Jurisdiction B News: LCD and Policy Article Revisions-Summary for October 2009

 

LCD and Policy Article Revisions - Summary for October 2009 Outlined below are the principal changes to several DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted.  Please review the entire LCD and each related Policy Article for complete information. Ankle Foot/Knee Ankle Foot Orthoses LCD Revision Effective Date: 12/01/2009HCPCS CODES AND MODIFIERS:Added: GA and GZ modifiersDeleted:  GY modifierDOCUMENTATION REQUIREMENTS: Added: Instructions for the use of GA and GZ modifiers Policy ArticleRevision Effective Date:  12/01/2009NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:Added:  Information on code A9283CODING GUIDELINES:Revised:  Instructions for coding A9283Revised:  Instructions for code L2770Revised:  Instructions for coding concentric adjustable torsion jointsRevised:  Instructions for RT/LT modifiers  Knee OrthosesLCDRevision Effective Date:  12/01/2009HCPCS CODES AND MODIFIERS:Added:  GA/GZ modifiersRevised:  RT/LT descriptorsDOCUMENTATION REQUIREMENTS:Added:  Instructions for GA/GZ modifier use Policy ArticleRevision Effective Date:  12/01/2009CODING GUIDELINES:Revised:  Instructions for code L2770Revised:  Instructions for coding concentric adjustable torsion jointsRevised:  Instructions for RT/LT modifiers  NebulizersLCDRevision Effective Date:  12/01/2009INDICATIONS AND LIMITATIONS OF COVERAGE:Added:  Language from Program Integrity Manual on timing of refills and shipping of supplies/medicationsRevised:  Coverage criteria for long-acting bronchodilatorsHCPCS CODES AND MODIFIERS:Added:  GA and GZ modifiersRevised:  KX modifier descriptorICD-9 CODES:Revised:  ICD-9 codes that support medical necessity for J7605, J7606DOCUMENTATION:Deleted: KX requirements from J7605 & J7606Added:  Instructions for use of GA and GZ modifiers  Oral Anticancer DrugsPolicy ArticleRevision Effective Date: 10/01/2009NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:Added: 208.92-209.36, 209.70-209.79 to accepted diagnoses for busulfan, capecitabine, cyclophosphamide, etoposide, melphalan, methotrexate, or temozolomideCODING GUIDELINES:Changed:  SADMERC to PDACICD-9 CODES THAT ARE COVERED:Added:  208.92-209.36, 209.70-209.79 to accepted diagnoses for busulfan, capecitabine, cyclophosphamide, etoposide, melphalan, methotrexate, or temozolomide  Oral Antiemetic DrugsLCDRevision Effective Date: 12/01/2009HCPCS CODES AND MODIFIERS:Added: GA and GZ modifiersRevised: KX modifierDOCUMENTATION REQUIREMENTS:Added: Instructions for use of the GA and GZ modifiers Policy ArticleRevision Effective Date: 10/01/2009CODING GUIDELINES:Changed: SADMERC to PDACICD-9 CODES THAT ARE COVERED:Added: 208.92 – 209.36, 209.70-209.79  Note: The information contained in this article is only a summary of revisions to LCDs and Policy Articles.  For complete information on any topic, you must review the LCD and/or Policy Article.

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