httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittalsDownloadsR101GIpdf bull The second transmittal updates the ldquoMedicare Benefit Policyrdquo manual is at

httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittalsDownloadsR228BPpdf bull The thirds updates the ldquoMedicare Claims Processingrdquo manual at

httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittalsDownloadsR3612CPpdf

Document History Date of Change Description October 17 2016 The article was revised on October 17 2016 to reflect a new CR That CR revised

Chapter 8 to correct minor omissions in Sections 102 and 70 Additionally Section 20 was removed from the CR in order to rescind unclear wording The transmittal number CR release date and link to the transmittal were also changed

September 18 2016 Initial Article Post

eServices Claim Status

To check on a particular claim status please enter the HICN and other required beneficiary information as well as the date(s) of service Should you not know the exact date of service you are able to enter a span or range of up to 45 days Please keep in mind retrieving claims older than six months takes a little longer than something more current Claims older than three years may not be searchable For more information about eServices and the many services

it offers please visit our website at httpwwwPalmettoGBAcomeServices


24 112016

Interactive Tools

These guides provide instruction on how to complete or interpret the following forms They are available on the home page under FormsTools

Remittance Advice

EDI Agreement

EDI Application

EDI Provider Authorization

CMS 1500 Claim Form


25 112016

Medical Directorrsquos Desk

Medical Affairs publishes Medicare Local Coverage Determination (LCDs) and medically related articles in this special section of the Medicare Advisory We encourage you to help us maintain accurate LCDs Please review LCDs and address your comments and concerns to your Carrier Advisory Committee specialty representative or contact the Medical Affairs Department

Medical articles are published in the Medicare Advisory to provide education and alert Medicare providers of billingcoding issues Remember physicians and non-physician practitioners (NPPs) who bill Medicare are responsible for accurate service coding Errors may result in overpayment requests or Recovery Auditor (RA) referrals If you purchase a new device or need to submit claims for a new procedure please review applicable service codes and descriptions in the current CPT and HCPCS manuals If you question the recommended service procedures received from other sources such as manufacturers send your inquiry and the device description to the Medical Affairs Department

To contact the Medical Affairs Department

e-mail BPolicyPalmettoGBAcom Mail Part B Medical Affairs AG-300 Palmetto GBA PO Box 100190 Columbia SC 29202-3190

Continued gtgt


26 112016

Part B Local Coverage Determinations Policy Title LCD Revisions Effective

Date Allergy Skin Testing

L33417 Rev 4

Under ICD-10 Codes That Support Medical Necessity-Groups 1 2 and 3 Codes added Z516 Under Group 1 2 and 3 Medical Necessity ICD-10 Codes Asterisk Explanation added verbiage regarding Z516 Under ICD-10 Codes That Support Medical Necessity Group 3 added K5229 Under ICD-10 Codes That Support Medical Necessity Group 3 deleted K522 This revision is due to the Annual ICD-10 Code Update

10116

Brain Natriuretic Peptide (BNP)

L33422 Rev 5

Under Coverage Indications Limitations andor Medical Necessity-Abstract corrected the formatting for the first paragraph Under ICD-10 Codes That Support Medical Necessity Group 1 added I160 I161 I169 I602 I63013 I63033 I63113 I63133 I63213 I63233 I63313 I63323 I63333 I63343 I63413 I63423 I63433 I63443 I63513 I63523 I63533 and I63543 This revision is due to the Annual ICD-10 Code Update

10116


L33422 Rev 6

Under ICD-10 Codes That Support Medical Necessity Group 1 Codes added R600 and R601

110316

Computerized Axial Tomography (CT)

Thorax L33459 Rev 4

Under ICD-10 Codes That Support Medical Necessity Group 1 added D49511 D49512 D49519 D4959 I725 I726 J95860 J95861 J95862 J95863 J9851 J9859 K8500 K8501 K8502 K8510 K8511 K8512 K8520 K8521 K8522 K8530 K8531 K8532 K8580 K8581 K8582 K8590 K8591 K8592 K8681 K8689 N610 N611 Q2521 Q2529 Q2540 Q2541 Q2542 Q2543 Q2544 Q2545 Q2546 Q2547 Q2548 Q2549 R9341 R93421 R93422 R93429 and R9349 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted J985 K850 K851 K852 K853 K858 K859 K868 N61 and Q254 Under ICD-10 Codes That Support Medical Necessity Group 1 updated code description for C7A094 C7A095 C7A096 C8110 C8111 C8112 C8113 C8114 C8115 C8116 C8117 C8118 C8119 C8120 C8121 C8122 C8123 C8124 C8125 C8126 C8127 C8128 C8129 C8130 C8131 C8132 C8133 C8134 C8135 C8136 C8137 C8138 C8139 C8140 C8141 C8142 C8143 C8144 C8145 C8146 C8147 C8148 C8149 C8170 C8171 C8172 C8173 C8174 C8175 C8176 C8177 C8178 and C8179 This revision is due to the Annual ICD-10 Code Update

10116

Cosmetic and Reconstructive Surgery

L33428 Rev 8

Under ICD-10 Codes That Support Medical Necessity-Group 4 Paragraph deleted the verbiage ldquoCovered forhelliprdquo and added the asterisk Under ICD-10 Codes That Support Medical Necessity-Group 4 Medical Necessity ICD-10 Codes Asterisk Explanation added verbiage for clarification regarding the billing of dual diagnoses for coverage of a reduction mammoplasty Under ICD-10 Codes That Support Medical Necessity-Group 5 Paragraph deleted the verbiage ldquoCovered forhelliprdquo

101316

3D Interpretation and Reporting of Imaging

Studies L33416 Rev 4

Under ICD-10 Codes That Support Medical Necessity Group 1 added R9341 R93421 R93422 R93429 and R9349 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted R934 This revision is due to the Annual ICD-10 Code Update

10116


27 112016

10116 Implantable Infusion Pump

L33461 Rev 8

Under ICD-10 Codes That Support Medical Necessity Group 1 added C49A0 C49A1 C49A2 C49A3 C49A4 C49A5 and C49A9 Under ICD-10 Codes That Support Medical Necessity Group 3 added C49A0 C49A1 C49A2 C49A3 C49A4 C49A5 C49A9 D49511 D49512 G5613 G5623 G5633 G5643 G5703 G5713 G5723 G5733 G5743 G5763 G5773 G6182 M25541 M25542 M50020 M50021 M50022 M50023 M50121 M50122 M50123 M50221 M50222 M50223 M50321 M50322 and M50323 Under ICD-10 Codes That Support Medical Necessity Group 3 deleted D495 M5002 M5012 M5022 M5032 M5082 and M5092 Under ICD-10 Codes That Support Medical Necessity Group 3 the code descriptions changed for C8110 C8111 C8112 C8113 C8114 C8115 C8116 C8117 C8118 C8119 C8120 C8121 C8122 C8123 C8124 C8125 C8126 C8127 C8128 C8129 C8130 C8131 C8132 C8133 C8134 C8135 C8136 C8137 C8138 C8139 C8140 C8141 C8142 C8143 C8144 C8145 C8146 C8147 C8148 C8149 C8170 C8171 C8172 C8173 C8174 C8175 C8176 C8177 C8178 and C8179 This revision is due to the Annual ICD-10 Code Update

Respiratory Therapy and Under ICD-10 Codes That Support Medical Necessity added J95860 J95861 J95862 10116 Oximetry Services J95863 J9851 and J9859 This revision is due to the Annual ICD-10 Code Update

L33446 Rev 5

Vestibular Function Under ICD-10 Codes That Support Medical Necessity added H90A21 H90A22 H90A31 10116 Testing and H90A32 This revision is due to the Annual ICD-10 Code Update L34537 Rev 4

Cardiac Computed Under ICD-10 Codes That Support Medical Necessity Group 2 Covered ICD-10 Codes 10116 Tomography amp for CPT code 75573 added Q2521 Q2529 Q2540 Q2541 Q2542 Q2543 Q2544

Angiography (CCTA) Q2545 Q2546 Q2547 Q2548 and Q2549 Under ICD-10 Codes That Support Medical L33423 Necessity Group 2 deleted Q252 and Q254 This revision is due to the Annual ICD-10 Rev 3 Code Update

Wireless Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes K5903 K5904 10116 Gastrointestinal Motility K581 K582 and K588 This revision is due to the Annual ICD-10 Code Update

Monitoring Systems L33455 Rev 4

Virtual Colonoscopy Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes C49A0 C49 10116 (CT Colonography) A1 C49A2 C49A3 C49A4 C49A5 C49A9 K55032 K55039 K55041 K55042

L33452 K55049 K55051 K55052 K55059 K55061 K55062 K55069 K5931 and K5939 Rev 4 This revision is due to the Annual ICD-10 Code Update

Cosmetic and Under Coverage Indications Limitations andor Medical Necessity re-numbered groups 10116 Reconstructive Surgery to be consistent with CPTHCPCS coding groups Under CPTHCPCS Codes Group 4

L33428 Paragraph added Primary to Reduction Mammoplasty Under CPTHCPCS Codes added Rev 7 Group 5 for Reduction Mammoplasty Secondary and renumbered Rhinoplasty to Group 6

