10/01/2019
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R11
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The LCD is revised to remove CPT/HCPCS codes in the Keyword Section of the LCD.
At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
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- Other (The LCD is revised to remove CPT/HCPCS codes in the Keyword Section of the LCD.)
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10/01/2019
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R10
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As required by CR 10901, all billing and coding information has been moved to the companion article, this article is linked to the LCD.
10/1/2019: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
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- Revisions Due To Code Removal
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10/01/2019
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R9
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Effective 10/01/2019, the following codes were added, deleted and revised per the 2019/2020 annual ICD-10 updates.
Added to Group 1:
- I26.93 - Single subsegmental pulmonary embolism without acute cor pulmonale
- I26.94 - Multiple subsegmental pulmonary emboli without acute cor pulmonale
- I48.11 - Longstanding persistent atrial fibrillation
- I48.19 - Other persistent atrial fibrillation
- I48.20 - Chronic atrial fibrillation, unspecified
- I48.21 - Permanent atrial fibrillation
- T6701XA - Heatstroke and sunstroke, initial encounter
- T6701XD - Heatstroke and sunstroke, subsequent encounter
- T6701XS - Heatstroke and sunstroke, sequela
- T6702XA - Exertional heatstroke, initial encounter
- T6702XD - Exertional heatstroke, subsequent encounter
- T6702XS - Exertional heatstroke, sequela
- T6709XA - Other heatstroke and sunstroke, initial encounter
- T6709XD -Other heatstroke and sunstroke, subsequent encounter
- T6709XS - Other heatstroke and sunstroke, sequela
Deleted from Group 1:
- I48.1 - Persistent atrial fibrillation
- I48.2 - Chronic atrial fibrillation
- T67.0XXA - Heatstroke and sunstroke, initial encounter
- T67.0XXD - Heatstroke and sunstroke, subsequent encounter
- T67.0XXS - Heatstroke and sunstroke, sequela
Description Changes from Group1
- Revised from J44.0 – Chronic obstructive pulmonary disease with acute lower respiratory infection to J44.0 - Chronic obstructive pulmonary disease with (acute) lower respiratory infection
09/16/2019 - At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
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- Creation of Uniform LCDs Within a MAC Jurisdiction
- Revisions Due To ICD-10-CM Code Changes
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10/01/2018
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R8
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09/06/2018 - At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
The following ICD-110 codes were added, deleted and revised per the Annual ICD-10 Updates.
Added: E78.41, E78.49, I63.81, I63.89, I67.850, I67.858, K82.A2, K83.01, T43.641A, T43.641D, T43.641S, T43.642A, T43.642D, T43.642S, T43.643A, T43.643D, T43.643S, T43.644A, T43.644D and T43.644S.
Deleted: E78.4 and I63.8.
Revised: I63.333 and T81.11XA, T81.11XD and T81.11XS.
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- Revisions Due To ICD-10-CM Code Changes
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03/26/2018
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R7
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05/08/2018 - At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
LCD revised to add ICD-10-CM Z51.81 and Z79.899 effective 03/26/2018. There is no change in the LCD coverage.
