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Retired Policies

The following are retired policies. To access the policies listed on this page, make a note of the MCD Policy #, 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 policy, as the policy will not appear as retired until the retired effective date. Prior to the retired effective date, the policy can be accessed by selecting the Local Coverage Determinations (LCD) link from the list of Policy links on the left side of this web page.

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

June 2015

POLICIES WILL BE AVAILABLE ON THE CMS AND WPS MEDICARE WEBSITES ON 05/29/2015.

Policy Title MCD Policy # WPS Policy # Effective Date
Brachytherapy LCD 30320 RAD-036 06/01/2015
Effective 06/01/2015 this Policy and Billing & Coding Guideline is being retired. Please refer to Internet Only Manual for guidance.

CMS Pub100-04 Medicare Claims Processing Manual, Chapter 13- Radiology Services and Other Diagnostic Procedures, Sections:

    20 - Payment Conditions for Radiology Services
    70 - Radiation Oncology
    70.1 - Weekly Radiation Therapy Management
    70.2 - Services Bundled Into Treatment Management Codes
    70.3 - Radiation Treatment Delivery
    70.4 - Clinical Brachytherapy
    70.5 - Radiation Physics Services
    80 - Supervision and Interpretation (S&I) Codes and Interventional Radiology
    100 - Interpretation of Diagnostic Tests
    110.0- Special Billing Instructions


May 2015

POLICIES WILL BE AVAILABLE ON THE CMS AND WPS MEDICARE WEBSITES ON 04/30/2015.

There are no retired policies for May 2015.


April 2015

POLICIES WILL BE AVAILABLE ON THE CMS AND WPS MEDICARE WEBSITES ON 03/26/2015.

There are no new policies for April 2015.