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Retired Policies/Articles

The following are retired policies/articles. To access the documents listed on this page, make a note of the MCD Policy /Article #, then enter that number in the Document ID field on the CMS Medicare Coverage Database (MCD). Be sure to note the retired effective date of the retired document, as the policy/article will not appear as retired until the retired effective date. Prior to the retired effective date, the document can be accessed by selecting the link from the list of Policy/Article links on the left side of this web page.

To access a previously retired policy/article (no longer included on this page), please visit the CMS MCD Archive Search web page.

June 2016

POLICIES/ARTICLES WILL BE AVAILABLE ON THE CMS AND WPS MEDICARE WEBSITES ON 05/26/2016.

Policy/Article Title MCD Policy/Article # WPS Policy # Effective Date
Radiopharmaceutical Agents & Billing and Coding Guidelines for Radiopharmaceutical Agents L34657 RAD-026 06/01/2016
This LCD is being retired. Please see our new Coding Radiopharmaceutical Agents article (A55052).

May 2016

POLICIES/ARTICLES WILL BE AVAILABLE ON THE CMS AND WPS GHA WEBSITES ON 04/28/2016.

Policy/Article Title MCD Policy/Article # WPS Policy # Effective Date
Capsule Endoscopy and Billing and Coding Guideline for Capsule Endoscopy L34613 GI-009 05/01/2016
 
Cardiovascular Stress Testing L34598 CV-004 05/01/2016
 
CT Colonography (Virtual Colonoscopy (VC)) L34697 RAD-035 05/01/2016
 
Epidural and Transforaminal Epidural Injections and Billing and Coding guideline L34622 NEURO-007 06/15/2016
Replaced with Lumbar Epidural Injections L36521.
Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions NCP INJ-040 05/01/2016
See the CMS Internet-Only Manual (IOM) Publication 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1 - Coverage Determinations, Part 2, Section 110.21 - Erythropoiesis Agents (ESAs) in Cancer and Related Neoplastic Conditions.
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs L34590 INJ-039 05/01/2016
 
Myocardial Perfusion Imaging and Cardiac Blood Pool Studies L34625 CV-017 05/01/2016
 

April 2016

POLICIES/ARTICLES WILL BE AVAILABLE ON THE CMS AND WPS GHA WEBSITES ON 03/31/2016.

Policy/Article Title MCD Policy/Article # WPS Policy # Effective Date
Ablative Therapy L34527 GSURG-033 04/01/2016
Bone Mass Measurement and Billing and Coding Guidelines L34639 MS-004 04/01/2016
Information on Bone Mass Measurement can be found in the NCD 150.3 Bone (Mineral) Density Studies and in the CMS Internet-Only Manual (IOM):
CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 15 - Covered Medical and Other Health Services:
Section 80.5 - Bone Mass Measurements (BMMs)
Section 80.5.1 - Background
Section 80.5.2 - Authority
Section 80.5.3 - Definition
Section 80.5.4 - Conditions for Coverage
Section 80.5.5 - Frequency Standards
Section 80.5.6 - Beneficiaries Who May be Covered
Section 80.5.7 - Noncovered BMMs
Section 80.5.8 - Claims Processing
Section 80.5.9 - National Coverage Determinations (NCDs)
and
CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 13 - Radiology Services and Other Diagnostic Procedures:
Section 140 - Bone Mass Measurements (BMMs)
Section 140.1 - Payment Methodology and HCPCS Coding.
Circulating Tumor Cell Marker Assays L34531 PATH-033 04/01/2016
Coding and Billing for Injectafer® (ferric carboxymaltose injection) A54397 NA 04/01/2016
Cranial Stereotactic Radiosurgery (SRS) and Cranial Stereotactic Radiotherapy (SRT) L34656 RAD-018 04/01/2016
Denosumab (PROLIA™) and (Xgeva™): Are You Coding Correctly? A54396 NA 04/01/2016
Please refer to the article, "Drug Administration Coding."
Dysphagia L34438 PHYSMED-017 04/01/2016
Please see the following CMS Internet-Only Manuals (IOMs) for guidance:
CMS IOM, Publication 100-02, Medicare Benefit Policy Manual:
Chapter 1 - Inpatient Hospital Services Covered under Part A, Sections
110 - Inpatient Rehabilitation Facility (IRF) Services.
Chapter 6 - Hospital Services Covered under Part B, Section
20.4.1 - Diagnostic Services Defined.
Chapter 8 - Coverage of Extended Care (SNF) Services under Hospital Insurance, Sections
30 - Skilled Nursing Facility Level of Care - General and
50.3 - Physical, Therapy, Speech-Language Pathology and Occupational Therapy Furnished by the Skilled Nursing Facility or by Others Under Arrangements with the Facility and Under its Supervision.
Chapter 12- Comprehensive Outpatient Rehabilitation Facility (CORF) Coverage, Sections
10 - Comprehensive Outpatient Rehabilitation Facility (CORF) Services Provided by Medicare,
20.2 - Optional CORF Services, and
40.4 - Speech-Language Pathology Services.
Chapter 15 - Covered Medical and Other Health Services, Sections
60 - Services and Supplies
80.4-Coverage of Portable X-ray Services Not Under the Direct Supervision of a Physician,
220-Coverage of Outpatient Rehabilitation Therapy Services (Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services) Under Medical Insurance, and
230-Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology.

