RETIRED Local Coverage Determination (LCD)

Electrocardiography

L33669

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Proposed LCD
Proposed LCDs are works in progress that are available on the Medicare Coverage Database site for public review. Proposed LCDs are not necessarily a reflection of the current policies or practices of the contractor.
Retired

Document Note

Note History

Contractor Information

LCD Information

Document Information

Source LCD ID
N/A
LCD ID
L33669
Original ICD-9 LCD ID
Not Applicable
LCD Title
Electrocardiography
Proposed LCD in Comment Period
N/A
Source Proposed LCD
N/A
Original Effective Date
For services performed on or after 10/01/2015
Revision Effective Date
For services performed on or after 10/01/2019
Revision Ending Date
08/22/2024
Retirement Date
08/22/2024
Notice Period Start Date
N/A
Notice Period End 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.

Issue

Issue Description
Issue - Explanation of Change Between Proposed LCD and Final LCD

CMS National Coverage Policy

This LCD supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for Electrocardiography. Federal statute and subsequent Medicare regulations regarding provision and payment for medical services are lengthy. They are not repeated in this LCD. Neither Medicare payment policy rules nor this LCD replace, modify or supersede applicable state statutes regarding medical practice or other health practice professions acts, definitions and/or scopes of practice. All providers who report services for Medicare payment must fully understand and follow all existing laws, regulations and rules for Medicare payment for Electrocardiography and must properly submit only valid claims for them. Please review and understand them and apply the medical necessity provisions in the policy within the context of the manual rules. Relevant CMS manual instructions and policies may be found in the following Internet-Only Manuals (IOMs) published on the CMS Web site.

Internet Only Manual (IOM) Citations:

  • CMS IOM Publication 100-02, Medicare Benefit Policy Manual,
    • Chapter 6, Section 20.3 Encounter Defined
  • CMS IOM Publication 100-03, Medicare National Coverage Determinations (NCD) Manual,
    • Chapter 1, Section 20.15 Electrocardiographic Services
  • CMS IOM Publication 100-08, Medicare Program Integrity Manual,
    • Chapter 13, Section 13.5.4 Reasonable and Necessary Provision in an LCD

Social Security Act (Title XVIII) Standard References:

  • Title XVIII of the Social Security Act, Section 1862(a)(1)(A) states that no Medicare payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury. 
  • Title XVIII of the Social Security Act, Section 1862(a)(7). This section excludes routine physical examinations. 
  • Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider for any claim that lacks the necessary information to process the claim. 

Federal Register References: 

  • Code of Federal Regulations (CFR), Title 42, Volume 2, Chapter IV, Part 410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Coverage Guidance

Coverage Indications, Limitations, and/or Medical Necessity

History/Background and/or General Information

For electrocardiogram (EKG) definition and coverage of EKG services as diagnostic tests, please refer to CMS IOM Publication 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Section 20.15.

Covered Indications

Electrocardiograms are indicated for diagnosis and patient management purposes involving symptoms of the heart, pericardium, thoracic cavity, and systemic diseases which produce cardiac abnormalities.

An EKG will be considered medically reasonable and necessary in any of the following circumstances:

