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Part A Local Medical Review Policy |
8/9/2004 |
The following Part A Medical Policies have been revised: CARDIAC REHABILITATION, ARA-03-002 - This policy has been reformatted from a LMRP (Local Medical Review Policy) to a new LCD (Local Coverage Determination) format. Moved the previous Description to the beginning of the Indications and Limitations section. Moved #2 from the previous Coding Guidelines section to the end of the Diagnostic Testing section in Indications and Limitations. Moved #3 from the previous Coding Guidelines section to the 2nd paragraph of the Frequency Guidelines section of Indications and Limitations. Deleted #1 from the previous Coding Guidelines section, and added Type of Bill 12X, 13X, 18X, 85X effective with original date of LCD. CRITICAL CARE, ARA-01-007 -
This policy has been retired from Medicare Part A effective July 31, 2004. HYPERBARIC OXYGEN THERAPY, ARA-01-012 - This policy has been reformatted from a LMRP (Local Medical Review Policy) to a new LCD (Local Coverage Determination) format. The previous Description has been moved to the beginning of the Indications and Limitations section. Moved numbers 2 and 4 from the previous Reasons for Denial to the end of the first paragraph in Indications and Limitations and to #16 in Indications and Limitations, respectively. Type of Bill 22X has been deleted, and number 8 was added to the Sources section. TRANSTHORACIC ECHOCARDIOGRAPHY (TTE), ARA-02-014 - This policy has been reformatted from a LMRP (Local Medical Review Policy) to a new LCD (Local Coverage Determination) format. The policy was revised to allow ICD-9-CM code V58.1 to allow for pre-chemotherapy assessment as outlined in Indication and Limitation #4. Revenue Code 0621 was added. |
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Part A Local Medical Review Policy |
8/2/2004 |
The following Part A Medical Policy has been revised: LEUPROLIDE ACETATE/GOSERELIN (GONADOTROPIN RELEASING HORMONE ANALOGS), ARA-01-019 - The latest revision of policy ARA-01-019 contained an incorrect effective date. The effective date for New Mexico's least costly alternative (LCA) provision was incorrectly listed as October 1, 2001 and has been changed to the correct date of September 30, 2001. The September 30, 2001 date coincides with the Revision Effective Date specified in the local policy titled "Leuprolide Acetate & Goserelin Acetate or Leuprolide Acetate Implant (Viadur), #96-030" that was in effect in 2001. |
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Part A Local Medical Review Policy |
7/15/2004 |
The following Part A Medical Policy has been revised: LEUPROLIDE ACETATE/GOSERELIN (GONADOTROPIN RELEASING HORMONE ANALOGS), ARA-01-019 - A typographical error was corrected on CPT code 11981 in the HCPCS section. When the policy converted to LCD, the "*" designating 11981 to be used only for the insertion, removal or removal with reinsertion of the Viadur implant was inadvertently omitted on CPT code 11981. This has been corrected. |
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Part A Local Medical Review Policy |
7/12/2004 |
The following Part A Medical Policies have been revised: AICD ARA-02-001, Flow Cytoemtry ARA-02-022, Insertable Loop Recorder ARA-99-529, Leuprolide Acetate/Goserelin (Gonadotropin Releasing Hormone Analogs) ARA-01-019, Non-Invasive Vascular Studies ARA-02-055, EPO For Treatment Of Anemia Associated With Chronic Renal Failure ARA-02-048, Partial Hospitalization Program (PHP) ARA-04-900. |
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July 2004 Part A Policy Notice Newsletter |
6/27/2004 |
Part A Policy Notice Newsletter |
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Part A Local Medical Review Policy |
5/18/2004 |
The following Part A Medical Policies have been revised: Ambulatory Blood Pressure Monitoring, Debridement Of Toenails, Low Osmolar Contrast Media (Locm), Epo For Treatment Of Anemia Associated With Chronic Renal Failure, Physical Medicine And Rehabilitation |
