Revised LCDs Give Updated Medicare Coverage Information

Check out these local coverage determinations (LCDs) from Novitas Solutions that recently were revised or will take effect Aug. 13, 2015. LCDs provide important guidance to help you in submitting correct Medicare claims to Novitas for payment, including information about coverage, correct coding, and documentation requirements.

The following draft LCDs from Novitas Solutions will become effective Aug. 13, 2015, for Jurisdiction H (which includes Texas):

  • Allergen Immunotherapy (L35759),
  • Allergy Testing (L35771),
  • Biomarkers Overview (L33638),*
  • Debridement of Mycotic Nails (L27487),
  • Magnetic Resonance Angiography (MRA) (L31399),
  • Surgical Treatment of Nails (L27532), and
  • Vestibular and Audiologic Function Studies (L32767).*

*Because of "system limitations," these two LCDs when accessed via Novitas' LCD lookup tool appear in their future version (i.e., the version effective Aug. 13, 2015) instead of their current version. To see the current versions (current through Aug. 12, 2015), view them on the Full Index of Current Active LCDs and Future Effective LCDs.

In addition, these LCDs recently were revised:

  • Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds (L27549), effective May 6, 2015;
  • Interventional Cardiology (L32603) effective June 25, 2015;
  • Monitored Anesthesia Care (L32628) effective June 25, 2015; and
  • Services That Are Not Reasonable and Necessary (L31686) effective June 25, 2015.

The JH Implantable Infusion Pump LCD has been assigned a new L number. Refer to L33115 for dates of service on or after June 25, 2015.

Also, Novitas has added a JH local coverage article: Microvascular Therapy (MVT) (A54342).

If you have questions about billing and coding or payment policies for Medicare or other payers, contact the specialists at paymentadvocacy[at]texmed[dot]org for help, or call the TMA Knowledge Center at (800) 880-7955. TMA members can use the TMA Hassle Factor Log to help resolve insurance-related problems. Also, visit the TMA Payment Advocacy Services webpage for more resources and information.

Published July 10, 2015 

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Last Updated On

May 13, 2016

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