Draft LCDs

Home Provider Part B Policies/Coverage Draft LCDs

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 education schedule for educational opportunities on a specific policy or topic.

decorative bulletList of Draft LCDs

decorative bulletComment on Draft LCDs

decorative bulletStatus of Draft LCDs


Draft LCDs

WPS Medicare draft Local Coverage Determinations (LCDs) are posted on the WPS Medicare Website as drafts for comment a minimum of 45 calendar days. At the close of the comment period, the draft LCD will be removed from this list.


Gastrointestinal
Capsule Endoscopy

GI-009

General Surgery
Treatment of Varicose Veins of the Lower Extremities

GSURG-041

Injections (Drugs)
Vitamin B 12 Injections

INJ-004

Immune Globulins

INJ-012

Bisphosphonate Drug Therapy

INJ-025

Intra-articular Injections of Hyaluronate

INJ-033

Thrombopoietic Growth factor

INJ-034

Musculoskeletal
Tendon Injections

MS-007

Trigger Points, Local Injections

MS-008

Ophthamology
Optometrist Services

OPHTH-003

Cataract Surgery and Complex Cataract Surgery

OPHTH-020

Pathology
Flow Cytometry

PATH-016

Helicobacter Pylori Testing

PATH-026

Radiology
Selective Internal Radiation Therapy (SIRT) for Primary and Secondary Hepatic Malignancy (90Y-Microsphere Hepatic Brachytherapy

RAD-038


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:
Medicare Policy Comments@wpsic.com or select this link to post a comment: Draft LCD Comment Board.


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.


Draft LCD Title

GI-009 Capsule Endoscopy

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

GSURG-041 Treatment of Varicose Veins of the Lower Extremities

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

INJ-004 Vitamin B 12 Injections

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

INJ-012 Immune Globulins

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

INJ-025 Bisphosphonate Drug Therapy

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

INJ-033 Intra-articular Injections of Hyaluronan

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

INJ-034 Thrombopoietic Growth factor

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

MS-007 Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

MS-008 Trigger Points, Local Injections

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

OPHTH-020 Cataract Surgery and Complex Cataract Surgery

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

OPHTH-003 Optometrist Services

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

PATH-016 Flow Cytometry

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

PATH-026 Helicobacter Pylori Testing

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available


Draft LCD Title

RAD-038 Selective Internal Radiation Therapy (SIRT) for Primary and Secondary Hepatic Malignancy (90Y-Microsphere Hepatic Brachytherapy)

Date of Release of Draft LCD for Comment
06/04/2009

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.bussan@wpsic.com
Dr. Kenneth Bussan
1751 W. Broadway
Madison, WI 53713

End Date for Comment Period
07/20/2009

Current Status*
C

Actual Date of Release of Final LCD
Not Yet Available

Web Link to Final LCD
Not Yet Available

Link to Final Comments
Not Yet Available

Draft LCD Title

CHIRO-001 Chiropractic Services

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
03/30/09

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

CV-016 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
03/30/09

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

DERM-008 Removal of Benign Skin Lesions

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
DERM-008

Link to Final Comments
Final Comments

Draft LCD Title

FT-001 Routine Foot Care And Debridement Of Nails

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
03/30/09

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
FT-001

Link to Final Comments
Not Yet Available

Draft LCD Title

GI-006 Diagnostic Sigmoidoscopy and Colonoscopy

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

GSURG-033 Ablative Therapy

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

INJ-019 Human Granulocyte/Macrophage Colony Stimulating Factor

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

OPHTH-015 Optical Coherence Tomography (OCT)

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
03/30/09

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

OPHTH-022 Blepharoplasty, Blepharoptosis and Brow Lift

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
03/30/09

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
OPHTH-022

Link to Final Comments
Final Comments

Draft LCD Title

RAD-014 Radiation Oncology Including Intensity Modulated Radiation Therapy (IMRT)

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
RAD-014

Link to Final Comments
Final Comments

Draft LCD Title

RAD-018 Cranial Stereotactic Radiosurgery (SRS) and Cranial Stereotactic Radiotherapy (SRT)

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
RAD-018

Link to Final Comments
Final Comments

Draft LCD Title

RAD-034 Computed Coronary Tomography Angiography

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
03/30/09

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
RAD-034

Link to Final Comments
Final Comments

Draft LCD Title

RAD-035 CT Colonography (Virtual Colonoscopy [VC])

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

RAD-036 Brachytherapy

Date of Release of Draft LCD for Comment
12/15/08

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
03/30/09

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
RAD-036

Link to Final Comments
Final Comments

Draft LCD Title

GSURG-052 Application of Bioengineered Skin Substitutes and Skin Grafting

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
06/24/09

Web Link to Final LCD
GSURG-052

Link to Final Comments
Final Comments

Draft LCD Title

MS-004 Bone Mass Measurement

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
02/01/2009

Web Link to Final LCD
MS-004

Link to Final Comments
Final Comments

Draft LCD Title

INJ-018 Botulinum Toxins

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
12/03/2008

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

CV-004 Cardiovascular Stress Testing

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
01/01/2009

Web Link to Final LCD
CV-004

Link to Final Comments
Not Yet Available

Draft LCD Title

HONC-010 Chemotherapy Drugs and Their Adjuncts

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
12/03/2008

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

RAD-033 Computerized Tomography (CAT Scans)

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Kenneth.Bussan@wpsic.com
Dr. Kenneth Bussan
WPS Medicare
1751 W Broadway
Madison, WI 53713

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
02/01/2009

Web Link to Final LCD
RAD-033

Link to Final Comments
Final Comments

Draft LCD Title

RAD-024 Magnetic Resonance Imaging

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
02/01/2009

Web Link to Final LCD
RAD-024

Link to Final Comments
Final Comments

Draft LCD Title

CV-033 Noninvasive Vascular Testing

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

CV-037 Percutaneous Coronary Interventions

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
01/01/2009

Web Link to Final LCD
CV-037

Link to Final Comments
Not Yet Available

Draft LCD Title

GSURG-043 Posterior tibial nerve stimulation (PTNS)

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
01/01/2009

Web Link to Final LCD
GSURG-043

Link to Final Comments
Final Comments

Draft LCD Title

PHYSMED-009 Physical Medicine and Rehabilitation

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

Draft LCD Title

CV-007 Transesophageal Echocardiography (includes Intraoperative TEE)

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
02/01/2009

Web Link to Final LCD
CV-007

Link to Final Comments
Final Comments

Draft LCD Title

CV-026 Transthoracic Echocardiography (TTE)

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
F

Actual Date of Release of Final LCD
02/01/2009

Web Link to Final LCD
CV-026

Link to Final Comments
Final Comments

Draft LCD Title

GSURG-051 Wound Care

Date of Release of Draft LCD for Comment
08/06/2008

Comments should be sent via e-mail/or written and sent to the following address
Stephen.Boren@wpsic.com
Dr. Stephen Boren
WPS Medicare
111 E. Wacker
Chicago, IL 60601

End Date for Comment Period
12/03/2008

Current Status*
E

Actual Date of Release of Final LCD

Web Link to Final LCD

Link to Final Comments
Not Yet Available

NOTE: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the files unless you read, agree to, and abide by the provisions of the copyright statement. Read the copyright statement now and you will be linked back to here.

Page Last Updated: Wednesday, 24-Jun-2009 16:50:28 CDT