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 the Listserv to receive the most current policy changes. Please check the Live Training schedule 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
Status of Draft LCDs
*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 | |||
| J5 MAC and Legacy A (FI) policy only | 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 12:05:49 CDT