Under ICD-10 Codes That Support Medical Necessity Group 3 Codes added ICD-10 code N611 This revision is due to the Annual ICD-10 Code Update

Swallowing Studies for Dysphagia L33449

Rev 4

Under ICD-10 Codes that Support Medical Necessity Group 1 Paragraph deleted Report dysphagia with the primary diagnosis of I69091 I69191 I69291 I69391 I69891 I69991 J690 R130 R1310-R1314 R1319 or T17XXXX codes listed in Group 1 Under ICD-10 Codes That Support Medical Necessity Group 2 Codes added ICD-10 codes C49A1 I63013 I63033 I63113 I63133 I63213 I63233 I63313 I63323 I63333 I63343 I63413 I63423 I63433 I63443 I63513 I63523 I63533 and I63543 This revision is due to the Annual ICD-10 Code Update


28 112016

10116

10116 MRI of a Joint L33464 Rev 6

Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control L33443

Rev 4

Octreotide Acetate for Injectable Suspension

(Sandostatin LAR depot)

L33438 Rev 3

Special Electroencephalography

L33448 Rev 7

Stress Echocardiography L33448 Rev 3

Transesophageal Echocardiography

(TEE) L33471 Rev 4

Under ICD-10 Codes That Support Medical Necessity Group 1 added M26601 M26602 M26603 M26611 M26612 M26613 M26619 M26621 M26622 M26623 M26631 M26632 M26633 S0301XA S0301XD S0301XS S0302XA S0302XD S0302XS S0303XA S0303XD S0303XS S0341XA S0341XD S0341XS S0342XA S0342XD S0342XS S0343XA S0343XD and S0343XS Under ICD-10 Codes That Support Medical Necessity Group 1 deleted M2661 M2662 M2663 S034XXA S034XXD and S034XXS Under ICD-10 Codes That Support Medical Necessity Group 2 added M25541 and M25542 Under ICD-10 Codes That Support Medical Necessity Group 2 deleted S030XXA S030XXD S030XXS S034XXA S034XXD and S034XXS This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity added ICD-10 code N39492 This revision is due to the Annual ICD-10 Code Update

Under ICD-10 Codes That Support Medical Necessity added Group 5 for Severe Liver Disease with ICD-10 codes K767 K9182 K9183 and O904

Under Coverage Indications Limitations andor Medical Necessity removed cassette and amplifier and the sentence referring to electrodes for at least four (4) recording channels Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes A925 and I602 and deleted I6021 and I6022 This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity the code descriptions were revised for ICD-10 codes T82817A T82817D T82817S T82818A T82818D T82818S T82827A T82827D T82827S T82828A T82828D T82828S T82837A T82837D T82837S T82838A T82838D T82838S T82847A T82847D T82847S T82848A T82848D T82848S T82857A T82857D T82857S T82858A T82858D T82858S T82867A T82867D T82867S T82868A T82868D and T82868S This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity Group 1 added I63113 I63133 I63413 I63423 I63433 I63443 Q2521 Q2529 Q2540 Q2541 Q2542 Q2543 Q2544 Q2545 Q2546 Q2547 Q2548 Q2549 and Q8782 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted H34811 H34812 H34813 H34831 H34832 H34833 Q252 Q254 and Z9889 Under ICD-10 Codes That Support Medical Necessity Group 1 updated code descriptions for T82817A T82817D T82817S T82827A T82827D T82827S T82837A T82837D T82837S T82847A T82847D T82847S T82857A T82857D T82857S T82867A T82867D and T82867S This revision is due to the Annual ICD-10 Code Update

10116

10116

10116

10116

10116


29 112016

10116 Transthoracic Echocardiography

(TTE) L33472 Rev 4

Under ICD-10 Codes That Support Medical Necessity Group 1 added Q2521 Q2529 Q2540 Q2541 Q2542 Q2543 Q2544 Q2545 Q2546 Q2547 Q2548 and Q2549 ICD-10 Codes That Support Medical Necessity Group 1 deleted Q252 and Q254 Under ICD-10 Codes That Support Medical Necessity Group 2 added I160 I161 I169 I63413 I63423 I63433 I63443 I63513 I63523 I63533 I63543 J9851 J9859 Q2521 Q2529 Q2540 Q2541 Q2542 Q2543 Q2544 Q2545 Q2546 Q2547 Q2548 and Q2549 Under ICD-10 Codes That Support Medical Necessity Group 2 deleted H34811 H34812 H34813 H34831 H34832 H34833 Q252 Q254 and Z9889 Under ICD-10 Codes That Support Medical Necessity Group 2 updated code description for T82817A T82817D T82817S T82827A T82827D T82827S T82837A T82837D T82837S T82847A T82847D T82847S T82857A T82857D T82857S T82867A T82867D and T82867S Under ICD-10 Codes That Support Medical Necessity Group 3 added Q2521 Q2529 Q2540 Q2541 Q2542 Q2543 Q2544 Q2545 Q2546 Q2547 Q2548 and Q2549 Under ICD-10 Codes That Support Medical Necessity Group 3 deleted Q252 Q254 and Z9889 Under ICD-10 Codes That Support Medical Necessity Group 3 updated code description for T82817A T82817D T82817S T82827A T82827D T82827S T82837A T82837D T82837S T82847A T82847D T82847S T82857A T82857D T82857S T82867A T82867D and T82867S Under ICD-10 Codes That Support Medical Necessity Group 4 added I97620 I97621 I97622 I97630 I97631 I97638 I97640 I97641 and I97648 Under ICD-10 Codes That Support Medical Necessity Group 4 updated code description for T82817A T82817D T82817S T82827A T82827D T82827S T82837A T82837D T82837S T82847A T82847D T82847S T82857A T82857D T82857S T82867A T82867D and T82867S This revision is due to the Annual ICD-10 Code Update


30 112016

HbA1c L33431 Rev 7

Varicose Veins of the Lower Extremities

L33454 Rev 7

Under ICD-10 Codes That Support Medical Necessity Group 2 Codes added ICD-10 codes E083211 E083212 E083213 E083219 E083291 E083292 E083293 E083299 E083311 E083312 E083313 E083319 E083391 E083392 E083393 E083399 E083411 E083412 E083413 E083419 E083491 E083492 E083493 E083499 E083511 E083512 E083513 E083519 E083521 E083522 E083523 E083529 E083531 E083532 E083533 E083539 E083541 E083542 E083543 E083549 E083551 E083552 E083553 E083559 E083591 E083592 E083593 E083599 E0837X1 E0837X2 E0837X3 E0837X9 E093211 E093212 E093213 E093219 E093291 E093292 E093293 E093299 E093311 E093312 E093313 E093319 E093391 E093392 E093393 E093399 E093411 E093412 E093413 E093419 E093491 E093492 E093493 E093499 E093511 E093512 E093513 E093519 E093521 E093522 E093523 E093529 E093531 E093532 E093533 E093539 E093541 E093542 E093543 E093549 E093551 E093552 E093553 E093559 E093591 E093592 E093593 E093599 E0937X1 E0937X2 E0937X3 E0937X9 E103211 E103212 E103213 E103219 E103291 E103292 E103293 E103299 E103311 E103312 E103313 E103319 E103391 E103392 E103393 E103399 E103411 E103412 E103413 E103419 E103491 E103492 E103493 E103499 E103511 E103512 E103513 E103519 E103521 E103522 E103523 E103529 E103531 E103532 E103533 E103539 E103541 E103542 E103543 E103549 E103551 E103552 E103553 E103559 E103591 E103592 E103593 E103599 E1037X1 E1037X2 E1037X3 E1037X9 E113211 E113212 E113213 E113219 E113291 E113292 E113293 E113299 E113311 E113312 E113313 E113319 E113391 E113392 E113393 E113399 E113411 E113412 E113413 E113419 E113491 E113492 E113493 E113499 E113511 E113512 E113513 E113519 E113521 E113522 E113523 E113529 E113531 E113532 E113533 E113539 E113541 E113542 E113543 E113549 E113551 E113552 E113553 E113559 E113591 E113592 E113593 E113599 E1137X1 E1137X2 E1137X3 E1137X9 E133211 E133212 E133213 E133219 E133291 E133292 E133293 E133299 E133311 E133312 E133313 E133319 E133391 E133392 E133393 E133399 E133411 E133412 E133413 E133419 E133491 E133492 E133493 E133499 E133511 E133512 E133513 E133519 E133521 E133522 E133523 E133529 E133531 E133532 E133533 E133539 E133541 E133542 E133543 E133549 E133551 E133552 E133553 E133559 E133591 E133592 E133593 E133599 E1337X1 E1337X2 E1337X3 and E1337X9 Under ICD-10 Codes That Support Medical Necessity Group 3 Codes added ICD-10 codes O24415 O24425 and O24435 and the code descriptions were revised for O24011 O24012 O24013 O24019 O24111 O24112 O24113 and O24119 This revision is due to the Annual ICD-10 Code Update Under Coverage Indications Limitations andor Medical Necessity-Limitations deleted the last bullet ldquoPatients who demonstrate a hypercoaguable staterdquo as literature supports that this is no longer considered to be an absolute contraindication to varicose vein procedures Under ICD-10 Codes That Support Medical Necessity Group 2 Paragraph added I83811 and I83812

