10/29/2020
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R13
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LCD revised and published on 10/29/2020. Title XVIII of the Social Security Act, Section 1833(e) reference, CPT codes 82306 and 82652 removed from LCD to comply with CR 10901, also LCD was updated to be consistent with GWS template.
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- Other (To comply with CR 10901 and new GWS template.)
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01/08/2019
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R12
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10/02/2019: The content in the LCD was revised to be consistent with the new format supported by CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13.5.1.
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- Other (Revisions based on CR 10901)
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01/08/2019
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R11
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Revision Number: 10 Publication: August 2019 Connection LCR A/B2019-045
Explanation of Revision: Based on CR 10901, the LCD was revised to remove all billing and coding and all language not related to reasonable and necessary provisions (“Bill Type Codes”, “Revenue Codes”, “CPT/HCPCS Codes”, “ICD-10 Codes that Support Medical Necessity”, “Documentation Requirements” and “Utilization Guidelines” sections of the LCD) and place them into a newly created billing and coding article. During the process of moving the ICD-10-CM diagnosis codes to the billing and coding article, the ICD-10-CM diagnosis code ranges were broken out and listed individually. The effective date of this revision is for claims processed on or after January 8, 2019, for dates of service on or after October 3, 2018.
01/08/2019: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination and therefore not all the fields included on the LCD are applicable as noted in this LCD.
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- Other (Revisions based on CR 10901)
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10/01/2018
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R10
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Revision Number: 9 Publication: September 2018 Connection LCR A/B2018-074
Explanation of Revision: Based on CR 10847 (Annual 2019 ICD-10-CM Update), the LCD was revised. Deleted ICD-10-CM diagnosis code M79.1. Added ICD-10-CM diagnosis code range M79.11-M79.18. The effective date of this revision is based on date of service.
10/01/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination and therefore not all the fields included on the LCD are applicable as noted in this LCD.
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- Revisions Due To ICD-10-CM Code Changes
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05/15/2018
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R9
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Revision Number: 8
Publication: May 2018 Connection
LCR A/B2018-045
Explanation of Revision: Based on an annual review of the LCD, it was determined that some of the italicized language in the “Coverage Indications, Limitations, and/or Medical Necessity” section of the LCD does not represent direct quotation from a CMS source listed in the LCD; therefore, this LCD is being revised to assure consistency with the CMS source. The effective date of this revision is based on date of service.
05/15/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination and therefore not all the fields included on the LCD are applicable as noted in this policy.
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- Other (Revisions based on annual review completed on 02/28/2018.)
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02/08/2018
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R8
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Revision Number: 7
Publication: February 2018 Connection
LCR A/B2018-012
Explanation of Revision: This LCD was revised in the “ICD-10 Codes that Support Medical Necessity” section of the LCD under “Group 1 Medical Necessity ICD-10 Codes Asterisk Explanation:” to include an explanation that all the codes within the asterisked range from the first code to the last code apply. The effective date of this revision is based on process date.
02/08/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination and therefore not all the fields included on the LCD are applicable as noted in this policy.
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- Provider Education/Guidance
- Public Education/Guidance
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10/01/2017
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R7
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Revision Number: 6
Publication: September 2017 Connection
LCR A/B2017-038
Explanation of Revision: Based on CR 10153 (Annual 2018 ICD-10-CM Update) the LCD was revised. Descriptor revised for ICD-10-CM diagnosis code M33.00. The effective date of this revision is based on date of service.
10/01/2017: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination and therefore not all the fields included on the LCD are applicable as noted in this policy.
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- Revisions Due To ICD-10-CM Code Changes
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06/22/2017
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R6
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Revision Number: 5 Publication: June 2017 Connection LCR A/B2017-022
Explanation of Revision: Based on CR 8776, the following verbiage was removed from the “CPT/HCPCS Codes” section of the LCD: “Per CR 8572, beginning in CY 2014, payment for most laboratory tests (except for molecular pathology tests) will be packaged under the OPPS, therefore the clinical laboratory tests listed below, for TOB 13X (outpatient hospital), are packaged in this setting.” The effective date of this revision is for claims processed on or after 05/12/2017, for dates of service on or after 01/01/2014. In addition, based on a reconsideration request multiple indications were added to the “Indications and Limitations of Coverage and/or Medical Necessity” section of the LCD and supporting ICD-10-CM codes A15.0—A19.9, B38.1— B38.9, B39.1— B39.9, C82.00— C82.99, D80.0— D80.9, D86.0— D86.9, D89.810— D89.813, E67.8, E68, E83.59, E84.0, E84.19— E84.8, G73.7, J63.2, K50.00— K51.319, K51.50—K52.0, K74.1, K74.2, K83.8, K86.0— K86.1, K86.81— K86.89, K87, K90.81, L40.0— L40.9, M32.0— M32.9, M33.00— M33.99, M36.0, M60.80— M60.9, M79.1, M79.7, M81.6, M85.80, Q78.0, Q78.2, Z68.30-Z68.45, *Z79.3, *Z79.51—*Z79.52, *Z79.891—*Z79.899, Z98.0, and Z98.84 were added to the “ICD-10 Codes that Support Medical Necessity” section of the LCD. Also, the Sources of Information section was updated. The effective date of this revision is based on dates of service on or after 06/22/2017.
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- Provider Education/Guidance
- Reconsideration Request
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10/01/2016
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R5
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Revision Number: 4 Publication: October 2016 Connection LCR A/B2016-097
Explanation of Revision: Based on CR 9677 (Annual 2017 ICD-10-CM Update) the LCD was revised. Revised ICD-10 diagnoses code range K90.0-K90.4 to read K90.0-K90.49. Deleted diagnosis code K90.4. The effective date of this revision is based on date of service.
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- Revisions Due To ICD-10-CM Code Changes
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06/30/2016
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R4
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Revision Number: 3 Publication: July 2016 Connection LCR A/B2016-077 Explanation of revision: This LCD was revised to add ICD-10-CM diagnosis codes M85.811, M85.812, M85.821, M85.822, M85.831, M85.832, M85.841, M85.842, M85.851, M85.852, M85.861, M85.862, M85.871, M85.872, M85.88, and M85.89 to the “ICD-10 Codes that Support Medical Necessity” section of the LCD, based on an external inquiry. The effective date of this revision is for claims processed on or after 06/30/2016, for dates of service on or after 10/01/15.
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- Revisions Due To ICD-10-CM Code Changes
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04/11/2016
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R3
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Revision Number: 2 Publication: March 2016 Connection LCR A/B 2016-045
Explanation of revision: This LCD was revised based upon data analysis displaying a high risk of improper claim payment. Utilization language was included in the “Utilization Guidelines” section of the LCD. The effective date of this revision is based on date of service.
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- Provider Education/Guidance
- Public Education/Guidance
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10/01/2015
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R2
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Revision Number: 1 Publication: January 2016 Connection LCR A/B 2015-038
Explanation of revision: This LCD was revised to include ICD-10 codes M89.9 and M94.9 in the “ICD-10 Codes that Support Medical Necessity” section of the LCD. The effective date of this revision is for claims processed on or after 12/28/15, for dates of service on or after 10/01/15.
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- Revisions Due To ICD-10-CM Code Changes
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10/01/2015
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R1
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The language and/or ICD-10-CM diagnoses were updated to be consistent with the current ICD-9-CM LCD’s language and coding.
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- Provider Education/Guidance
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