Draft Policies

CMS and WPS Medicare develop policies to help ensure proper Medicare payments. Providers use the policies to verify coverage of a procedure or service.

WPS Medicare has a staff of physicians and registered nurses responsible for developing, monitoring, and updating policies. The policy staff is dedicated to helping Medicare beneficiaries as well as providing Medicare providers medical necessity reimbursement guidance.

The policy staff works closely with Provider Outreach and Education (POE) to ensure timely and accurate policy education is provided. Sign up for our eNews to receive the most current policy changes. Also, please check our Training Schedule section for educational opportunities on a specific policy or topic.

Comment on the Draft LCDs

Your input is important to Local Coverage Determination (LCD) development. To comment electronically on the policies listed above, please send an email to the following address:

policycomments@wpsic.com.

The official Local Coverage Determination (LCD) is the version on the Medicare Coverage Database at http://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx(external link)

J5 MAC Draft LCD Status

*Current Status Indicators are as follows:
D = draft under development; not yet released for comment
C = draft LCD released for comment
E = formal comment period has ended; comments now being considered
F = final LCD has been issued (this is not the local coverage determination effective date)
A = active policy; notice period complete and the policy is in effect

Actual date of release of the final LCD is the date the policy is published in our newsletter/website.

The effective date is 45 days after the release/publication of the final LCD.

Title
Acute Inpatient Services versus Observation (Outpatient) Services (HOSP-001)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32222 10/06/11

Dr. Olatokunbo Awodele
WPS Medicare
3333 Farnam Street
Omaha, NE. 68131
11/20/11 A 02/01/12
Final LCD Final Comments
L32222 Final CommentsAdobe Portable Document Format
Title
Category III Codes (PHYS-082)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32569 06/07/12

Dr. Olatokunbo Awodele
WPS Medicare
3333 Farnam Street
Omaha, NE. 68131
07/22/12 D Not Yet Available
Final LCD Final Comments
Not Yet Available Not Yet Available
Title
Circulating Tumor Cell Marker Assays (PATH-033)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32218 10/06/11

Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713
11/20/11 A 01/01/12
Final LCD Final Comments
L32218 Final CommentsAdobe Portable Document Format
Title
Dialysis Shunt Maintenance (CV-027)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32009 06/17/11

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
08/01/11 A 12/01/11
Final LCD Final Comments
L32009 Final CommentsAdobe Portable Document Format
Title
Drugs and Biologics (Non-chemotherapy) (INJ-041)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32013 06/17/11

Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713
08/01/11 A 10/01/11
Final LCD Final Comments
L32013 Final CommentsAdobe Portable Document Format
Title
Dysphasia/Swallowing Therapy (PHYSMED-015)Adobe Portable Format Document
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL30717 02/19/10

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
04/05/10 E Not Yet Available
Final LCD Final Comments
Not Yet Available Not Yet Available
Title
Hyperbaric Oxygen (HBO) Therapy (PHYS-056)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL31357 10/07/10

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
11/21/10 E NA
Final LCD Final Comments
Not Yet Available Not Yet Available
Title
Low Vision Services (OPHTH-026)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32007 06/17/11

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
08/01/11 A 01/01/12
Final LCD Final Comments
L32007 Final CommentsAdobe Portable Document Format
Title
Nerve Blocks for Peripheral Neuropathy (NEURO-011)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32565 06/07/12

Dr. Cheryl Ray
WPS Medicare
1717 W. Broadway
Madison, WI 53701-1787
07/22/12 D Not Yet Available
Final LCD Final Comments
Not Yet Available Not Yet Available
Title
Proton Beam Therapy (RAD-040)Adobe Portable Format Document
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL31617 02/10/11

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
03/27/11 A 02/01/12
Final LCD Final Comments
L31617 Final CommentsAdobe Portable Document Format
Title
Psychological and Neuropsychological Testing (PSYCH-017)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL31990 06/17/11

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
08/01/11 A 04/01/12
Final LCD Final Comments
L31990 Final CommentsAdobe Portable Document Format
Title
Qualitative Drug Testing (PATH-035)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32450 02/02/12

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
03/14/12 D NA
Final LCD Final Comments
Not Yet Available Not Yet Available
Title
Transcranial Magnetic Stimulation (TMS) (NEURO-010)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32220 10/06/11

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
11/20/11 A 03/01/12
Final LCD Final Comments
L32220 Final CommentsAdobe Portable Document Format
Title
Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency (CV-042)
CMS ID# Date of Release for Comment Comment Period End Date Current Status* Release to Final Date
DL32452 02/02/12

Dr. Stephen Boren
WPS Medicare
111 E. Wacker Ste 950
Chicago, IL 60601
03/14/12 F 05/01/12
Final LCD Final Comments
L32452 Final CommentsAdobe Portable Document Format

Page Last Updated: Wednesday, 16-May-2012 12:04:05 CDT