10116

110316


31 112016

Vestibular Functioning Testing L34537

Rev 5



L33438 Rev 4

Implantable Infusion Pump L33461

Rev 9

MRI of a Joint L33464 Rev 7

Under CMS National Coverage Policy revised the verbiage for Title XVIII of the Social Security Act sect1862(a)(1)(A) to read ldquoallows coverage and payment for only those services that are considered reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body memberrdquo For Title XVIII of the Social Security Act sectsect1861(ll)(3) and (ll)(4)(B) revised the verbiage to read ldquodefines Speech-Language Pathology Services and Audiology Servicesrdquo 42 CFR sect410327700(b) (3) was removed as this CFR does not exist For CMS Internet-Only Manual Pub 100-02 Medicare Benefit Policy Manual Chapter 15 sectsect803 and 8031 revised the verbiage to read ldquodefines Audiology Services and a qualified audiologistrdquo For 42 CFR sect41032 revised the verbiage to read ldquoindicates that diagnostic tests may only be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements)rdquo For 42 CFR sect41032 revised the verbiage to read ldquoIndependent diagnostic testing facilityrdquo Capitalization and punctuation was corrected throughout this section Under Coverage Indications Limitations andor Medical Necessity-Vestibular Testing in the second paragraph defined the acronym Electrocardiography (ECG) Under Associated Information ndash Documentation Requirements revised the ldquoICD-9-CMrdquo to ldquoICD-10rdquo throughout this section Under Sources of Information and Basis for Decision deleted the verbiage in the fi rst line ldquoSpecialists in Neurology Neurosurgery Neuro-otolaryngologyrdquo The authorrsquos initial and volume number were added to the first cited reference Deleted the last sentence ldquoNOTE Some of the websites used to create this policy may no longer be availablerdquo Under CMS National Coverage Policy for Title XVIII of the Social Security Act Section 1861 (s) and (t) deleted the verbiage ldquoThese sections outline coverage for drugs and biologicals and services and suppliesrdquo and revised the verbiage to read ldquodefines the terms drugs and biologicals and outlines coverage for the drugs biologicals services and suppliesrdquo For Title XVIII of the Social Security Act Section 1862(a)(1)(A) deleted the verbiage ldquoThis section allows coverage and payment for only those services that are considered to be reasonable and medically necessary ie reasonable and necessary are those tests used in the diagnosis and management of illness or injury or to improve the function of a malformed body partrdquo and revised the verbiage to read ldquoallows coverage and payment for only those services that are considered to be medically reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body memberrdquo For CMS Online-internet only Manual Pub 100-08 Medicare Program Integrity Manual Chapter 13 deleted section 1314 as this section was removed from Chapter 13 Under Sources of Information and Basis for Decision added authorrsquos names and initials Under CMS National Coverage Policy for Title XVIII of the Social Security Act sect1862(a)(1) (A) revised the verbiage to read ldquoallows coverage and payment for only those services that are considered to be medically reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body memberrdquo For Title XVIII of the Social Security Act sect1833(e) revised the verbiage to read ldquoprohibits Medicare payment for any claim lacking the necessary information to process that claimrdquo Capitalization punctuation typographical errors and titles to cited references were corrected Under CMS National Coverage Policy for Title XVIII of the Social Security Act sect1833(e) revised the verbiage to read ldquoprohibits Medicare payment for any claim lacking the necessary information to process that claimrdquo for 42 CFR sect41032(b)(3) revised the title to read ldquolevels of supervision by a physicianrdquo and corrected capitalization to cited references

100616

101316

101316

101316


32 112016

Article Title

Bevacizumab Off-Label Ophthalmologic Use

Article A53595 Rev 8

Iluvien for Diabetic Macular Edema

A54750 Rev 2

Medicare Preventive Coverage for Certain

Vaccines A54767 Rev 7

Implantable Miniature Telescope (IMT) for

Macular Degeneration Article A53501 Rev 5

Articles

Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes E083211 E083212 E083213 E083311 E083312 E083313 E083411 E083412 E083413 E083511 E083512 E083513 E093211 E093212 E093213 E093311 E093312 E093313 E093411 E093412 E093413 E093511 E093512 E093513 E103211 E103212 E103213 E103311 E103312 E103313 E103411 E103412 E103413 E103511 E103512 E103513 E113211 E113212 E113213 E113311 E113312 E113313 E113411 E113412 E113413 E113511 E113512 E113513 E133211 E133212 E133213 E133311 E133312 E133313 E133411 E133412 E133413 E133511 E133512 E133513 H348110 H348111 H348112 H348120 H348121 H348122 H348130 H348131 H348132 H348310 H348311 H348312 H348320 H348321 H348322 H348330 H348331 H348332 H353210 H353211 H353212 H353213 H353220 H353221 H353222 H353223 H353230 H353231 H353232 and H353233 Under ICD-10 Codes That Support Medical Necessity deleted ICD-10 codes E08321 E08331 E08341 E08351 E08359 E09321 E09331 E09341 E09351 E09359 E10321 E10331 E10341 E10351 E10359 E11321 E11331 E11341 E11351 E11359 E13321 E13331 E13341 E13351 E13359 H34811 H34812 H34813 H34831 H34832 H34833 and H3532 This revision is due to the Annual ICDshy10 Code Update Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes E103211 E103212 E103213 E103311 E103312 E103313 E103411 E103412 E103413 E103511 E103512 E103513 E103521 E103522 E103523 E113211 E113212 E113213 E113311 E113312 E113313 E113411 E113412 E113413 E113511 E113512 and E113513 Under ICD-10 Codes That Support Medical Necessity deleted ICDshy10 codes E10321 E10331 E10341 E10351 E11321 E11331 E11341 and E11351 This revision is due to the Annual ICD-10 Code Update Under Article Text deleted Z23 and added Z2914 under Rabies (90675-90676) Under Covered ICD-10 Codes Group 2 Codes added the ICD-10 code Z2914 and deleted Z23 Under Covered ICD-10 Codes Group 3 Codes added ICD-10 codes S02101B S02102B S0211AB S0211BB S0211CB S0211DB S0211EB S0211FB S0211GB S0211HB S0231XB S0232XB S0240AB S0240BB S0240CB S0240DB S0240EB S0240FB S02601B S02602B S02611B S02612B S02621B S02622B S02631B S02632B S02641B S02642B S02651B S02652B S02671B S02672B S0281XB S0282XB S92811B S92812B S99001B S99002B S99011B S99012B S99021B S99022B S99031B S99032B S99041B S99042B S99091B S99092B S99101B S99102B S99111B S99112B S99121B S99122B S99131B S99132B S99141B S99142B S99191B S99192B S99201B S99202B S99211B S99212B S99221B S99222B S99231B S99232B S99241B S99242B S99291B and S99292B and deleted S0210XB S0261XB S0262XB S0264XB S0265XB S0267XB and S028XXB Under Covered ICD-10 Codes Group 3 Codes ICD-10 codes S02110B S02111B S02112B S02118B S02401B S02402B and S02600B had descriptor changes This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes H353110 H353111 H353112 H353113 H353114 H353120 H353121 H353122 H353123 H353124 H353130 H353131 H353132 H353133 and H353134 Under ICD-10 Codes That Support Medical Necessity deleted ICD-10 code H3531 This revision is due to the Annual ICD-10 Code Update

Effective Date 10116

10116

10116

10116


33 112016

Billing and Coding for Rezumreg Procedure

A55324 New

CPT Modifi er 59 Gastroenterology

A53399 Rev 3

Radiology Services Multiple Identical

Services on Same Day A53488 Rev 3

On August 27 2015 the FDA cleared for marketing the Rezumreg System to relieve lower urinary tract symptoms secondary to benign prostatic hyperplasia This procedure involves the transurethral injection of steam into the prostate Once injected the steam condenses to water imparting convective energy to the tissue causing cell death and damage The technology uses radiofrequency (RF) to boil the water to create the steam that is injected but does not impart radiofrequency directly to the prostate tissue

Claims for procedures involving Rezumreg steam injection should NOT be coded as CPT 53852 because the technology does not apply radiofrequency energy to the prostate Prostatic tissue destruction is accomplished via steam generated by RF not by the RF itself

Claims for procedures involving Rezumreg should be coded as CPT 53899 The claim must also indicate that the Rezum procedure was performed in Box 19 on the CMS 1500 form (or its electronic equivalent)

Available evidence as to whether Rezumreg procedure for treatment of BPH can be considered reasonable and necessary is currently under review by Palmetto GBA This article is for coding information only coverage at this time is not certain

Sources of Information 1 McVary KT Gange SN Gittelman MC et al J Sex Med 201613924-933 2 McVary KT Gange SN Gittelman MC et al J Urol 20161951529-1538 3 Dixon C Rijo Cedano E Pacik D et al Urology 201586(5)1042-1047 4 Mynderse LA Hanson D Robb RA et al Urology 201586(1)122-127 Under Article Text-Background revised the verbiage in the sentence ldquoMedicare carrier and MAC Part B claim processing systems utilize NCCI-associated modifiers to allow payment of both codes of an editrdquo to read ldquoThe Part B MAC claim processing system utilizes NCCI-associated modifiers to allow payment of both codes of an editrdquo Under Article Text-Examples of CPT Modifier 59 Usage the word ldquodiagnosticrdquo was deleted from the descriptions of CPT code 45385 and CPT code 45380 Under Article Text in the last sentence citing the CMS Citation the ldquo4rdquo in ldquoSection 10014rdquo was deleted and revised to read ldquoSection 1001rdquo

