Retired Policies
The following are retired policies. Please access these policies in the CMS Medicare Coverage Database (MCD) 
. Be sure to note the effective date of the retired policy, as the policy will not appear as retired until the effective date. Prior to the effective date, the policy can be found by selecting the link "Display Future Effective Documents" within the CMS Medicare Coverage Database (MCD) .
To access previous retired policy updates, please visit the CMS Medicare Coverage Database (MCD) .
March 2010
POLICIES WILL BE AVAILABLE ON THE CMS WEBSITE 02/25/10 AND ON THE WPS MEDICARE WEBSITE 02/26/10.
| Policy Title | MCD Policy # | WPS Policy # | Effective Date |
| Allergy Testing and Allergy Immunotherapy | L19671, L19674, L19685, L19686 | ALRG-001 | 02/16/2010 |
| The policy listed above was replaced with policy Allergy Testing and Allergy Immunotherapy L30471 on 02/16/2010. | |||
| Coverage of Services and Procedures in Nursing Facilities | WI: L8338 IL: L10884 MI: L11061 MN: L13586 |
PHYS-068 | 03/01/2010 |
| This LCD for Legacy B states is retired effective 031/01/2010. There is no replacement LCD. | |||
| T-Wave Alternans Testing | WI L7016 IL L17816 MI L17817 MN L17818 |
CV-036 | 03/01/2010 |
| This LCD and its companion Coding and Billing document are retired 03/01/2010. There is no replacement policy. An NCD on this topic is available and can be found in CMS publication 100-3, Part 1, 20.3. | |||
| Verteporfin (Visudyne TM) and Ocular Photodynamic Therapy (OPT) | NA | OPHTH-023 | 03/01/2010 |
| 03/01/2010. The WPS Medicare maintained NCD for Legacy B States is retired effective 03/01/2010. Readers are referred to the CMS on-line manual 100-3, 80.2. All instructions found in the CMS NCD for this topic remain in effect. The WPS Medicare maintained companion Coding and Billing Guidelines for NCD OPHTH-023 for Legacy B States is retired effective 03/01/2010. Readers are referred to the CMS on-line manual 100-3, 80.2. All instructions found in the CMS NCD for this topic remain in effect. | |||
February 2010
POLICIES WILL BE AVAILABLE ON THE CMS WEBSITE 01/28/10 AND ON THE WPS MEDICARE WEBSITE 01/29/10.
| Policy Title | MCD Policy # | WPS Policy # | Effective Date |
| Corneal Pachymetry | WI; L13993, IL; L13578, MI; L13579, MN; L13580 |
OPHTH-025 | 03/17/2010 |
| This LCD is retired effective 03/17/2010, and replaced by LCD L 30485, also entitled Corneal Pachymetry | |||
| Cytogenetic Studies | L20728 L20735 L20736 L20737 |
PATH-527 | 03/18/2010 |
| Gonadotropin-Releasing Hormone Analogs | WI; L22464, IL; L22464, MI; L22466, MN; L22467 |
INJ-039 | 03/17/2010 |
| This LCD is retired and replaced by L30479 entitled Luteinizing Hormone-Releasing Hormone (LHRH) Analogs | |||
| Health and Behavior Assessment Intervention | L21749 L21751 L21753 L21755 |
PSYCH-015 | 03/18/2010 |
| Psychiatry and Psychological Services | L20828 | PSYCH-014 | 03/18/2010 |
January 2010
| Policy Title | MCD Policy # | WPS Policy # | Effective Date |
| Ambulance Services | NA | AMB-001 | 02/01/2010 |
| WPS Medicare is retiring the AMB-001 01/31/10. Please refer to the Ambulance Guide for all carrier guidance | |||
| Cardiac Rehabilitation Programs | NA | CV-012 | 01/01/2010 |
| This NCD and the Billing and Coding Instructions for CV-012 Cardiac Rehabilitation are being retired. Information on Cardiac rehabilitation services can be found in the Medicare National Coverage Determinations (NCD) Manual, Publication 100-03, Chapter 1, Part 1, Section 20.10. |
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Page Last Updated: Thursday, 18-Mar-2010 05:57:16 CDT
