Notification of Medical Policy Revisions for September 2023
| Medical Policy | Revision |
|---|---|
| Clinical Trial Services (PDF) | I. Annual Review: NCD 310.1 Medicare Managed Care Manual Chp 4 section 10.7 and 10.7.1 Medicare Benefit Policy Manual Chp 14 section 20 Medicare Claims Processing Manual Chp 32 section 68 & 69 Blue Medicare “Evidence of Coverage” (EOC) Chp 3 section 5 Department of Health and Human Services; CMS; Medicare Learning Network; “Items and Services That Are Not Covered Under the Medicare Program” “Medicare and Clinical Research Studies” CMS publication US Food and Drug Administration (FDA); Medical Devices II. No CMS Updates; Minor Revisions only. Additional references added |
| Immunoglobulin Therapy (IV & SC) in the Home (PDF) | I. Annual Review: LCD L33610 LCD L34580 LCD L33794 LCA A52509 LCA A56718 Medicare Claims Processing Manual Chp 17 section 80.6 Medicare Benefit Manual Chp 15 section 50.6 Medicare Prescription Drug Benefit Manual Chp 6 section 10.2 CGS: Celerian Group Company News and Publication: Cuvitru-Correct Coding II. No CMS Updates. Verbiage added to reflect LCDs/LCAs. Coding Update: Added J1576 and J1558 per LCD. Added additional ICD 10 diagnosis codes under indications for coverage. Added additional LCD and LCAs to the reference section. |
| Lung Volume Reduction Surgery (PDF) | I. Annual Review NCD 240.1 II. No CMS Updates. Verbiage added to reflect NCD |
| Observation Services (PDF) | I. Annual Review LCD L34552 Medicare Benefit Policy Manual Chp 6 section 20.6 II. No CMS Updates. Verbiage added to reflect LCD. Codes added. |
| Upper Limb Prosthetics (PDF) | I. Annual Review BCBSNC Corporate Medical Policy: Myoelectric Prosthetic Components for the Upper Limb Medicare Benefit Policy Manual Chp 15 section 110, 120 & 130 II. Annual Review. No CMS Updates. Additional reference added. Four (4) CPT codes added |
| Varicose Vein Treatment (PDF) | I. Annual Review LCD L39121 LCA A58876 LCD L34536 LCA A56914 BCBSNC Corporate Medical Policy: Varicose Veins of the Lower Extremities, Treatment for II. No CMS Updates. Verbiage added to reflect NCD. Additional references added |
| Ventricular Assist Device (PDF) | I. Annual Review NCD 20.9.1 Medicare NCA Tracking Sheet for Assist Devices as Destination Therapy CAG-00119N Decision Memo for VAD for Bridge to Heart Transplant CAG-00432R LCA A53986 Decision Memo for Artificial Hearts and related Devices, Including VAD for Bridge to Transplant and Destination Therapy CAG-00453N NYHA Functional Classification and Outcomes After Transcatheter Mitral Valve Repair in Heart Failure II. No CMS Updates. Verbiage added to reflect NCD |
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