September Updates to Cahaba LCDs

on Thursday, 10 September 2009. All News Items

Cahaba GBA has updated several LCDs effective October 1, 2009.  Please see the information below from Cahaba.  You can access all the Cahaba LCDs and articles at Cahaba LCDs and Articles.

LCD – J10 MAC A – Drugs and Biologicals:  Oxaliplatin (Eloxatin™) (L29999)

Effective October 1, 2009 the Local Coverage Determination (LCD) for Drugs and Biologicals:  Oxaliplatin (Eloxatin™) (L29999) has been revised.  Please review the following LCD update:

The “Indications and Limitations” section has been updated to include coverage for the following OFF LABEL indications:

  • Ovarian Cancer
  • Testicular Cancer

The following ICD-9 codes have been added:
183.0
183.2-183.5
183.8
183.9
186.0
186.9


LCD – J10 MAC A – Drugs and Biologicals:  Bevacizumab (AVASTIN)

Effective October 1, 2009, The Centers for Medicare and Medicaid Services (CMS) announced the addition of HCPCS Code Q2024 {Injection, Bevacizumab, 0.25 mg} to Drugs and Biologicals.  In response to this change, the Local Coverage Determination (LCD) for Drugs and Biologicals:  Bevacizumab (AVASTIN) has been revised. 


LCD – J10 MAC A – Drugs and Biologicals:  Gemcitabine Hydrochloride (Gemzar ®) (L29995)

Effective October 1, 2009 the Local Coverage Determination (LCD) for Drugs and Biologicals:  Gemcitabine Hydrochloride (Gemzar ®)(L29995) has been revised.  Please review the following LCD update:

The “Indications and Limitations” section has been revised to reflect coverage for the following indications:

  • Uterine neoplasms – Uterine sarcoma
  • Head and neck cancers – Cancer of the nasopharynx

The following ICD-9 codes have been added:
149.0
149.1
149.9
180.0
182.0
182.1
182.8


LCD – J10 MAC A – Drugs and Biologicals:  Erythropoietin Analogues (L30069)

Effective October 1, 2009, the following indications and ICD-9 codes will be added to the LCD Drugs and Biologicals: Erythropoietin Analogues for J0881 and J0885:

  • Rheumatoid Arthritis 714.0 - 714.4
  • Ulcerative Colitis 556.0 - 556.9
  • Regional Enteritis 555.0 - 555.9
  • Systemic Lupus Erythematous 710.0

LCDs – J10 MAC A – Annual Update for 2009-2010 ICD-9-CM

The LCD revisions listed below are based on the 2009-2010 ICD-9-CM coding update. Revisions apply to Alabama (AL, 10101), Georgia (GA, 10201) and Tennessee (TN, 10301) Part A providers who submit claims to Cahaba GBA.

Effective October 1, 2009, these revised LCDs may be accessed at https://www.cahabagba.com/part_a/policies_medical_review/lcd_active.htm

2009-2010 ICD-9 CM Codes

LCDs

Invalid

Replaced With

ADD

Drugs and Biologicals:  Erythropoietin Analogues (L30069) For J0881, J0885:  285.3
Drugs and Biologicals: Immune Globulin Intravenous (IVIg)  (L29996) For J1459, J1561, J1566, J1568, J1569, J1572:  279.41, 279.49
Drugs and Biologicals: Pamidronate Disodium (Aredia ®)  (L30001) For hypercalcemia of malignancy (with ICD-9 code 275.42):  209.31-209.36, 209.70-209.75, 209.79
Drugs and Biologicals: Zoledronic Acid  (L30003) For J3487:  209.31-209.36, 209.70-209.75, 209.79
Medicine: Speech Language Pathology – Outpatient  (L30010) 784.5 784.51, 784.59 438.13, 438.14, 784.42-784.44
Radiology: Computed Tomography of the Abdomen and Pelvis  (L30015) 209.31-209.36, 209.70-209.75, 209.79, 453.77, 453.87, 569.71, 569.79, 569.87, 670.10, 670.12, 670.14, 670.20, 670.22, 670.24, 670.30, 670.32, 670.34, 670.80, 670.82, 670.84, 787.04, 789.7
Radiology: Computed Tomography of the Head or Brain  (L30016) 348.8, 768.7, 784.5 348.81, 348.89, 768.70-768.73, 784.51, 784.59 209.31, 209.32, 209.75, 239.81, 438.13, 438.14, 784.42-784.44
Radiology: Computed Tomography of the Thorax  (L30017) 209.31-209.36, 209.70-209.75, 209.79, 416.2, 453.77, 453.87, 793.82
Radiology: Magnetic Resonance Imaging of the Brain  (L30018) 348.8 348.81, 348.89 209.31, 209.32, 209.75, 239.81, 438.13, 438.14, 784.42-784.44, 784.51, 784.59
Radiology: Magnetic Resonance Imaging of the Spine  (L30019) 209.31-209.36, 209.70-209.75, 209.79
Surgery: Colonoscopy (Diagnostic)      
(L30020)
569.71, 569.79, 569.87, 789.7
Surgery: Upper Gastrointestinal Endoscopy   (L30021) 209.70, 209.72, 209.74, 209.79, 787.04, 789.7

     

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