  1. Initial diagnostic workup for a patient that presents with complaints of symptoms such as chest pain, palpitations, dyspnea, dizziness, syncope, etc. which may suggest a cardiac origin. 
  2. Evaluation of a patient on a cardiac medication for a cardiac arrhythmia or other cardiac condition which affects the electrical conduction system of the heart (e.g., inotropics such as digoxin; antiarrhythmics such as Tambocor, Procainamide, or Quinidine; and antianginals such as Cardizem, Isordil, Corgard, Procardia, Inderal and Verapamil). The EKG is necessary to evaluate the effect of the cardiac medication on the patient’s cardiac rhythm and/or conduction system. 
  3. Evaluation of a patient with a pacemaker with or without clinical findings (history or physical examination) that suggest possible pacemaker malfunction. 
  4. Evaluation of a patient who has a significant cardiac arrhythmia or conduction disorder in which an EKG is necessary as part of the evaluation and management of the patient. These disorders may include, but are not limited to, the following: Complete Heart Block, Second Degree AV Block, Left Bundle Branch Block, Right Bundle Branch Block, Paroxysmal VT, Atrial Fib/Flutter, Ventricular Fib/Flutter, Cardiac Arrest, Frequent PVCs, Frequent PACs, Wandering Atrial Pacemaker, and any other unspecified cardiac arrhythmia. 
  5. Evaluation of a patient with known Coronary Artery Disease (CAD) and/or heart muscle disease that presents with symptoms such as increasing shortness of breath (SOB), palpitations, angina, etc. 
  6. Evaluation of a patient’s response to a newly established therapy for angina, palpitations, arrhythmias, SOB or other cardiopulmonary disease process. 
  7. Evaluation of patients after coronary artery revascularization by Coronary Artery Bypass Grafting (CABGs), Percutaneous Transluminal Coronary Angiography (PTCA), thrombolytic therapy (e.g., TPA, Streptokinase, Urokinase), and/or stent placement. 
  8. Evaluation of patients presenting with symptoms of a Myocardial Infarction (MI). 
  9. Evaluation of other symptomatology which may indicate a cardiac origin especially in those patients who have a history of an MI, CABG surgery or PTCA or patients who are being treated medically after a positive stress test or cardiac catheterization. 
  10. Pre-operative Evaluation of the patient when: 
    • undergoing cardiac surgery such as CABGs, automatic implantable cardiac defibrillator, or pacemaker, or
    • the patient has a medical condition associated with a significant risk of serious cardiac arrhythmia and/or myocardial ischemia such as Diabetes, history of MI, angina pectoris, aneurysm of heart wall, chronic ischemic heart disease, pericarditis, valvular disease or cardiomyopathy to name a few. 
  11. Evaluation of a patient’s response to the administration of an agent known to result in cardiac or EKG abnormalities (for patients with suspected, or at increased risk of developing, cardiovascular disease or dysfunction). Examples of these agents are antineoplastic drugs, lithium, tranquilizers, anticonvulsants, and antidepressant agents. 
  12. When performed as a baseline evaluation prior to the initiation of an agent known to result in cardiac or EKG abnormalities. An example of such an agent is verapamil. 

Limitations 

The Code of Federal Regulations (CFR), Title 42, part 410.32, specifies that all diagnostic tests must be ordered by a provider who is the treating provider for the patient and who will use the test results in the patient’s care. Tests not ordered by the physician who is treating the beneficiary are not reasonable and necessary. 

As published in the CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13.5.4, an item or service may be covered by a contractor LCD if it is reasonable and necessary under the Social Security Act Section 1862 (a)(1)(A). Contractors shall determine and describe the circumstances under which the item or service is considered reasonable and necessary.

Summary of Evidence

N/A

Analysis of Evidence (Rationale for Determination)

N/A

Proposed Process Information

Synopsis of Changes
Changes Fields Changed
N/A
Associated Information
Sources of Information
Bibliography
Open Meetings
Meeting Date Meeting States Meeting Information
N/A
Contractor Advisory Committee (CAC) Meetings
Meeting Date Meeting States Meeting Information
N/A
MAC Meeting Information URLs
N/A
Proposed LCD Posting Date
Comment Period Start Date
Comment Period End Date
Reason for Proposed LCD
Requestor Information
This request was MAC initiated.
Requestor Name Requestor Letter
View Letter
N/A
Contact for Comments on Proposed LCD

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

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

Additional ICD-10 Information

General Information

Associated Information

Documentation Requirements

Please refer to the Local Coverage Article: Billing and Coding: Electrocardiography (A57066) for documentation requirements that apply to the reasonable and necessary provisions outlined in this LCD.

