Medicare Coverage Updates May and June 2012

on Thursday, 05 July 2012. All News Items | Medicare Coverage

Medicare Coverage Facts

National Coverage Determination (NCD) – NCDs describe whether specific medical items, services, treatment procedures, or technologies can be paid for under Medicare. National coverage determinations (NCDs) are made through an evidence-based process, with opportunities for public participation.

Local Coverage Determination (LCD) - An LCD is a decision by a Medicare Administrative Contractor (MAC) whether to cover a particular service on a MAC-wide basis in accordance with Section 1862(a)(1)(A) of the Social Security Act (i.e., a determination as to whether the service is reasonable and necessary).

Service

MAC

Type

Policy #

Change

Comments

Effective

Extracorporeal Photopheresis

N/A

NCD

110.4

new

MLN Matters Article MM7806

4/31/12

Radiology: Magnetic Resonance Imaging of the Spine

Cahaba

LCD

L30052

retired

 

5/31/2012

Medicine: Noninvasive Peripheral Arterial and Venous Studies

Cahaba

LCD

DL30040

new

draft finalized

notice period: 6/15/12 – 7/31/12

8/1/2012

Transportation Services: Ambulance

Cahaba

LCD

DL30022

new

draft finalized

notice period: 6/15/12 – 7/31/12

8/1/2012

Medicine: Repetitive Transcranial Magnetic Stimulation (rTMS) for Treatment of Resistant Depression

Cahaba

LCD

DL32834

draft

comment period: 7/27/12– 9/10/12

 

Radiology: PET for Myocardial Perfusion Imaging (MPI) and Myocardial Viability (MV)

Cahaba

LCD

DL32838

draft

comment period: 7/27/12– 9/10/12

 

 

Surgery: Interventional Renal Denervation (IRD) for Resistant Hypertension

Cahaba

LCD

DL32836

draft

comment period: 7/27/12– 9/10/12

 

Surgery: IRF Admission after Single Joint Replacement with CMGs A801-A806

Cahaba

LCD

DL32816

draft

comment period: 7/27/12– 9/10/12

 

Surgery: Transoral Incisionless Fundoplication (TIF)

Cahaba

LCD

DL32826

draft

comment period: 7/27/12– 9/10/12

 

 

Polices and articles can be viewed on the Medicare Coverage Database by entering the policy number in the Document ID search.

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