BILLING NEWS

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

The changes that are effective for dates of service on and after October 1, 2010 are as follows:

For Bacterial Urine Cultures:

  • Add ICD-9-CM code 780.66 to the list of ICD-9-CM codes that are covered by Medicare for the Urine Culture, Bacterial (190.12) NCD.

For Human Immunodeficiency Virus (HIV) Testing (Diagnosis):

  • Add ICD-9-CM codes 780.66, 786.30, 786.31, and 786.39 to the list of ICD-9-CM codes that are covered by Medicare for the Human Immunodeficiency Virus (HIV) Testing (Diagnosis) (190.14) NCD.
  • Delete ICD-9-CM code 786.3 from the list of covered ICD-9-CM codes for the Human Immunodeficiency Virus (HIV) Testing (Diagnosis) (190.14) NCD.

For Blood Counts:

  • Add ICD-9-CM codes 832.2, V11.4, V25.11, V25.12, V25.13, V49.86, and V62.85 to the list of “Do Not Support Medical Necessity” ICD-9-CM codes that are covered by Medicare for the Blood Counts (190.15) NCD.
  • Delete ICD-9-CM code V25.1 from the list of covered “Do Not Support Medical Necessity” ICD-9-CM codes for the Blood Counts (190.15) NCD.

For Partial Thromboplastin Time (PTT):

  • Add ICD-9-CM codes 275.01, 275.02, 275.03, 275.09, 287.41, 287.49, 786.30, 786.31, and 786.39 to the list of ICD-9-CM codes covered by Medicare for the Partial Thromboplastin Time (PTT) (190.16) NCD.
  • Delete ICD-9-CM codes 275.0, 287.4, and 786.3 from the list of covered ICD-9-CM codes for the PTT (190.16) NCD.

For Prothrombin Time:

  • Add ICD-9-CM codes 275.01, 275.02, 275.03, 275.09, 287.41, 287.49, 786.30, 786.31, 786.39, 999.80, 999.83, 999.84, and 999.85 to the list of ICD-9-CM codes covered by Medicare for the Prothrombin Time (190.17) NCD.
  • Delete ICD-9-CM codes 275.0, 287.4, and 786.3 from the list of covered ICD-9-CM codes covered for the Prothrombin Time (190.17) NCD.
  • Correct a typographical error by replacing ICD-9-CM code 531.21 with ICD-9-CM code 534.21 within the code range 534.20-531.21 for the Prothrombin Time (190.17) NCD.

For Serum Iron Studies:

  • Add ICD-9-CM codes 237.73, 237.79, 275.01, 275.02, 275.03, 275.09, 287.41, 287.49, 999.80, 999.83, 999.84, and 999.85 to the list of ICD-9-CM codes covered by Medicare for the Serum Iron Studies (190.18) NCD.
  • Delete ICD-9-CM codes 275.0 and 287.4 from the list of covered ICD-9-CM codes for the Serum Iron Studies (190.18) NCD.

For Blood Glucose Testing:

  • Add ICD-9-CM codes 275.01, 275.02, 275.03, 275.09, 276.61, 276.69, 780.33, 787.60, 787.61, 787.62, and 787.63 to the list of ICD-9-CM codes covered by Medicare for the Blood Glucose Testing (190.20) NCD.
  • Delete ICD-9-CM codes 275.0, 276.6, and 787.6 from the list of covered ICD-9-CM codes for the Blood Glucose Testing (190.20) NCD.

For Glycated Hemoglobin/Glycated Protein:

  • Add ICD-9-CM codes 275.01, 275.02, 275.03, and 275.09 to the list of ICD-9-CM codes covered by Medicare for the Glycated Hemoglobin/Glycated Protein (190.21) NCD.
  • Delete ICD-9-CM code 275.0 from the list of covered ICD-9-CM codes for the Glycated Hemoglobin/Glycated Protein (190.21) NCD.

For Lipids Testing:

  • Add ICD-9-CM code 278.03 to the list of ICD-9-CM codes covered by Medicare for the Lipids Testing (190.23) NCD.

For Digoxin Therapeutic Drug Assay:

  • Add ICD-9-CM codes 276.61 and 276.69 to the list of ICD-9-CM codes covered by Medicare for the Digoxin Therapeutic Drug Assay(190.24) NCD.
  • Delete ICD-9-CM code 276.6 from the list of covered ICD-9-CM codes for the Digoxin Therapeutic Drug Assay (190.24) NCD.

For Alpha-fetoprotein:

  • Add ICD-9-CM codes 275.01, 275.02, 275.03, and 275.09 to the list of ICD-9-CM codes covered by Medicare for the Alpha-fetoprotein (190.25) NCD.
  • Delete ICD-9-CM code 275.0 from the list of covered ICD-9-CM codes for the Alpha-fetoprotein (190.25) NCD.

For Gamma Glutamyl Transferase:

  • Add ICD-9-CM codes 273.73, 237.79, 275.01, 275.02, 275.03, 275.09, 560.32, 780.66, 970.81, and 970.89 to the list of ICD-9-CM codes covered by Medicare for the Gamma Glutamyl Transferase (190.32) NCD.
  • Delete ICD-9-CM codes 275.0 and 970.8 from the list of covered ICD-9-CM codes for the Gamma Glutamyl Transferase (190.32) NCD.

For Hepatitis Panel/Acute Hepatitis Panel:

  • Add ICD-9-CM code 780.33 to the list of ICD-9-CM codes covered by Medicare for the Hepatitis Panel/Acute Hepatitis Panel (190.33) NCD.

For Fecal Occult Blood Test:

  • Add ICD-9-CM codes 287.41, 287.49, and 560.32 to the list of ICD-9-CM codes covered by Medicare for the Fecal Occult Blood Test (190.34) NCD.
  • Delete ICD-9-CM code 287.4 from the list of covered ICD-9-CM codes for the Fecal Occult Blood Test (190.34) NCD.

SOURCE: Source:
INDUSTRY NEWS TAGS: CMS


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