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Part A Local Medical Review Policy |
4/5/2004 |
Effective April 1, 2004 this policy has been retired: Electrogastrography. |
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Part A Local Medical Review Policy |
4/5/2004 |
The following Part A Medical Policies have been revised: Pulmonary Function Testing, Sandostatin® Depot (Octreotide Acetate for Injectable Suspension), Immune Globulin Intravenous
Colonoscopy Diagnostic Therapeutic and Screening. |
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Part A Local Medical Review Policy |
3/2/2004 |
The following Part A Medical Policies have been revised: AICD (Automatic Implantable Cardiac Defibrillator), Bilaminate Skin Substitutes, Debridement Of Toenails, Ibritumomab Tiuxetan (Zevalin), Local Injections For Trigger Points, Magnetic Resonance Angiography (MRA), Noninvasive Vascular Studies, Physical Medicine And Rehabilitation. |
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Part A Local Medical Review Policy |
3/2/2004 |
Effective March 1, 2004, the following Medicare Part A policies have been retired: Diabetes Outpatient Self-Management Services, Left Heart Catheterization, Suprascapular Nerve Injection, Aphasia
General Health Panel, and Speech-Language Pathology |
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Part A Local Medical Review Policy |
1/30/2004 |
The following Part A Medical Policy has been updated: EPO FOR TREATMENT OF ANEMIA ASSOCIATED WITH CHRONIC RENAL FAILURE - Effective with dates of service on or after January 1, 2004, HCPCS code Q4055 has been added to replace Q9920-Q9940 for ESRD patients on dialysis. Added HCPCS code Q0136 for ESRD patients not on dialysis. In the "Coding Guidelines", numbers 1.g, 2.b and the Special Note have been updated to reflect these changes. Number 8 in the "Coding Guidelines" was added. Number 7 was added in the "Sources" section. The Type of Bill was changed to 72X and the Revenue Codes were changed to 0634 and 0635. |
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Part A Local Medical Review Policy |
1/27/2004 |
The following Part A Medical Policy has been updated: COLONOSCOPY, DIAGNOSTIC, THERAPEUTIC, AND SCREENING: Effective for services on or after January 1, 2004, HCPCS code G0328 has been added to "CPT/HCPCS Codes" per CMS Pub. 100-04, Transmittal 52. |
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Part A Local Medical Review Policy |
1/14/2004 |
The following Part A Medical Policies have been updated: Ibritumomab Tiuxetan (Zevalin), Interferon, Noninvasive Vascular Studies, Oprelvekin (Neumega), Radiation Oncology, Recombinant Human Thyrotropin For Radionucleotide Scanning, Stereotactic Radiosurgery/Fractionated Stereotactic Radiotherapy, Upper Gastrointestinal Endoscopy (Diagnostic And Therapeutic) |
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Part A Local Medical Review Policy |
12/24/2003 |
Effective January 1, 2004, the Independent Diagnostic Testing Facility (IDTF) policy has been retired for Part A. |
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Part A Local Medical Review Policy |
12/24/2003 |
The Partial Hospitalization Program (PHP) Part A Medical Policy has been updated: Retroactive to January 1, 2003, CPT codes 90875, 90876 and 97770 were deleted and were replaced with 90817, 90819, 90822, 90824, 90827 and 90829. Addition of "Coding Guideline" #3 that states claims for services in a CAH bill partial hospitalization under bill type 85X. Added "Sources" #2-#4. |
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Part A Local Medical Review Policy |
12/24/2003 |
The Magnetic Resonance Angiography (MRA) Part A Medical Policy has been updated: The ICD-9-CM codes were revised for 74185 and 72198 by adding 402.00-402.01 and 440.0. Also 71555 was revised by removing 402.00-402.01, 404.00 and 440.0 which were added in error. Please refer to the policy for a complete listing of ICD-9-CM codes. These changes are retroactive to August 15, 2003. |
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Part A Local Medical Review Policy |
