LCD Reference Article Response To Comments Article

Response to Comments: Fluid Jet System Treatment for LUTS/BPH

A59605

Expand All | Collapse All
Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

Document Note

Note History

Contractor Information

Article Information

General Information

Source Article ID
N/A
Article ID
A59605
Original ICD-9 Article ID
Not Applicable
Article Title
Response to Comments: Fluid Jet System Treatment for LUTS/BPH
Article Type
Response to Comments
Original Effective Date
04/01/2024
Revision Effective Date
N/A
Revision Ending Date
N/A
Retirement Date
N/A

CPT codes, descriptions, and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

Copyright © 2024, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution, or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

N/A

Article Guidance

Article Text

As an important part of Medicare Local Coverage Determination (LCD) development, National Government Services solicits comments from the provider community and from members of the public who may be affected by or interested in our LCDs. The purpose of the advice and comment process is to gain the expertise and experience of those commenting.

We would like to thank those who suggested changes to the Fluid Jet System Treatment for LUTS/BPH Local Coverage Determination. The official notice period for the final LCD begins on February 15, 2024, and the final determination will become effective on April 1, 2024.

Response To Comments

Number Comment Response
1

NGS received the following comment from a Urologist: 

I provide the Aquablation procedure for my Medicare patients. I am a board-certified urologic surgeon and practice primarily St Vincent Hospital which is located in Worcester, Massachusetts. I have performed over 30 Aquablation procedures over the last couple of years. The outcomes for my surgeries are comparable to TURP. The proposed local coverage determination (LCD) Fluid Jet System Treatment for LUTS/BPH (DL38367) that removes the age restrictions for the procedure is a very welcome change. There is no particular reason for the age range used in the early study protocols. The most rapidly growing population is the 85 and above age group. Men is this age category tend to have very large prostates and due to their health issues need a procedure that will be quick, effective and be done with low complications. The treatment options like Aquablation is that option which is precise, safe, effective and perfectly suited for older patients. I look forward to the removal of this age limitation for the procedure.”

NGS thanks the Urologist for offering his opinion and informing NGS that he had no concerns about the changes made to DL38367-Fluid Jet System Treatment for LUTS/BPH.

2

NGS received the following comment from a board-certified Urologist: 

"I support the proposed local coverage determination (LCD) Fluid Jet System Treatment for LUTS/BPH (DL38367) that removes the coverage criteria to only cover men 80 years old or less. Patients over 80 years of age typically have large prostates and would need to have an open or robotic procedure. Time under general anesthesia is far shorter than the open or robotic procedures; therefore, Aquablation is often a safer approach for these patients."

NGS agrees and appreciates your supportive comment.

N/A

Coding Information

Bill Type Codes

Code Description

Please accept the License to see the codes.

N/A

Revenue Codes

Code Description

Please accept the License to see the codes.

N/A

CPT/HCPCS Codes

Please accept the License to see the codes.

N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Additional ICD-10 Information

Bill Type Codes

Code Description

Please accept the License to see the codes.

N/A

Revenue Codes

Code Description

Please accept the License to see the codes.

N/A

Other Coding Information

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
N/A
Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation
N/A

Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L38367 - Fluid Jet System Treatment for LUTS/BPH
Related National Coverage Documents
N/A
SAD Process URL 1
N/A
SAD Process URL 2
N/A
Statutory Requirements URLs
N/A
Rules and Regulations URLs
N/A
CMS Manual Explanations URLs
N/A
Other URLs
N/A
Public Versions
Updated On Effective Dates Status
02/05/2024 04/01/2024 - N/A Currently in Effect You are here

Keywords

N/A