Part AB Local Coverage Determinations

92216

100616

100616

Policy Title Response to Comments Effective Date

Upper Gastrointestinal Endoscopy and Visualization

L34434

Palmetto GBA received three comments regarding the draft Upper Gastrointestinal Endoscopy and Visualization DL34434 LCD

Comment All three comments were requests for coverage of Transoral Incisionless Fundoplication employing the Esophyx device (CPT 43210) Copies of recent clinical studies were submitted Response

Upon review of current peer reviewed literature regarding the safety and efficacy of this procedure Palmetto GBA has made the decision to cover this procedure and will remove the existing language indicating non-coverage from the final version of the policy

101316


34 112016

Policy Title

Colonoscopy Sigmoidoscopy

Proctosigmoidoscopy L34454 Rev 9

Flow Cytometry L34513 Rev 5

LCD Revisions

Under ICD-10 Codes That Support Medical Necessity Group 1 Paragraph added the following new ICD-10 codes and descriptions K55031 K55032 K55039 K55041 K55042 K55049 K55051 K55052 and K55059 to the second paragraph and deleted the fourth paragraph Under ICD-10 Codes That Support Medical Necessity Group 1 added ICD-10 codes K5221 K5222 K5229 K523 K52831 K52832 K52838 K52839 K55031 K55032 K55039 K55041 K55042 K55049 K55051 K55052 K55059 K55061 K55062 K55069 K9049 C49A4 C49A5 C49A9 K5530 K5531 K5532 K5533 K581 K582 K588 K5903 K5904 K5931 K5939 K91870 K91871 K91872 and K91873 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted ICD-10 codes K522 K550 K593 and K904 Under ICD-10 Codes That Support Medical Necessity Group 1 updated the code description for ICD-10 code C7A096 This revision is due to the Annual ICD-10 Code Update that becomes effective October 1 2016 Under ICD-10 Codes That Support Medical Necessity Group 1 added ICD-10 code D47 Z2 Under ICD-10 Codes That Support Medical Necessity Group 1 updated the code descriptions for ICD-10 codes C8110 C8111 C8112 C8113 C8114 C8115 C8116 C8117 C8118 C8119 C8120 C8121 C8122 C8123 C8124 C8125 C8126 C8127 C8128 C8129 C8130 C8131 C8132 C8133 C8134 C8135 C8136 C8137 C8138 C8139 C8140 C8141 C8142 C8143 C8144 C8145 C8146 C8147 C8148 C8149 C8170 C8171 C8172 C8173 C8174 C8175 C8176 C8177 C8178 and C8179 This revision is due to the Annual ICD-10 Code Update


10116


35 112016

Laparoscopic Sleeve Gastrectomy for Severe

Obesity L34537 Rev 9

Application of Skin Substitutes L36466

Rev 2

Corneal Pachymetry L34512 Rev 6

Under ICD-10 Codes That Support Medical Necessity Group 3 added E083211 E083212 E083213 E083219 E083291 E083292 E083293 E083299 E083311 E083312 E083313 E083319 E083391 E083392 E083393 E083399 E083411 E083412 E083413 E083419 E083491 E083492 E083493 E083499 E083511 E083512 E083513 E083519 E083521 E083522 E083523 E083529 E083531 E083532 E083533 E083539 E083541 E083542 E083543 E083549 E083551 E083552 E083553 E083559 E083591 E083592 E083593 E083599 E0837X1 E0837X2 E0837X3 E0837X9E093211 E093212 E093213 E093219 E093291 E093292 E093293 E093299 E093311 E093312 E093313 E093319 E093391 E093392 E093393 E093399 E093411 E093412 E093413 E093419 E093491 E093492 E093493 E093499 E093511 E093512 E093513 E093519 E093521 E093522 E093523 E093529 E093531 E093532 E093533 E093539 E093541 E093542 E093543 E093549 E093551 E093552 E093553 E093559 E093591 E093592 E093593 E093599 E0937X1 E0937X2 E0937X3 E0937X9 E103211 E103212 E103213 E103219 E103291 E103292 E103293 E103299 E103311 E103312 E103313 E103319 E103391 E103392 E103393 E103399 E103411 E103412 E103413 E103419 E103491 E103492 E103493 E103499 E103511 E103512 E103513 E103519 E103521 E103522 E103523 E103529 E103531 E103532 E103533 E103539 E103541 E103542 E103543 E103549 E103551 E103552 E103553 E103559 E103591 E103592 E103593 E103599 E1037X1 E1037X2 E1037X3 E1037X9 E113211 E113212 E113213 E113219 E113291 E113292 E113293 E113299 E113311 E113312 E113313 E113319 E113391 E113392 E113393 E113399 E113411 E113412 E113413 E113419 E113491 E113492 E113493 E113499 E113511 E113512 E113513 E113519 E113521 E113522 E113523 E113529 E113531 E113532 E113533 E113539 E113541 E113542 E113543 E113549 E113551 E113552 E113553 E113559 E113591 E113592 E113593 E113599 E1137X1 E1137X2 E1137X3 E1137X9 E133211 E133212 E133213 E133219 E133291 E133292 E133293 E133299 E133311 E133312 E133313 E133319 E133391 E133392 E133393 E133399 E133411 E133412 E133413 E133419 E133491 E133492 E133493 E133499 E133511 E133512 E133513 E133519 E133521 E133522 E133523 E133529 E133531 E133532 E133533 E133539 E133541 E133542 E133543 E133549 E133551 E133552 E133553 E133559 E133591 E133592 E133593 E133599 E1337X1 E1337X2 E1337X3 E1337X9 I160 I161 and I169 Under ICD-10 Codes That Support Medical Necessity Group 3 deleted E10321 E10329 E10331 E10339 E10341 E10349 E10351 E10359 E11321 E11329 E11331 E11339 E11341 E11349 E11351 E11359 E13321 E13329 E13331 E13339 E13341 E13349 E13351 and E13359 This revision is due to the Annual ICD-10 Code Update Under Coverage Indications Limitations andor Medical Necessity-Indications revised the verbiage in bullet 1 to read ldquoPartial- andor full-thickness ulcers not involving tendon muscle joint capsule or exhibiting exposed bone or sinus tracts with a clean granular base andor specific to the product labeling or instructions for userdquo Under Limitations in the last paragraph and last sentence revised the verbiage to read ldquoNote that combination therapy with any of these platelet rich plasma rich systems and bioengineered skin substitute (CTP) will be considered not reasonable and necessaryrdquo Under ICD-10 Codes that Support Medical Necessity-Group1 Codes added ICD-10 codes I87311 I87312 I87313 I87331 I87332 and I87333 Under ICD-10 Codes That Support Medical Necessity Group 1 added ICD-10 codes H401110 H401111 H401112 H401113 H401114 H401120 H401121 H401122 H401123 H401124 H401130 H401131 H401132 H401133 H401134 H401190 H401191 H401192 H401193 and H401194 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted ICD-10 codes H4011X0 H4011X1 H4011X2 H4011X3 and H4011X4 This revision is due to the Annual ICD-10 Code Update

10116

92216

10116


36 112016

Nerve Conduction Studies and

Electromyography L35048 Rev 12

Ophthalmic Angiography

(Fluorescein and Indocyanine Green)

L34426 Rev 6



L34426 Rev 7

Under CPTHCPCS Codes Group 1 Codes deleted CPT 95873 and under Group 2 Codes deleted CPT code 95874 as these CPT codes are for guidance used for therapeutic procedures and are not diagnostic procedures as per their code descriptions This revision is retroactive to 10012015