Utilization Guidelines

Please refer to the Local Coverage Article: Billing and Coding: Electrocardiography (A57066) for utilization guidelines that apply to the reasonable and necessary provisions outlined in this LCD.

Sources of Information

First Coast Service Options, Inc.  reference LCD number(s) – L28866, L29163, L29337

Bibliography
  1. Hurst JW. Current status of clinical electrocardiography with suggestions for the improvement of the interpretive process. Am J Cardiol. 2003;92(9):1072-1079. 
  2. Lee TH. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. Vol. 101.  
  3. S. Preventative Services Task Force. Screening for Coronary Heart Disease: Recommendation statement. Ann Intern Med. 2004;40(7).

Revision History Information

Revision History Date Revision History Number Revision History Explanation Reasons for Change
08/22/2024 R6

This LCD is being retired effective for dates of service on and after 08/22/2024.

  • LCD Being Retired
10/01/2019 R5

Revision Number: 5
Publication: September 2019 Connection
LCR A/B 2019-058

Explanation of Revision: Based on CR 10901, the LCD was revised to remove all billing and coding and all language not related to reasonable and necessary provisions (“Bill Type Codes”, “Revenue Codes”, “CPT/HCPCS Codes”, “ICD-10 Codes that Support Medical Necessity”, “Documentation Requirements” and “Utilization Guidelines” sections of the LCD) and place them into a newly created billing and coding article. In addition, during the process of moving the ICD-10-CM diagnosis codes to the billing and coding article, the ICD-10-CM diagnosis code ranges were broken out and listed individually. Also, the CMS IOM language has been removed from the LCD and instead, the IOM citation related to this language is referenced in the “CMS National Coverage Policy” and “History/Background and/or General Information” sections of the LCD. The effective date of this revision is for claims processed on or after January 8, 2019, for dates of service on or after October 3, 2018.