12/9/2003 |
The following Part A Medical Policies have been updated: Ablation Of Hepatic Tumors, Anoscopy/Proctoscopy/Sigmoidoscopy (Diagnostic, Therapeutic, And Screening)/Fecal Occult Blood, Audiology Services, Biofeedback Therapy, Bladder Scan, Colonoscopy, Diagnostic, Therapeutic, And Screening, Coronary Angiography, Critical Care, Deep Brain Stimulation, Endovascular Repair Of Infrarenal Abdominal Aortic Aneurysm, Granulocyte Colony-Stimulating Factor, Holter Monitor, Immune Globulin, Intravenous, Interventional Cardiology, Left Heart Catheterization, Low Osmolar Contrast Media, Monitored Anesthesia Care, Myocardial Perfusion Testing, Noninvasive Vascular Studies, Percutaneous Transluminal Angioplasty With Or Without Stenting For Abdominal Aortic Stenosis Or Chronic Total Occlusion And Lower Exptremity Claudication, Percutaneous Renal Artery Angiopolasty With Or Without Stenting, Physical Medicine And Rehabilitation, Pulmonary Function Testing, Radiation Oncology, Respiratory Therapy, Sandostatin Depot (Octreotide Acetate For Injectable Suspension), Small Intestinal Imaging, Thermotherapies (Minimally Invasive Surgical Techniques (Mists) For Benign Prostatic Hyperplasia (Bphs), Therapeutic Apheresis, Transesophageal Echocardiography, Transjugular Intrahepatic Portosystemic Shunt (Tips), Transthoracic Echocardiography, Upper Gastrointestinal Endoscopy (Diagnostic And Therapeutic), Urolumetm Endoprosthesis |
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Outpatient Sleep Studies, AC-03-030 LMRP (Part A and B) |
12/5/2003 |
Outpatient Sleep Studies, AC-03-030: The Description and Documentation Requirements sections of the policy that was published in our November 2003 Providers' News contained certification/accreditation requirements that were effective with the implementation date of December 15, 2003. However, the Carrier received comments during the notice period regarding the timeframe required for certification. Therefore, we are postponing implementation of the certification/accreditation requirements until we can establish an appropriate timeframe.
This postponement applies only to the certification/accreditation requirements. All other aspects of policy AC-03-030 remain effective with date of service December 15, 2003. |
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Part A Local Medical Review Policy |
9/30/2003 |
The following Part A Medical Policies have been updated: Bone Density Studies, Chest X-Ray, Debridement of Toenails, Dermal Skin Substitutes, Diagnostic Abdominal Aortography and Renal Angiography, EKG and Related Cardiac Studies, Insertable Loop Recorder (ILR), Nerve Conduction Studies (NCS)/Electromyography (EMG), Patient Activated EKG Recorders |
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Part A Local Medical Review Policy |
8/28/2003 |
The following Part A Medical Policies have been updated: Lipid Apheresis, Protein A Column Apheresis, and Therapeutic Apheresis |
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Part A Local Medical Review Policy |
8/12/2003 |
The following Part A Medical Policies have been updated: Magnetic Resonance Imaging of the Brain, Myocardial Perfusion Testing, Noninvasive Vascular Studies |
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Part A Local Medical Review Policy |
7/25/2003 |
The following Part A Medical Policies have been updated: EPO Administration for Secondary Anemia, EPO for Treatment of Anemia Associated ZT Therapy, EPO for Treatment of Anemia Associated with Chronic Renal Failure, EPO-Preoperative, Granulocyte Colony-Stimulating Factors, Leuprolide Acetate/Goserelin (Gonadotropin Releasing Hormone Analogs), Ocular Photodynamic Therapy (OPT) with Verteporfin (Visudyne), Physical Medicine and Rehabilitation, Routine Foot Care, Sandostatin® Depot (Octreotide Acetate for Injectable Suspension), Myocardial Perfusion Testing |
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Medicare Part A and B Self-Administered Drugs |
1/3/2003 |
A listing of Self-Administered Drugs and rationale has been posted online. |