Under ICD-10 Codes That Support Medical Necessity Group 1 added E083211 E083212 E083213 E083291 E083292 E083293 E083311 E083312 E083313 E083391 E083392 E083393 E083411 E083412 E083413 E083491 E083492 E083493 E083511 E083512 E083513 E083521 E083522 E083523 E083531 E083532 E083533 E083539 E083541 E083542 E083543 E083551 E083552 E083553 E083591 E083592 E083593 E0837X1 E0837X2 E0837X3 E093211 E093212 E093213 E093291 E093292 E093293 E093311 E093312 E093313 E093391 E093392 E093393 E093411 E093412 E093413 E093491 E093492 E093493 E093511 E093512 E093513 E093521 E093522 E093523 E093531 E093532 E093533 E093541 E093542 E093543 E093551 E093552 E093553 E093591 E093592 E093593 E0937X1 E0937X2 E0937X3 E103211 E103212 E103213 E103291 E103292 E103293 E103311 E103312 E103313 E103391 E103392 E103393 E103411 E103412 E103413 E103491 E103492 E103493 E103511 E103512 E103513 E103521 E103522 E103523 E103531 E103532 E103533 E103541 E103542 E103543 E103551 E103552 E103553 E103591 E103592 E103593 E103599 E1037X1 E1037X2 E1037X3 E113211 E113212 E113213 E113291 E113292 E113293 E113311 E113312 E113313 E113391 E113392 E113393 E113411 E113412 E113413 E113491 E113492 E113493 E113511 E113512 E113513 E113521 E113522 E113523 E113531 E113532 E113533 E113541 E113542 E113543 E113551 E113552 E113553 E113591 E113592 E113593 E1137X1 E1137X2 E1137X3 E133211 E133212 E133213 E133291 E133292 E133293 E133311 E133312 E133313 E133391 E133392 E133393 E133411 E133412 E133413 E133491 E133492 E133493 E133511 E133512 E133513 E133521 E133522 E133523 E133531 E133532 E133533 E133541 E133542 E133543 E133551 E133552 E133553 E133591 E133592 E133593 E1337X1 E1337X2 E1337X3 E7800 E7801 E89820 E89821 E89822 and E89823 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted E08329 E08341 E09329 E09339 E09341 E11329 E11331 E13359 H34831 E08321 E08349 E09321 E09331 E09351 E10341 E10351 E08339 E08359 E09359 E10321 E10339 E10349 E10329 E10331 E10359 E11341 E11359 E13329 E13331 E13349 H34811 E11349 E11351 E13321 E13339 E13341 H34812 H34813 H34833 E11321 E11339 E13351 H34832 H3532 E08331 E08351 and E09349 Under ICD-10 Codes That Support Medical Necessity Group 2 added H353210 H353211 H353212 H353213 H353220 H353221 H353222 H353223 H353230 H353231 H353232 and H353233 Under ICD-10 Codes That Support Medical Necessity Group 2 deleted H3532 This revision is due to the Annual ICD-10 Code Update and becomes effective 102416 Under ICD-10 Codes That Support Medical Necessity Group 1 Codes and Group 2 Codes added ICD-10 codes H3403 H348110 H348111 H348112 H348120 H348121 H348122 H348130 H348131 H348132 H348310 H348311 H348312 H348320 H348321 H348322 H348330 H348331 and H348332 This revision is due to the Annual ICD-10 Code Update and becomes effective 102416

103116

102416

102416


37 112016

Scanning Computerized Ophthalmic Diagnostic

Imaging (SCODI) L34431 Rev 8

Under ICD-10 Codes That Support Medical Necessity Group 1 added E083211 E083212 E083213 E083291 E083292 E083293 E083311 E083312 E083313 E083391 E083392 E083393 E083411 E083412 E083413 E083491 E083492 E083493 E083511 E083512 E083513 E083521 E083522 E083523 E083531 E083532 E083533 E083541 E083542 E083543 E083551 E083552 E083553 E083591 E083592 E083593 E0837X1 E0837X2 E0837X3 E093211 E093212 E093213 E093291 E093292 E093293 E093311 E093312 E093313 E093391 E093392 E093393 E093411 E093412 E093413 E093491 E093492 E093493 E093511 E093512 E093513 E093521 E093522 E093523 E093531 E093532 E093533 E093541 E093542 E093543 E093551 E093552 E093553 E093591 E093592 E093593 E0937X1 E0937X2 E0937X3 E103211 E103212 E103213 E103291 E103292 E103293 E103311 E103312 E103313 E103391 E103392 E103393 E103411 E103412 E103413 E103491 E103492 E103493 E103511 E103512 E103513 E103521 E103522 E103523 E103531 E103532 E103533 E103541 E103542 E103543 E103551 E103552 E103553 E103591 E103592 E103593 E1037X1 E1037X2 E1037X3 E113211 E113212 E113213 E113291 E113292 E113293 E113311 E113312 E113313 E113391 E113392 E113393 E113411 E113412 E113413 E113491 E113492 E113493 E113511 E113512 E113513 E113521 E113522 E113523 E113531 E113532 E113533 E113541 E113542 E113543 E113551 E113552 E113553 E113591 E113592 E113593 E1137X1 E1137X2 E1137X3 E133211 E133212 E133213 E133291 E133292 E133293 E133311 E133312 E133313 E133391 E133392 E133393 E133411 E133412 E133413 E133491 E133492 E133493 E133511 E133512 E133513 E133521 E133522 E133523 E133531 E133532 E133533 E133541 E133542 E133543 E133551 E133552 E133553 E133591 E133592 E133593 E1337X1 E1337X2 E1337X3 H348110 H348111 H348112 H348120 H348121 H348122 H348130 H348131 H348132 H348310 H348311 H348312 H348320 H348321 H348322 H348330 H348331 H348332 H353110 H353111 H353112 H353113 H353114 H353120 H353121 H353122 H353123 H353124 H353130 H353131 H353132 H353133 H353134 H353210 H353211 H353212 H353213 H353220 H353221 H353222 H353223 H353230 H353231 H353232 H353233 H401110 H401111 H401112 H401113 H401114 H401120 H401121 H401122 H401123 H401124 H401130 H401131 H401132 H401133 and H401134 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted E08321 E08329 E08331 E08339 E08341 E08349 E08351 E08359 E09321 E09329 E09331 E09339 E09341 E09349 E09351 E09359 E10321 E10329E10331 E10339 E10341 E10349 E10351 E10359 E11321 E11329 E11331 E11339 E11341 E11349 E11351 E11359 E13321 E13329 E13331 E13339 E13341 E13349 E13351 E13359 H34811 H34812 H34813 H34831 H34832 H34833 H3531 H3532 H4011X1 H4011X2 H4011X3 and H4011X4 This revision is due to the Annual ICD-10 Code Update which becomes effective October 1 2016

10316


38 112016

Total Joint Arthroplasty L33456 Rev 10

Wireless Capsule Endoscopy

L36427 Rev 1

Cardiac Radionuclide Imaging L33457 Rev 8

Cardiac Rehabilitation L34412 Rev 10

Minimally Invasive Treatment for Benign Prostatic Hyperplasia Involving Prostatic

Urethral Lift (Uroliftreg) L36109 Rev 2

Cataract Surgery L33413 Rev 8

Under ICD-10 Codes That Support Medical Necessity Group 1 added M84751A M84751D M84751G M84751K M84751P M84751S M84752A M84752D M84752G M84752K M84752P M84752S M84754A M84754D M84754G M84754K M84754P M84754S M84755A M84755D M84755G M84755K M84755P M84755S M84757A M84757D M84757G M84757K M84757P M84757S M84758A M84758D M84758G M84758K M84758P and M84758S Under ICD-10 Codes That Support Medical Necessity Group 2 added M9701XA M9701XD M9701XS M9702XA M9702XD and M9702XS Under ICD-10 Codes That Support Medical Necessity Group 2 Asterisk added M9701XA-M9702XS to the paragraph and deleted T84040A-T84041S from the paragraph Under ICD-10 Codes That Support Medical Necessity Group 4 added M9711XA M9711XD M9711XS M9712XA M9712XD and M9712XS Under ICD-10 Codes That Support Medical Necessity Group 4 Asterisk added M9711XA-M9712XS to the paragraph Under ICD-10 Codes That Support Medical Necessity Group 2 deleted T84040A T84040D T84040S T84041A T84041D and T84041S Under ICD-10 Codes That Support Medical Necessity Group 4 deleted T84042S and T84043S This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity Group 1 added K55011 K55012 K55019 K55021 K55022 K55029 K55051 K55052 K55059 K55061 K55062 K55069 K5530 K5531 K5532 and K5533 Under ICD-10 Codes That Support Medical Necessity Group 1 deleted K522 This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity Group 2 added C58 C8110 C8111 C8112 C8113 C8114 C8115 C8116 C8117 C8118 C8119 C8120 C8121 C8122 C8123 C8124 C8125 C8126 C8127 C8128 C8129 C8130 C8131 C8132 C8133 C8134 C8135 C8136 C8137 C8138 C8139 C8140 C8141 C8142 C8143 C8144 C8145 C8146 C8147 C8148 C8149 C8170 C8171 C8172 C8173 C8174 C8175 C8176 C8177 C8178 and C8179 This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity Group 1 deleted Z9889 This revision is due to the Annual ICD-10 Code Update

Under ICD-10 Codes That Support Medical Necessity Group 1 updated code description for N401This revision is due to the Annual ICD-10 Code Update

Under ICD-10 Codes that Support Medical Necessity Group 1 Codes deleted ICD-10 codes H4011X2 and H4011X3 Under ICD-10 Codes that Support Medical Necessity added Group 2 with ICD-10 codes H401110 H401111 H401112 H401113 H401114 H401120 H401121 H401122 H401123 H401124 H401130 H401131 H401132 H401133 and H401134 This revision is due to the Annual ICD-10 Code Update and becomes effective 10116