Also, the following unspecified ICD-10-CM diagnosis codes were removed as it is the provider’s responsibility to code to the highest level of specificity: A40.9, A41.9, E03.9, E04.9, E06.9, E07.9, E10.3219, E10.3299, E10.3319, E10.3399, E10.3419, E10.3499, E10.3519, E10.3529, E10.3539, E10.3549, E10.3559, E10.3599, E10.37X9 E10.8, E11.3219, E11.3299, E11.3319, E11.3399, E11.3419, E11.3499, E11.3519, E11.3529, E11.3539, E11.3549, E11.3559, E11.3599, E11.37X9, E11.8, E13.3219, E13.3299, E13.3319, E13.3399, E13.3419, E13.3499, E13.3519, E13.3529, E13.3539, E13.3549, E13.3559, E13.3599, E13.37X9, E13.8, E85.9, E87.70, G90.9, I01.9, I05.9, I06.9, I07.9, I08.9, I09.9, I15.9, I20.9, I21.3, I22.9, I24.9, I25.119, I25.709, I25.719, I25.729, I25.739, I25.759, I25.769, I25.799, I25.9, I27.9, I28.9, I30.9, I31.9, I34.9, I35.9, I36.9, I37.9, I40.9, I42.9, I44.30, I44.60, I45.10, I45.9, I49.40, I49.9, I50.20, I50.30, I50.40, I50.9, I51.9, I70.209, I70.219, I70.229, I70.239, I70.249, I70.269, I70.299, I70.309, I70.319, I70.329, I70.339, I70.349, I70.369, I70.399, I70.409, I70.419, I70.429, I70.439, I70.449, I70.469, I70.499, I70.509, I70.519, I70.529, I70.539, I70.549, I70.569, I70.599, I70.609, I70.619, I70.629, I70.639, I70.649, I70.669, I70.699, I70.709, I70.719, I70.729, I70.739, I70.749, I70.769, I70.799, I72.9, I73.9, I74.10, I74.4, I74.9, I75.019, I75.029, I77.70, I77.9, I78.9, M05.019, M05.029, M05.039, M05.049, M05.059, M05.069, M05.079, M05.119, M05.129, M05.139, M05.149, M05.159, M05.169, M05.179, M05.219, M05.229, M05.239, M05.249, M05.259, M05.269, M05.279, M05.319, M05.329, M05.339, M05.349, M05.359, M05.369, M05.379, M05.419, M05.429, M05.439, M05.449, M05.459, M05.469, M05.479, M05.519, M05.529, M05.539, M05.549, M05.559, M05.569, M05.579, M05.619, M05.629, M05.639, M05.649, M05.659, M05.669, M05.679, M05.719, M05.729, M05.739, M05.749, M05.759, M05.769, M05.779, M05.819, M05.829, M05.839, M05.849, M05.859, M05.869, M05.879, M05.9, M06.019, M06.029, M06.039, M06.049, M06.059, M06.069, M06.079, M06.219, M06.229, M06.239, M06.249, M06.259, M06.269, M06.279, M06.319, M06.329, M06.339, M06.349, M06.359, M06.369, M06.379, M06.819, M06.829, M06.839, M06.849, M06.859, M06.869, M06.879, M06.9, M08.019, M08.029, M08.039, M08.049, M08.059, M08.069, M08.079, M08.219, M08.229, M08.239, M08.249, M08.259, M08.269, M08.279, M08.419, M08.429, M08.439, M08.449, M08.459, M08.469, M08.479, M08.819, M08.829, M08.839, M08.849, M08.859, M08.869, M08.879, M08.90, M08.919, M08.929, M08.939, M08.949, M08.959, M08.969, M08.979, M1A.1190, M1A.1191, M1A.1290, M1A.1291, M1A.1390, M1A.1391, M1A.1490, M1A.1491, M1A.1590, M1A.1591, M1A.1690, M1A.1691, M1A.1790, M1A.1791, M12.019, M12.029, M12.039, M12.049, M12.059, M12.069, M12.079, M31.9, M32.10, M32.9, M33.90, M33.91, M33.92, M33.93, M33.99, M34.9, M35.9, M79.603, M79.606, M79.609, M79.629, M79.639, M79.643, M79.646, M79.669, M79.673, M79.676, Q20.9, Q21.9, Q22.9, Q23.9, Q24.9, Q25.40, Q25.9, Q26.9, Q27.30, Q27.9, Q28.9, R00.9, R06.00, R06.9, R07.9, R20.9, R57.9, S26.00XA, S26.00XD, S26.00XS, S26.10XA, S26.10XD, S26.10XS, S26.90XA, S26.90XD, S26.90XS, S27.309A, S27.309D, S27.309S, S27.319A, S27.319D, S27.319S, S27.329A, S27.329D, S27.329S, S27.339A, S27.339D, S27.339S, S27.399A