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- Creation of Uniform LCDs Within a MAC Jurisdiction
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03/26/2018
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R6
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01/17/18-At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
LCD revised to update the language referenced from the IOM 100-4 Chapter 13 Section 100.1 from carriers to A/B MACs (B) and add the following ICD-10 codes new for 2018 because they are within the coverage indications of this LCD: E85.81-E85.82, E85.89, I21.9, I21.A1, I21.A9, I27.20-I27.24, I27.29, I27.83, I50.810-I50.814, I50.82-I50.84, I50.89 and R06.03,
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- Creation of Uniform LCDs Within a MAC Jurisdiction
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10/01/2017
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R5
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08/24/2017: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
Effective DOS 10/01/2017 the following ICD-10-CM codes were added, deleted and had a description change:
Added:
- E85.81
- E85.82
- E85.89
- I21.9
- I21.A1
- I21.A9
- I27.20
- I27.21
- I27.22
- I27.23
- I27.24
- I27.29
- I27.83
- I50.810
- I50.811
- I50.812
- I50.813
- I50.814
- I50.82
- I50.83
- I50.84
- I50.89
- R06.03
The following ICD-10 codes were deleted from the ICD-10 Codes that Support Medical Necessity field: E85.8 was deleted from Group 1 I27.2 was deleted from Group 1
The following ICD-10 code descriptions were changed in the ICD-10 Codes that Support Medical Necessity field: I50.1 descriptor was changed in Group 1 I63.323 descriptor was changed in Group 1 I63.333 descriptor was changed in Group 1 I63.513 descriptor was changed in Group 1 I63.523 descriptor was changed in Group 1 I63.533 descriptor was changed in Group 1
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- Aberrant Local Utilization
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10/01/2016
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R4
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The LCD is revised to add ICD-10 codes effective 10/1/2016: E78.00, E78.01, H34.8110, H34.8111, H34.8120, H34.8121, H34.8130, H34.8131, H34.8310, H34.8311, H34.8320, H34.8321, H34.8330, H34.8331 ,I63.033, I63.113, I63.133, I63.213, I63.233, I63.313, I63.323, I63.333, I63.413, I63.423, I63.433, I63.443, I63.513, I63.523, I63.533, I63.543, I97.621, I97.622, I97.630, I97.631, I97.638, I97.640, I97.641, J98.51, J98.59, Q25.21, Q25.29, Q25.40, Q25.41, Q25.42, Q25.43, Q25.44, Q25.45, Q25.46, Q25.47, Q25.48, Q25.49.
ICD-10 codes deleted from Group 1 effective 10/1/2016: E78.0, H34.811, H34.812, H34.813, H34.831, H34.832, H34.833, J98.5, Q25.2, Q25.4.
ICD-10 code descriptions were changed in Group 1: I77.79, O15.02, O15.03, O15.1, O15.2, T82.817A, T82.817D, T82.817S, T82.827A, T82.827D, T82.827S, T82.837A, T82.837D, T82.837S, T82.847A, T82.847D, T82.847S, T82.857A, T82.857D, T82.857S, T82.867A, T82.867D, T82.867S.
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- Revisions Due To ICD-10-CM Code Changes
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10/01/2015
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R3
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R3 LCD updated to add ICD-10-CM codes A17.89 A39.50 B33.20 B33.24 B39.0 B39.1 B39.2 B39.3 B39.4 B39.5 M10.9 E05.91 E85.9 E85.2 D57.819 F11.129 I01.9 I09.1 I05.9 I06.9 I08.9 I24.9 I20.9 I25.119 I25.701 I25.708 I25.709 I25.719 I25.729 I25.739 I25.759 I25.769 I25.799 I30.9 I33.9 I40.9 I44.30 I44.7 I45.9 I47.9 I49.40 I63.511 I63.512 I63.521 I63.522 I63.531 I63.532 I63.541 I63.542 I63.59 I63.9 J44.9 J45.902 K20.9 O03.81 O03.7 O14.92 O14.93 O14.10 O14.20 O88.019 O88.119 O88.319 Q21.9 Q24.9 R00.0 R56.9 R57.9 R10.9 R10.10 R68.84 G47.31 G47.32 G47.33 G47.34 G47.11 G47.12 G47.21 G47.22 G47.23 G47.24 S25.429A S25.429D S25.429S S26.00XA S26.00XD S26.00XS S26.10XA S26.10XD S26.10XS S26.90XA S26.90XD S26.90XS S26.99XA S26.99XD S26.99XS S21.301A S21.301D S21.301S S21.302A S21.302D S21.302S S21.309A S21.309D S21.309S S21.319A S21.319D S21.319S S21.329A S21.329D S21.329S S21.339A S21.339D S21.339S S21.349A S21.349D S21.349S T46.901A T46.901D T46.901S T46.902A T46.902D T46.902S T46.903A T46.903D T46.903S T46.904A T46.904D T46.904S T78.2XXA T78.2XXD T78.2XXS T78.00XA T78.00XD T78.00XS Z95.820 Z95.828 Z01.812 effective 10/1/15
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- Reconsideration Request
- Revisions Due To ICD-10-CM Code Changes
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10/01/2015
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R2
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R2 LCD revised to add I49.9 and R00.1
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10/01/2015
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R1
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The LCD revised to add ICD-10 code I48.91, I48.92 and R07.9 to group 1. The effective date remains 10/1/2015.
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