10116

10116

10116

10116

10116

10116


39 112016

Computerized Tomography of the

Abdomen and Pelvis L34415 Rev 9

Rituximab (Rituxanreg) L35026 Rev 9

Under ICD-10 Codes That Support Medical Necessity Group 1 C49A0 C49A1 C49A2 C49A3 C49A4 C49A5 C49A9 D47Z2 D49511 D49512 D49519 D4959 G9761 G9762 G9763 G9764 I97620 I97621 I97622 I97630 I97631 I97638 I97640 I97641 I97648 K5221 K5222 K5229 K523 K52831 K52832 K52838 K52839 K55011 K55012 K55019 K55021 K55022 K55029 K55031 K55032 K55039 K55041 K55042 K55049 K55051 K55052 K55059 K55061 K55062 K55069 K5530 K5531 K5532 K5533 K581 K582 K588 K5903 K5904 K5931 K5939 K8500 K8501 K8502 K8510 K8511 K8512 K8520 K8521 K8522 K8530 K8531 K8532 K8580 K8581 K8582 K8590 K8591 K8592 K8681 K8689 K9041 K9049 K91870 K91871 K91872 K91873 M96840 M96841 M96842 M96843 N8301 N8302 N8311 N8312 N83201 N83202 N83291 N83292 N83311 N83312 N83321 N83322 N83331 N83332 N8341 N8342 N83511 N83512 N83521 N83522 N99523 N99524 N99533 N99534 N99840 N99841 N99842 N99843 R3121 R3129 R9341 R93421 R93422 R93429 R9349 T83113A T83113D T83113S T83123A T83123D T83123S T83193A T83193D T83193S T8324XA T8324XD T8324XS T8325XA T8325XD T8325XS T83512A T83512D T83512S T83590A T83590D T83590S T83592A T83592D T83592S T83593A T83593D T83593S T83598A T83598D T83598S T8361XA T8361XD T8361XS T8369XA T8369XD T8369XS T83712A T83712D T83712S T83713A T83713D T83713S T83714A T83714D T83714S T83719A T83719D T83719S T83722A T83722D T83722S T83723A T83723D T83723S T83724A T83724D T83724S T83729A T83729D T83729S T8379XA T8379XD and T8379XS Under ICD-10 Codes That Support Medical Necessity Group 1 deleted D495 I9762 K522 K550 K593 K850 K851 K852 K853 K858 K859 K868 N830 N831 N8320 N8329 N8331 N8332 N8333 N834 N8351 N8352 Q5212 R312 and R934 Under ICD-10 Codes That Support Medical Necessity Group 1 updated code description for C7A094 C7A095 C7A096 C8110 C8111 C8112 C8113 C8114 C8115 C8116 C8117 C8118 C8119 C8120 C8121 C8122 C8123 C8124 C8125 C8126 C8127 C8128 C8129 C8130 C8131 C8132 C8133 C8134 C8135 C8136 C8137 C8138 C8139 C8140 C8141 C8142 C8143 C8144 C8145 C8146 C8147 C8148 C8149 C8170 C8171 C8172 C8173 C8174 C8175 C8176 C8177 C8178 C8179 D3A094 D3A095 D3A096 D7821 D7822 G9751 G9752 I97610 I97611 I97618 K9161 K91840 K91841 L7621 L7622 M96830 M96831 N400 N401 N99520 N99521 N99522 N99528 N99530 N99531 N99532 N99538 N99820 N99821 T83018A T83018D T83018S T83028A T83028D T83028S T83038A T83038D T83038S T83098A T83098D T83098S T83111A T83111D T83111S T83112A T83112D T83112S T83121A T83121D T83121S T83122A T83122D T83122S T83191A T83191D T83191S T83192A T83192D T83192S T83420A T83420D T83420S T83711A T83711D T83711S T83718A T83718D T83718S T83721A T83721D T83721S T83728A T83728D and T83728S This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes that Support Medical Necessity the descriptions were revised for ICD-10 codes C8110 C8111 C8112 C8113 C8114 C8115 C8116 C8117 C8118 C8119 C8120 C8121 C8122 C8123 C8124 C8125 C8126 C8127 C8128 C8129 C8130 C8131 C8132 C8133 C8134 C8135 C8136 C8137 C8138 C8139 C8140 C8141 C8142 C8143 C8144 C8145 C8146 C8147 C8148 C8149 C8170 C8171 C8172 C8173 C8174 C8175 C8176 C8177 C8178 and C8179 This revision is due to the Annual ICD-10 Code Update

10116

10116


40 112016

Ophthalmology Extended

Ophthalmoscopy and Fundus Photography

L33467 Rev 5

White Cell Colony Stimulating Factors

L36598 Rev 1

Under ICD-10 Codes That Support Medical Necessity Group 1 Codes added ICDshy10 codes E083211 E083212 E083213 E083219 E083291 E083292 E083293 E083299 E083311 E083312 E083313 E083319 E083391 E083392 E083393 E083399 E083411 E083412 E083413 E083419 E083491 E083492 E083493 E083499 E083511 E083512 E083513 E083519 E083521 E083522 E083523 E083529 E083531 E083532 E083533 E083539 E083541 E083542 E083543 E083549 E083551 E083552 E083553 E083559 E083591 E083592 E083593 E083599 E093211 E093212 E093213 E093219 E093291 E093292 E093293 E093299 E093311 E093312 E093313 E093319 E093391 E093392 E093393 E093399 E093411 E093412 E093413 E093419 E093491 E093492 E093493 E093499 E093511 E093512 E093513 E093519 E093521 E093522 E093523 E093529 E093531 E093532 E093533 E093539 E093541 E093542 E093543 E093549 E093551 E093552 E093553 E093559 E093591 E093592 E093593 E093599 E103211 E103212 E103213 E103219 E103291 E103292 E103293 E103299 E103311 E103312 E103313 E103319 E103391 E103392 E103393 E103399 E103411 E103412 E103413 E103419 E103491 E103492 E103493 E103499 E103511 E103512 E103513 E103519 E103521 E103522 E103523 E103529 E103531 E103532 E103533 E103539 E103541 E103542 E103543 E103549 E103551 E103552 E103553 E103559 E103591 E103592 E103593 E103599 E113211 E113212 E113213 E113219 E113291 E113292 E113293 E113299 E113311 E113312 E113313 E113319 E113391 E113392 E113393 E113399 E113411 E113412 E113413 E113419 E113491 E113492 E113493 E113499 E113511 E113512 E113513 E113519 E113521 E113522 E113523 E113529 E113531 E113532 E113533 E113539 E113541 E113542 E113543 E113549 E113551 E113552 E113553 E113559 E113591 E113592 E113593 E113599 E133211 E133212 E133213 E133219 E133291 E133292 E133293 E133299 E133311 E133312 E133313 E133319 E133391 E133392 E133393 E133399 E133411 E133412 E133413 E133419 E133491 E133492 E133493 E133499 E133511 E133512 E133513 E133519 E133521 E133522 E133523 E133529 E133531 E133532 E133533 E133539 E133541 E133542 E133543 E133549 E133551 E133552 E133553 E133559 E133591 E133592 E133593 E133599 H348110 H348111 H348112 H348120 H348121 H348122 H348130 H348131 H348132 H348310 H348311 H348312 H348320 H348321 H348322 H348330 H348331 H348332 H353110 H353111 H353112 H353113 H353114 H353120 H353121 H353122 H353123 H353124 H353130 H353131 H353132 H353133 H353134 E0837X1 E0837X2 E0837X3 E0837X9 E0937X1 E0937X2 E0937X3 E0937X9 E1037X1 E1037X2 E1037X3 E1037X9 E1137X1 E1137X2 E1137X3 E1137X9 E1337X1 E1337X2 E1337X3 and E1337X9 Under ICD-10 Codes That Support Medical Necessity Group 1 Codes deleted ICD-10 codes E08321 E08329 E08331 E08339 E08341 E08349 E08351 E08359 E09321 E09329 E09331 E09339 E09341 E09349 E09351 E09359 E10321 E10329 E10331 E10339 E10341 E10349 E10351 E10359 E11321 E11329 E11331 E11339 E11341 E11349 E11351 E11359 E13321 E13329 E13331 E13339 E13341 E13349 E13351 E13359 H34811 H34812 H34813 H34831 H34832 H34833 H3531 H3532 H4011X1 H4011X2 H4011X3 and H4011X4 This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity Group 1 Codes added ICD-10 codes C49A0 C49A1 C49A2 C49A3 C49A4 C49A5 C49A9 and D47Z2 and the code descriptions were revised for ICD-10 codes C7A094 C7A095 C7A096 C8110 C8119 C8120 C8129 C8130 C8139 C8140 C8149 C8170 and C8179 Under ICD-10 Codes That Support Medical Necessity Group 2 Codes added ICD-10 codes C49 A0 C49A1 C49A2 C49A3 C49A4 C49A5 C49A9 and D47Z2

10116

101016


41 112016

Nerve Conduction Studies L35048 Rev 11

Upper Gastrointestinal Endoscopy and

Visualization L34434 Rev 8



Infl iximab (Remicadereg) L35677 Rev 12

Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes G5603 G5613 G5623 G5633 G5643 G5683 G5693 G5703 G5713 G5723 G5733 G5743 G5753 G5763 G5773 G5783 G5793 G6182 M50020 M50021 M50022 M50023 M50121 M50122 and M50123 deleted ICD-10 codes M5002 M5012 M5022 M5032 M5082 and M5092 and revised the code descriptions for ICD-10 codes S548X1A S548X1D S548X1S S548X2A S548X2D and S548X2S This revision is due to the Annual ICD-10 Code Update Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes K5221 K5222 K5229 K523 K52831 K52832 K52838 K52839 K55011 K55012 K55019 K55021 K55022 K55029 K55051 K55052 K55059 K55061 K55062 K55069 K8500 K8501 K8502 K8510 K8511 K8512 K8520 K8521 K8522 K8530 K8531 K8532 K8580 K8581 K8582 K8590 K8591 K8592 K8681 K8689 K9041 K9049 K5530 K5531 K5532 K5533 K91870 K91871 K91872 and K91873 deleted ICD-10 codes K522 K550 K850 K851 K852 K853 K858 K859 K868 and K904 and revised the code descriptions for ICD-10 codes C8111 C8112 C8113 C8121 C8122 C8123 C8131 C8132 C8133 C8141 C8142 C8143 C8171 C8172 and C8173 This revision is due to the Annual ICD-10 Code Update Under Coverage Indications Limitations andor Medical Necessity the acronyms were defined throughout the policy The International Prostate Symptom Score (IPSS) Quality of Life Scale (QOL) Randomized Control Trial (RCT) and American Urological Association (AUA) Under Sources of Information and Basis for Decision corrected capitalization and added volume supplement and page numbers for journal titles