CMS IOM, Publication 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 3:
170.3 Speech-Language Pathology Services for the Treatment of Dysphagia.

CMS IOM, Publication 100-04, Medicare Claims Processing Manual:
Chapter 5 - Part B Outpatient Rehabilitation and CORF/OPT Services, Sections
10-Part B Outpatient Rehabilitation and Comprehensive Outpatient Rehabilitation Facility (CORF) Services-General.
40 - Special Claims Processing Rules for Institutional Outpatient Rehabilitation Claims, and
100 - Special Rules for Comprehensive Outpatient Rehabilitation Facilities (CORFs).
Chapter 7 - SNF Part B Billing, Section
10 - Billing for Medical and Other Health Services.
Chapter 12 - Physicians/Nonphysician Practitioners, Sections
20-Medicare Physicians Fee Schedule (MPFSDB).
Hemophilia Clotting Factors L34439 INJ-003 04/01/2016
Information can be found in CMS Internet-Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15 - Covered Medical and Other Health Services, Section 50.5.5 - Hemophilia Clotting Factors.

CMS IOM Publication 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 2, Section 110.3 - Anti-Inhibitor Coagulant Complex (AICC).

CMS IOM Publication 100-04, Medicare Claim Processing Manual, Chapter 17 - Drugs and Biologicals, Section 40 - Discarded Drugs and Biologicals,
Section 80.4 - Billing for Hemophilia Clotting Factors,
Section 80.4.1 - Clotting Factor Furnishing Fee, and
Section 90.2 Drugs, Biologicals, and Radiopharmaceuticals.
Home and Domiciliary Services L34643 PHYS-081 04/01/2016
Independent Diagnostic Testing Facilities (IDTF's), Billing and Enrollment Guideline and Appendix A L34763 PHYS-078 04/01/2016
Information on Independent Diagnostic Testing Facilities can be found in:
CMS Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, Chapter 35 - Independent Diagnostic Testing Facility (IDTF);
CMS Internet-Only Manual, Publication 100-08, Program Integrity Manual (PIM), Chapter 15 - Medicare Enrollment;
CMS Internet-Only Manual, Publication 100-20, One Time Notification, Transmittal 727 - Mailing To All Individual Practitioners, Medical Groups and Clinics and Independent Diagnostic Testing Facilities (IDTF) Who Are Billing or Have Billed For Advanced Diagnostic Imaging Services.

See our new article, "Independent Diagnostic Testing Facilities - Physician Supervision and Technician Requirements" (A54953).
Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma and Billing and Coding Guideline L34589 MS-007 04/01/2016
Psychiatric Inpatient Hospitalization L35223 PSYCH-022 04/01/2016
See CMS Internet-Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 2 - Inpatient Psychiatric Hospital Services, for guidance.
Psychiatric Partial Hospitalization Program (PHP) L34601 PSYCH-016 04/01/2016
See CMS Internet-Only Manual (IOM), Publication 100-02, Chapter 6, Section 70.3, for guidance.
Radiation Oncology Including Intensity Modulated Radiation Therapy (IMRT) L34652 RAD-014 04/01/2016
For information on Radiation Oncology including intensity modulated radiation therapy (IMRT) refer to CMS Internet-Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 4, Sections: 200.3 - Billing Codes for Intensity Modulated Radiation Therapy (IMRT) and Stereotactic Radiosurgery (SRS),
200.3.1 - Billing for IMRT Planning and Delivery
200.3.2 - Additional Billing Instructions for IMRT Planning
Chapter 13, Radiology Services and Other Diagnostic Procedures, Sections:
20 - Payment Conditions for Radiology Services
70 - Radiation Oncology (Therapeutic Radiology)
70.1 - Weekly Radiation Therapy Management (CPT 77419 - 77430)
70.2 - Services Bundled Into Treatment Management Codes
70.3 - Radiation Treatment Delivery (CPT 77401 - 77417)
70.4 - Clinical Brachytherapy (CPT Codes 77750 - 77799)
70.5 - Radiation Physics Services (CPT Codes 77300 - 77399)
80 - Supervision and Interpretation (S&I) Codes and Interventional Radiology
100 - Interpretation of Diagnostic Tests
Radiofrequency Treatment for Urinary Incontinence L34642 GU-021 04/01/2016
Sacroiliac Joint Injections and Billing and Coding Guidelines L34443 MS-009 04/01/2016
Selective Internal Radiation Therapy (SIRT) for Primary and Secondary Hepatic Malignancy (Yttrium-90-Microsphere Hepatic Brachytherapy) L34524 RAD-038 04/01/2016
Stereotactic Body Radiation Therapy L34647 RAD-039 04/01/2016
Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency L34523 CV-042 04/01/2016
Vitamin B 12 Injections L34444 INJ-004 04/01/2016