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Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2010

For Serum Iron Studies:

Delete ICD-9-CM codes 453.50-453.52 from the list of ICD-9-CM codes that are covered by Medicare for the Serum Iron Studies (190.18) NCD.

For Gamma Glutamyl Transferase:

Add ICD-9-CM codes 453.50-453.52 to the list of ICD-9-CM codes that are covered by Medicare for the Gamma Glutamyl Transferase (190.32) NCD.

NOTE: Effective dates for the following codes were inadvertently changed to July 1, 2009, with the July 1, 2009 quarterly release. The correct actual effective dates were October 1, 2007 and those dates will be reinstated with the January 2010 release of Medicare’s edit module.

This article announces the changes that will be included in the January 2010 release of the edit module for clinical diagnostic laboratory National Coverage Determinations (NCDs).

For Prothrombin Time (PT):

Revise the effective date from July 1, 2009, to October 1, 2007 for ICD-9-CM codes 200.30, 200.31, 200.32, 200.33, 200.34, 200.35, 200.36, 200.37, 200.38, 200.40, 200.41, 200.42, 200.43, 200.44, 200.45, 200.46, 200.47, 200.48, 200.50, 200.51, 200.52, 200.53, 200.54, 200.55, 200.56, 200.57, 200.58, 200.60, 200.61, 200.62, 200.63, 200.64, 200.65, 200.66, 200.67, 200.68, 200.70, 200.71, 200.72, 200.73, 200.74, 200.75, 200.76, 200.77, 200.78, 202.70, 202.71, 202.72, 202.73, 202.74, 202.75, 202.76, 202.77, and 202.78 that are listed for the Prothrombin Time (PT) (190.17) NCD.

For Serum Iron Studies:

Revise the effective date from July 1, 2009, to October 1, 2007 for ICD-9-CM codes 200.30, 200.31, 200.32, 200.33, 200.34, 200.35, 200.36, 200.37, 200.38, 200.40, 200.41, 200.42, 200.43, 200.44, 200.45, 200.46, 200.47, 200.48, 200.50, 200.51, 200.52, 200.53, 200.54, 200.55, 200.56, 200.57, 200.58, 200.60, 200.61, 200.62, 200.63, 200.64, 200.65, 200.66, 200.67, 200.68, 200.70, 200.71, 200.72, 200.73, 200.74, 200.75, 200.76, 200.77, 200.78, 202.70, 202.71, 202.72, 202.73, 202.74, 202.75, 202.76, 202.77, and 202.78 that are listed for the Serum Iron Studies (190.18) NCD.

For Gamma Glutamyl Transferase:

Revise the effective date from July 1, 2009, to October 1, 2007 for ICD-9-CM codes 200.30, 200.31, 200.32, 200.33, 200.34, 200.35, 200.36, 200.37, 200.38, 200.40, 200.41, 200.42, 200.43, 200.44, 200.45, 200.46, 200.47, 200.48, 200.50, 200.51, 200.52, 200.53, 200.54, 200.55, 200.56, 200.57, 200.58, 200.60, 200.61, 200.62, 200.63, 200.64, 200.65, 200.66, 200.67, 200.68, 200.70, 200.71, 200.72, 200.73, 200.74, 200.75, 200.76, 200.77, 200.78, 202.70, 202.71, 202.72, 202.73, 202.74, 202.75, 202.76, 202.77, and 202.78 that are listed for the Gamma Glutamyl Transferase (190.32) NCD.

Note that Medicare contractors will adjust claims affected by the above three categories if you bring such claims to their attention.


SOURCE: Source
INDUSTRY NEWS TAGS: CMS


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