Under CMS National Coverage Policy for Title XVIII of the Social Security Act sect1862(a) (1)(A) revised the verbiage to read ldquoallows coverage and payment for only those services that are considered to be medically reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body memberrdquo For Title XVIII of the Social Security Act sect1833(e) revised the verbiage to read ldquoprohibits Medicare payment for any claim lacking the necessary information to process that claimrdquo Under Sources of Information and Basis for Decision added authorrsquos initials and names added volume numbers and corrected capitalization for numerous journal titles

10116

10116

100116

100616


42 112016

Upper Gastrointestinal Endoscopy and Visualization L34434 Rev 9

Once in a Lifetime Abdominal Aortic Aneurysm (AAA)

Screening A55071 Rev 3

Gender Reassignment Services for Gender

Dysphoria A53793 Rev 7

Self-Administered Drug Exclusion List A53066

Rev 6

Under Coverage Indications Limitations andor Medical Necessity- C Noncovered Transesophageal Endoscopic Procedures for the Treatment of GERD added the word ldquosomerdquo to the beginning of the first sentence to now read ldquoSome transesophageal endoscopic procedures for the treatment of GERD are not currently covered as the safety and efficacy of these procedures cannot be established by review of the available published peer reviewed literaturerdquo and deleted the verbiage in the first bullet ldquoEsophyXreg is a device used in a transoral incisionless fundoplication (TIFreg) procedure to repair the natural antireflux barrier and is also indicated to narrow the gastroesophageal junction and reduce hiatel hernia = 2cm in size EsophyXreg includes SerosaFuse Fasteners and consists of a flexible fastener delivery system comprised of three elements a stylet a pusher rod and a delivery tube The EsophyXreg procedure is designed for use in transoral tissue approximation full thickness serosa to serosa plications and to construct valves in the gastrointestinal tract which are used The procedure is performed with the patient under general anesthesiardquo Reshynamed section D to now read ldquoCovered Transesophageal Endoscopic Procedure for the Treatment of GERDrdquo and added the verbiage ldquoTransoral incisionless fundoplication (TIF) is a transesophageal endoscopic procedure for the treatment of GERD that is covered under this LCD Current published peer reviewed literature supports the safety and efficacy of the EsophyXreg device used in this procedure (CPT43210)rdquoand ldquoEsophyXreg is a device used in a transoral incisionless fundoplication (TIFreg) procedure to repair the natural antireflux barrier and is also indicated to narrow the gastroesophageal junction and reduce hiatel hernia = 2cm in size EsophyXreg includes SerosaFuse Fasteners and consists of a fl exible fastener delivery system comprised of three elements a stylet a pusher rod and a delivery tube The EsophyXreg procedure is designed for use in transoral tissue approximation full thickness serosa to serosa plications and to construct valves in the gastrointestinal tract which are used The procedure is performed with the patient under general anesthesiardquo The statement ldquoAll unlisted procedure codes billed for services are subject to development and medical reviewrdquo was moved from section C to section D the alphabet indicators for all remaining sections were revised Under CPTHCPCS Codes Group 1 Paragraph deleted the Note Under CPTHCPCS Codes Group 1 Codes added CPT code 43210 and 43236 Under CPTHCPCS Codes Group 2 Codes deleted CPT code 43210 and added CPT code 43499

Articles Under Covered ICD-10 Codes Group1 Paragraph added the last two paragraphs

Under Covered ICD-10 Codes the description was revised for ICD-10 code F641 This revision is due to the Annual ICD-10 Code Update and becomes effective 100116

Under Coding Table Information-Excluded CPTHCPCS Codes for J3590 added Toujeoreg SoloSTARreg Lantusreg and Lantusreg SoloSTARreg all with the effective date of 51616 For J3590 added HyQvia IxekizumabTaltzreg LiraglutideSaxendareg and Metreleptin Myaleptreg all with the effective date of 111416

112816

10616

10116

111416


43 112016

Billing and Coding of Drug and Biological

Infusions Article A55297 Rev 1

Additional Claim Documentation

Requirements for Not Otherwise Classified

(NOC) Drugs and Biological Products with

Specific FDA Label Indications

A54880 Rev 2


Infusions A55297 Rev 2

Under Article Text-Prolonged Drug and Biological Pump (currently applies to Yondelisreg) deleted all the verbiage in the section and added the verbiage ldquoIn addition to the code for the drug Trabectedin (Yondelis) J9999 and the applicable chemotherapy administration code HCPCS code G0498 is the only code that should appear on the claim to represent the expense incurred for the pump and associated supplies Do not include any other codes related to pumps or pump supplies as G0498 is priced to be comprehensive in this situationrdquo Under Article Text-Part B deleted the article ldquoDrug and Biological Injections amp Infusions Use of the Quantity Billed Field (QB)rdquo as the article was removed from the Palmetto GBA Website

Under Article Text- Generic Name (Trade Name) HCPCS Code corrected the spelling of ldquoStelararegrdquo Deleted all the verbiage under Infusions Non-Chemotherapy ldquoPalmetto GBA has received inquiries about the use of a chemotherapy administration code for an infusion (or push) of the following drugs The administration of any of the drugs listed below should NOT be billed using a chemotherapy administration code Instead these should be billed with an appropriate from the range of CPTreg codes 96365-96379 (infusion for therapy prophylaxis or diagnosis)rdquo and deleted all the verbiage under Generic Name (Trade Name) HCPCS Code decitabine (Dacogenreg) J0894 eculizumab (Solirisreg) J1300 golimumab (Simponi Ariareg) J1602 tocilizumab (Actemrareg) J3262 and vedolizumab (Entyvioreg) J3380 due to the drugs specifically listed as not eligible for chemotherapy administration in this paragraph All have reported incidences of anaphylaxis on IV admi nistration andor black box warnings Therefore require a higher level of surveillance during administration justifying the chemotherapy administration code

101016

92916

101316


44 112016

MolDX Local Coverage Determinations Policy Title LCD Revision Effective Date

Bladder Tumor Markers L33420 Revision History 4 amp 5

Revisions Due To ICD-10-CM Code Changes Reconsideration Request 1) In response to comments received by Noridian for LCD DL36678 Revised the 1st and 2nd paragraph under subtopic ldquoLimitationsrdquo under the Coverage Indications Limitations andor Medical Necessity section bullREMOVED - Bladder cancer tumor markers performed by immunoassay are ONLY considered medically necessary as an adjunct in the diagnosis and monitoring of bladder cancer in conjunction with cystoscopy

bullADDED - Cystoscopy in conjunction with bladder tumor markers is standard practice to evaluate patients with symptoms suggesting bladder cancer and to monitor treated patients for recurrence or progression Exceptions such as high grade bladder cancers sp radical cystectomy do exist which preclude cystoscopy prior to testing

bullADDED ldquoand FISH testingrdquo to the 1st sentence in the 2nd paragraph to read as follows Bladder cancer tumor markers performed by immunoassay and FISH testing are not covered for screening of all patients with hematuria

2) ICD-10 code changes bullDELETED - R312 bullADDED - R3121 bullADDED - R3129

Typographical Error Removed reference to 6 reference from policy text

10012016

Infectious Disease Molecular Diagnostic

ICD-10-CM Code Changes 10012016

Testing L33418

Group 3 (Added) K5221 K5222 K5229 K523 K52831 K52832 K581 and K582

Revision History 5 Group 4 (Added) G5783 G5793 and G6182

Group 8 (Added) E7800 and E7801 MolDX-CDD NSCLC Comprehensive Genomic Profile Testing L36143 Revision History 5

Other - Expanded coverage to include smokers with NSCLC and added clarified the CDD registry criteria Under ldquoSources of Information and Basis for Decisionrdquo added reference 16 and 17

9292016

MolDX 4KScore Assay L36763

This LCD version was created as a result of DL36763 being released to a Final LCD

11212016

MolDX Genetic Testing for Lynch Syndrome L35024 Revision History 10

Reconsideration Request Redefined age limitation of patient added more clarity for NGS ldquohotspotrdquo and updated reference numbers 13 14 16 and 23

10132016


45 112016

MolDX MGMT Promoter Methylation Analysis L35974 Revision History 3

Typographical Error Completed annual validation - corrected typographical errors to the following paragraphs under subtopic Background 2nd paragraph- 2nd sentence removed the letter ldquosrdquo from the word performance 4th paragraph- 3rd sentence added the word ldquotherdquo before ldquobenefitrdquo 5th paragraph - last sentence added the word ldquoandrdquo before ldquofoundrdquo

