NHIC

National Heritage Insurance Company revised the Local Medical Review Policy pertinent to Cytogenetic Studies.

The CPT codes are:

88230, 88233, 88235, 88237, 88239, 88240, 88241, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88267, 88269, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, 88291 and 88299.

This change is effective 10/01/2003 and expands the truncated code 752.8 to 752.89

Reference:  Policy # 03-02.3R1

Empire Medicare Services (New York)

Revised Local Medical Review Policies

URINALYSIS:

CPTs: 81000, 81001, 81002, 81003, 81005, 81007 and 81015

Effective for dates of service on or after 10/01/2003, the following ICD-9-CM codes were added: 277.89, 600.00-600.01, 600.10-600.11, 600.20-600.21, 600.90-600.91, 607.85, 785.52 and 788.63

This change is effective 10/01/2003 and expands the truncated code 752.8 to 752.89

Reference:   YPATH29r4




SERUM MAGNESIUM:

CPT: 83735

Effective for dates of service on or after 10/01/2003 the following ICD-9-CM codes were added: 255.10-255.14, 458.21 and 458.29

Reference:   YPATH#15r1




RAST TYPE TESTS:

CPTs: 86003,86005

Effective for dates of service on or after 10/01/2003 ICD code 493.82 was added.

Reference:   YPATH#11r1




IMMUNOCYTOCHEMISTRY:

CPT 88342

Effective for dates of service on or after 10/01/2003, the following ICD codes were added: 600.00, 600.01, 600.10, 600.11, 600.20, 600.21, 600.90 and 600.91

Reference:   YPATH#06r2




ERYTHROCYTE SEDIMENTATION RATE (ESR)

CPTs: 85651,85652

Effective for dates of service on or after 10/01/2003, ICD-9-CM code 289.89 was added.

Reference:   YPTH#05r1




VIRAL HEPATITIS SEROLOGY TESTS:

CPTs: 86704, 86705, 86706, 86707, 86708, 86709, 86803, 86804, 87340, 87341, 87350, 87380

• Per CMS Transmittal B-03-040, Change Request 2730, POS (49) independent clinic has been added as an eligible POS effective 10/01/2003.
• Per CMS Transmittal B-03-045, Change Request 2725, "paper claims" was added to the reasons for denial #7 of the "Reasons for Denial" section of the policy and coding guideline #2 was added to the "Coding Guidelines" section of the policy, effective 10/01/2003.

Reference:   LB013E01