S27.399D, S27.399S, S29.001A, S29.001D, S29.001S, S29.002A, S29.002D, S29.002S, S29.009A, S29.009D, S29.009S, S29.099A, S29.009D, S29.099S, S29.9XXA, S29.9XXD, S29.9XXS, S39.001A, S39.001D, S39.001S, S39.002A, S39.002D, S39.002S, S39.003A, S39.003D, S39.003S, S39.91XA, S39.91XD, S39.91XS, S39.92XA, S39.92XD, S39.92XS, S39.93XA, S39.93XD, S39.93XS, S39.94XA, S39.94XD, S39.94XS, T36.95XA, T36.95XD, T36.95XS, T37.95XA, T37.95XD, T37.95XS, T38.805A, T38.805D, T38.805S, T38.905A, T38.905D, T38.905S, T39.95XA, T39.95XD, T39.95XS, T40.605A, T40.605D, T05.605S, T40.905A, T40.905D, T40.905S, T41.205A, T41.205D, T41.205S, T42.75XA, T42.75XD, T42.75XS, T43.205A, T43.205D, T43.205S, T43.505A, T43.505D, T43.505S, T43.605A, T43.605D, T43.605S, T43.95XA, T43.95XD, T45.95XS, T44.905A, T44.905D, T44.905S, T45.605A, T45.605D, T45.605S, T45.95XA, T45.95XD, T45.95XS, T46.901A, T46.901D, T46901S, T46.902A, T46.902D, T46.902S, T46.903A, T46.903D, T46.903S, T46.904A, T46.904D, T46.904S, T46.905A, T46.905D, T46.905S, T47.95XA, T47.95XD, T47.95XS, T48.205A, T48.205D, T48.205S, T48.905A, T48.905D, T48.905S, T49.95XA, T49.95XD, T45.95XS, T50.905A, T50.905D, T50.905S, T51.91XA, T51.91XD, T51.91XS, T51.92XA, T51.92XD, T51.92XS, T51.93XA, T51.93XD, T51.93XS, T51.94XA, T51.94XD, T51.94XS, T52.91XA, T52.91XD, T52.91XS, T52.92XA, T52.92XD, T52.92XS, T52.93XA, T52.93XD, T52.93XS, T52.94XA, T52.94XD, T52.94XS, T56.91XA, T56.91XD, T56.91XS, T56.92XA, T56.92XD, T56.92XS, T56.93XA, T56.93XD, T56.93XS, T56.94XA, T56.94XD, T56.94XS, T57.91XA, T57.91XD, T57.91XS, T57.92XA, T57.92XD, T57.92XS, T57.93XA, T57.93XD, T57.93XS, T57.94XA, T57.94XD, T57.94XS, T58.91XA, T58.91XD, T58.91XS, T58.92XA, T58.92XD, T58.92XS, T58.93XA, T58.93XD, T58.93XS, T58.94XA, T58.94XD, T58.94XS, T59.91XA, T59.91XD, T59.91XS, T59.92XA, T59.92XD, T59.92XS, T59.93XA, T59.93XD, T59.93XS, T59.94XA, T59.94XD, T59.94XS, T60.91XA, T60.91XD, T60.91XS, T60.92XA, T60.92XD, T60.92XS, T60.93XA, T60.93XD, T60.93XS, T60.94XA, T60.94XD, T60.94XS, T61.91XA, T61.91XD, T61.91XS, T61.92XA, T61.92XD, T61.92XS, T61.93XA, T61.93XD, T61.93XS, T61.94XA, T61.94XD, T61.94XS, T62.91XA, T62.91XD, T62.91XS, T62.92XA, T62.92XD, T62.92XS, T62.93XA, T62.93XD, T62.93XS, T62.94XA, T62.94XD, T62.94XS, T63.001A, T63.001D, T63.001S, T63.002A, T63.002D, T63.002S, T63.003A, T63.003D, T63.003S, T63.004A, T63.004D, T63.004S, T63.301A, T63.301D, T63.301S, T63.302A, T63.302D, T63.302S, T63.303A, T63.303D, T63.303S, T63.304A, T63.304D, T63.304S, T63.91XA, T63.91XD, T63.91XS, T63.92XA, T63.92XD, T63.92XS, T63.93XA, T63.93XD, T63.93XS, T63.94XA, T63.94XD, T63.94XS, T65.91XA, T65.91XD, T65.91XS, T65.92XA, T65.92XD, T65.92XS, T65.93XA, T65.93XD, T65.93XS, T65.94XA, T65.94XD, T65.94XS, T78.00XA, T78.00XD, T78.00XS, T78.40XA, T78.40XD, T78.40XS, T81.719A, T81.719D, T81.719S, T82.119A, T82.119D, T82.119S, T82.129A, T82.129D, T82.129S, T82.199A, T82.199D, T82.199S, T82.519A, T82.519D, T82.519S, T82.529A, T82.529D, T82.529S, T82.539A, T82.539D, T82.539S, T82.599A, T82.599D, T82.599S, T86.00, T86.10, T86.20, T86.30, T86.40, T86.819, T86.839,T86.859, T86.899, and T86.90. The effective date of this revision is for dates of service on or after 11/12/2019.