Under References - Updated version and date for reference 13 from Version 22014 to Version12015

10052015 (did not change)

MolDX Genetic Testing for BCRshyABL Negative Myeloproliferative Disease L36044 Revision History 7

Annual validation completed and Reconsideration request

Annual validation - Minor typographical errors corrected see BOLD text in the sentences below

Indications and Limitations of Coverage- (bullet 13) bull CALR mutations are reported to predict a more indolent disease course than (added ldquothat ofrdquo) patients with JAK2 mutations

Molecular Genetic Testing- (3rd paragraph) Studies have shown that a significant proportion of patients with myeloproliferative neoplasms and normal JAK2 (added ldquovrdquo)617F mutation testing have a CALR gene mutation

Reconsideration request - Added C9211 and C9212

10132016

Article Title Article Revision Effective Date Response to Comments Bladder Tumors Markers A55333

Address comments received by Noridian on draft (JE) policy DL36678 09192016

Response to The comment period began on 061316 and ended on 07292016 Comments were 11212016 Comments 4Kscore received from the provider community The notice period begins on 10062016 and Assay A55335

ends 11202016 The LCD becomes final on 11212016


46 112016

_______________________________________

CMS e-News e-News contains a weekrsquos worth of Medicare-related messages instead of many different messages being sent to you throughout the week This notification process ensures planned coordinated messages are delivered timely about Medicare-related topics

MLN Connectstrade Provider eNews

MLN Connectstrade Provider eNews for September 29 2016 httpswwwcmsgovOutreach-and-EducationOutreachFFSProvPartProgDownloads2016-09-29-eNewspdf

MLN Connectstrade Provider eNews for October 6 2016 httpswwwcmsgovOutreach-and-EducationOutreachFFSProvPartProgDownloads2016-10-06-eNewspdf




Receive ADRs Electronically Go Green via eServices

Providers can now opt to receive Additional Documentation Requests (ADRs) through eServices If your claim is selected for review you can receive your request as it is generated ndash instead of by mail (which decreases the amount of time you have to respond)

This new process is free secure and easy to use Our messaging function in eServices will send an inbox message to let users know that an lsquoeLetterrsquo is now available This new process delivers the electronic document as a link within the secure message once you sign into eServices

For more information about eServices and the many services it offers please visit our website at wwwPalmettoGBAcomeServices


47 112016

CMS Offers FREE Medicare Training for Providers CMS Web Training The Centers for Medicare amp Medicaid Services (CMS) has launched a series of education and training programs designed to leverage emerging Internet and satellite technologies to offer just-in-time training to Medicare providers and suppliers throughout the United States Many of these programs include free downloadable computerWeb based training courses These courses are also available on CD-ROM

httpwwwcmsgovMLNGenInfo

Palmetto GBA Medicare Customer Information and Outreach

Training Available To request a Medicare Education meetingseminar at no cost to you complete and fax the form located on the httpwwwPalmettoGBAcomJMBforms

httpwwwPalmettoGBAcomMedicare

Important Sources For You bull httpwwwcmsgov bull httpwwwcmsgovMLNGenInfo bull httpwwwcmsgovCMSformsCMSformslistasp

Important Telephone Numbers Provider Contact Center (855) 696-0705 (Toll-Free)

Electronic Data Interchange (EDI) Technical Support

(855) 696-0705

Medicare Beneficiary Call Center

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

Attention Billing Manager

48 112016

Whatrsquos Inside


Going Beyond Diagnosis


Medicare Learning Networkreg (MLN)

Notification of the 2017 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review

CMS Finalizes the New Medicare Quality Payment Program


Implementation of New Influenza Virus Vaccine Code


Stem Cell Transplantation for Multiple Myeloma Myelofibrosis and Sickle Cell Disease and Myelodysplastic Syndromes






CMS e-News

PART B MEDICARE ADVISORY Latest Medicare News for Part B

Whatrsquos Inside Administration

CMS Quarterly Provider Update 3 Going Beyond Diagnosis 3 Get Your Medicare News Electronically 5 Notification of the 2017 Dollar Amount in Controversy Required to Sustain Appeal Rights

for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review 8 CMS Finalizes the New Medicare Quality Payment Program 9

Drugs and Biologicals Medicare Part B Drug Average Sales Price Reporting by Manufacturers ndash Blending

National Drug Codes 10 Implementation of New Influenza Virus Vaccine Code 12

Education Educational Events Now Available 15

Medicine Stem Cell Transplantation for Multiple Myeloma Myelofibrosis and Sickle Cell Disease

and Myelodysplastic Syndromes 16 Update to Hepatitis B Deductible and Coinsurance and Screening Pap Smears Claims Processing Information 20

Ambulance Ambulance Inflation Factor for CY 2017 and Productivity Adjustment 21

Laboratory Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2017 22

Continued gtgt

palmettogbacomJMB

The Part B Medicare Advisory contains coverage billing and other information for Part B This information is not intended to constitute legal advice It is our ofϐicial notice to those we serve concerning their responsibilities and obligations as mandated by Medicare regulations and guidelines This information is readily available at no cost on the Palmetto GBA website It is the responsibility of each facility to obtain this information and to follow the guidelines The Part B Medicare Advisory includes information provided by the Centers for Medicare amp Medicaid Services (CMS) and is current at the time of publication The information is subject to change at any time This bul-letin should be shared with all health care practitioners and managerial members of the provider staff Bulletins are available at no-cost from our website at httpwwwPalmettoGBAcomJMB

CPT only copyright 2015 American Medical Association All rights reserved CPT is a registered trademark of the American Medical Association Applicable FARSDFARS Restrictions Apply to Government Use Fee schedules relative value units conversion factors andor related components are not assigned by the AMA and are not part of CPTreg and the AMA is not recommending their use The AMA does not directly or indirectly practice medicine or dispense medical services The AMA assumes no liability for data contained or not contained herein The Code on Dental Procedures and Nomenclature is published in Current Dental Terminology (CDT) Copyright copy 2015 American Dental Association (ADA) All rights reserved

November 2016 Volume 2016 Issue 11





2 112016











3 112016









4 112016








5 112016












6 112016














7 112016









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News





2 112016











3 112016









4 112016








5 112016












6 112016














7 112016









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News











3 112016









4 112016








5 112016












6 112016














7 112016









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News









4 112016








5 112016












6 112016














7 112016









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News








5 112016












6 112016














7 112016









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News












6 112016














7 112016









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News














7 112016









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News









8 112016









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News









9 112016










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News










10 112016





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News





11 112016









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News









12 112016










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News










13 112016

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

b



8 am and 7 pm ET





14 112016














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News














15 112016










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News










16 112016













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News













17 112016


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News


D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



D57212 D57219 D5740 D57411 D57412 D57419 D5780 D57811 D57812 or D57819



18 112016











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News











19 112016








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News








20 112016












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News












21 112016









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News









22 112016














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News














23 112016

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

b

b













24 112016

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

Interactive Tools


Remittance Advice

EDI Agreement

EDI Application


CMS 1500 Claim Form


25 112016






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News






Continued gtgt


26 112016



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News



L33417 Rev 4


10116


L33422 Rev 5


10116


L33422 Rev 6


110316


Thorax L33459 Rev 4


10116


L33428 Rev 8


101316




10116


27 112016


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News


L33461 Rev 8



L33446 Rev 5












Rev 4



28 112016

10116



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News



Rev 4



L33438 Rev 3


L33448 Rev 7



(TEE) L33471 Rev 4




10116

10116

10116

10116

10116


29 112016


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News


(TTE) L33472 Rev 4



30 112016

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

HbA1c L33431 Rev 7


L33454 Rev 7


10116

110316


31 112016


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News


Rev 5



L33438 Rev 4


Rev 9



100616

101316

101316

101316


32 112016

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

Article Title




A54750 Rev 2





Articles



10116

10116

10116


33 112016


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News


A55324 New


A53399 Rev 3









92216

100616

100616



L34434




101316


34 112016

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

Policy Title




LCD Revisions



10116


35 112016




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News




Rev 2



10116

92216

10116


36 112016





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News





L34426 Rev 6



L34426 Rev 7



103116

102416

102416


37 112016




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News




10316


38 112016



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News



L36427 Rev 1









10116

10116

10116

10116

10116

10116


39 112016





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News





10116

10116


40 112016



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News



L33467 Rev 5


L36598 Rev 1


10116

101016


41 112016









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News









10116

10116

100116

100616


42 112016







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News







Rev 6





112816

10616

10116

111416


43 112016







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News







A54880 Rev 2





101016

92916

101316


44 112016








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News








10012016



Testing L33418





9292016



11212016



10132016


45 112016











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News











10132016






46 112016

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

_______________________________________













47 112016









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News









(855) 696-0705


1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048


48 112016

Whatrsquos Inside
















CMS e-News

NOTE: Should you have landed here as a result of a search engine … · 2016. 10. 26. · the MCS...

Documents

Transcript of NOTE: Should you have landed here as a result of a search engine … · 2016. 10. 26. · the MCS...