In addition, based on CR 11322/CR 11333 (Annual 2020 ICD-10-CM Update) the newly created billing and coding article was revised. Descriptor revised for ICD-10-CM diagnosis codes I70.238 and I70.248. Added ICD-10-CM diagnosis codes I26.93, I26.94, I48.11, I48.19, I48.20, and I48.21. Deleted ICD-10-CM diagnosis codes I48.1 and I48.2. The effective date of this revision is for dates of service on or after 10/01/2019.

10/01/2019: 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 LCD.

  • Revisions Due To ICD-10-CM Code Changes
  • Other (Revisions based on CRs 10901, 11322, 11333)
10/01/2018 R4

Revision Number: 4
Publication: September 2018 Connection
LCR A/B2018-074

Explanation of Revision: Based on CR 10847 (Annual 2019 ICD-10-CM Update), the LCD was revised to add ICD-10-CM diagnosis codes I67.850, I67.858, and T43.641A – T43.641S. The effective date of this revision is for dates of service on or after 10/01/18. Also, additional diagnosis codes were asterisked in the “ICD-10 Codes that Support Medical Necessity/Group 1 Codes:” section of the LCD based on information in the ICD-10-CM Codebook and the “Group 1 Medical Necessity ICD-10 Codes Asterisk Explanation:” section of the LCD was revised. The effective date of this revision is for claims processed on or after 10/01/18. In addition, this LCD was revised to change diagnosis code T36.4X5A to diagnosis code range T36.4X5A-T36.4X5S, diagnosis code T45.515A to diagnosis code range T45.515A-T45.515S, and diagnosis code T50.B95A to diagnosis code range T50.B95A-T50.B95S, as they were omitted in error. The effective date of this revision is for claims processed on or after 10/01/2018, for dates of service on or after 10/01/2015.

10/01/2018: 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.

  • Revisions Due To ICD-10-CM Code Changes
02/08/2018 R3

Revision Number: 3

Publication: February 2018 Connection

LCR A/B2018-012

Explanation of Revision: This LCD was revised in the “ICD-10 Codes that Support Medical Necessity” section of  the LCD under “Group 1 Medical Necessity ICD-10 Codes Asterisk Explanation:” to include an explanation that all the codes within the asterisked range from the first code to the last code apply. The effective date of this revision is based on process date.

02/08/2018:  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.

  • Provider Education/Guidance
  • Public Education/Guidance
10/01/2017 R2

Revision Number: 2

Publication: September 2017 Connection 

LCR A/B2017-038 

Explanation of Revision: Based on CR 10153 (Annual 2018 ICD-10-CM Update) the LCD was revised. Changed diagnosis code range E85.1-E85.8 to E85.1-E85.89. Added ICD-10-CM diagnosis codes P29.30 – P29.38. Deleted ICD-10-CM diagnosis codes E85.8, P29.3. The effective date of this revision is based on date of service.

 

10/01/2017:  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.

  • Revisions Due To ICD-10-CM Code Changes
10/01/2016 R1 Revision Number: 1
Publication: October 2016 Connection
LCR A/B2016-097

Explanation of Revision: Based on CR 9677 (Annual 2017 ICD-10-CM Update) the LCD was revised. Added ICD-10-CM diagnosis code ranges I16.0 – I16.9 and T88.53XA – T88.53XS. The effective date of this revision is based on date of service.
  • Revisions Due To ICD-10-CM Code Changes
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Associated Documents

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Related Local Coverage Documents
Articles
A57066 - Billing and Coding: Electrocardiography
Related National Coverage Documents
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Public Versions
Updated On Effective Dates Status
08/22/2024 10/01/2019 - 08/22/2024 Retired You are here
10/02/2019 10/01/2019 - N/A Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

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