10/24/2019
|
R12
|
This LCD is being revised in order to adhere to CMS requirements per chapter 13, section 13.5.1 of the Program Integrity Manual, to remove all coding from LCDs. There has been no change in coverage with this LCD revision. Regulations regarding billing and coding were removed from the CMS National Coverage Policy section of this LCD and placed in the related Billing and Coding: Magnetic Resonance Angiography A56775 article.
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
|
08/01/2019
|
R11
|
All coding located in the Coding Information section has been moved into the related Billing and Coding: Magnetic Resonance Angiography A56775 article and removed from the LCD. Acronyms were inserted where appropriate throughout 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.
|
- Provider Education/Guidance
|
10/01/2018
|
R10
|
Under ICD-10 Codes that Support Medical Necessity: Group 1 added ICD-10 codes I63.81, I63.89, I67.850 and I67.858. Under ICD-10 Codes that Support Medical Necessity: Group 1 deleted ICD-10 code I63.8. Under ICD-10 Codes that Support Medical Necessity: Group 1 the code description was revised for ICD-10 codes I63.333 and I63.343. Under ICD-10 Codes that Support Medical Necessity: Group 4 added ICD-10 code R93.89. Under ICD-10 Codes that Support Medical Necessity: Group 4 deleted ICD-10 code R93.8. This revision is due to the 2018 Annual ICD-10 Code Update and is effective on October 1, 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
|
04/12/2018
|
R9
|
Under CMS National Coverage Policy updated 42 CFR, Sec 410.32 with the most current information and corrected the title on the CMS Internet-Only Manual, Pub 100-03, Ch 1, Part 4, Sec 220.2. Under Bibliography changes were made to citations to reflect AMA citation guidelines and all American College of Radiology references were updated to the most current year.
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
|
01/29/2018
|
R8
|
The Jurisdiction "J" Part A Contracts for Alabama (10111), Georgia (10211) and Tennessee (10311) are now being serviced by Palmetto GBA. The notice period for this LCD begins on 12/14/17 and ends on 01/28/18. Effective 01/29/18, these three contract numbers are being added to this LCD. No coverage, coding or other substantive changes (beyond the addition of the 3 Part A contract numbers) have been completed in this revision.
|
- Change in Affiliated Contract Numbers
|
10/01/2017
|
R7
|
Under ICD-10 Codes That Support Medical Necessity Group 1: Codes the code description was revised for I63.211, I63.212, I63.22, I63.323, I63.333, I63.513, I63.523, and I63.533. Under ICD-10 Codes That Support Medical Necessity Group 3: Codes added K91.30, K91.31 and K91.32. Under ICD-10 Codes That Support Medical Necessity Group 4: Codes deleted I27.2 and added I27.20, I27.21, I27.22, I27.23, I27.24, I27.29, I27.83 and R06.03. This revision is due to the 2017 Annual ICD-10 Updates.
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
- Revisions Due To ICD-10-CM Code Changes
|
08/03/2017
|
R6
|
Under CPT/HCPCS Codes Group 1: Paragraph deleted codes 71555, 72198, 73225, 73725 and 74185 and added codes C8934, C8935 and C8936. Under CPT/HCPCS Group 2: Paragraph deleted 73725 from the verbiage “73725, C8912-C8914 Magnetic Resonance Angiography, Lower Extremity”. Under CPT/HCPCS Group 3: Paragraph deleted 74185 from the verbiage “74185, C8900-C8902 Magnetic Resonance Angiography, Abdomen”. Under CPT/HCPCS Group 4: Paragraph deleted 71555 from the verbiage “71555, C8909-C8911 Magnetic Resonance Angiography, Chest”. Under CPT/HCPCS Group 5: Paragraph deleted 72198 from the verbiage “72198, C8918-C8920 Magnetic Resonance Angiography, Pelvis”. Under CPT/HCPCS Group 6: Paragraph deleted the verbiage “73225, Magnetic resonance angiography, upper extremity, with or without contrast material(s)” and added the verbiage “C8934, C8935, C8936, Magnetic Resonance Angiography, Upper Extremity, with or without contrast”. Revisions due to codes no longer payable under Outpatient Prospective Payment System" (OPPS) as of July 01, 2017.
|
- Provider Education/Guidance
|
05/29/2017
|
R5
|
No revisions were made as there were no comments received from the provider community.
|
- Provider Education/Guidance
|
10/01/2016
|
R4
|
Under ICD-10 Codes That Support Medical Necessity Group 1: Codes added ICD-10 codes H59.331, H59.332, H59.333, H59.339, H59.341, H59.342, H59.343, H59.349, H59.351, H59.352, H59.353, H59.359, H59.361, H59.362, H59.363, H59.369, H90.A11, H90.A12, H90.A21, H90.A22, H90.A31, H90.A32, H93.A1, H93.A2, H93.A3, H93.A9, H95.51, H95.52, H95.53, H95.54 I60.2, I63.013, I63.033, I63.113, I63.133, I63.213, I63.233, I63.313, I63.323, I63.333, I63.343, I63.413, I63.423, I63.433, I63.443, I63.513, I63.523, I63.533, I63.543, I72.5, I72.6, I77.75 and Q87.82 and deleted ICD-10 codes H34.811, H34.812, H34.813, H34.831, H34.832, H34.833, I60.21 and I60.22. Under ICD-10 Codes That Support Medical Necessity Group 2: Codes added ICD-10 code I77.77 and revised the code description for ICD-10 code I77.79. Under ICD-10 Codes That Support Medical Necessity Group 3: Codes added ICD-10 codes C49.A0, C49.A1, C49.A2, C49.A3, C49.A4, D49.511, D49.512, D49.519, D49.59, D78.31, D78.32, D78.33, D78.34, K55.011, K55.012, K55.019, K55.021, K55.022, K55.029, K55.031, K55.032, K55.039, K55.041, K55.042, K55.049, K55.051, K55.052, K55.059, K55.061, K55.062, K55.069, K55.30, K55.31, K55.32, K55.33, K85.01, K85.02, K85.81, K85.82, K85.91, K85.92, K91.870, K91.871, K91.872, K91.873, N99.840, N99.841, Q25.42, Q25.43, Q25.44, Q25.49, Q87.82, R93.41, R93.421, R93.422, R93.429 and R93.49. Under ICD-10 Codes That Support Medical Necessity Group 4: Codes added ICD-10 codes J95.860, J95.861, J95.862, J95.863, Q25.21, Q25.29, Q25.40, Q25.41, Q25.42, Q25.43, Q25.44, Q25.45, Q25.46, Q25.47, Q25.48, Q25.49 and Q87.82. Under ICD-10 Codes That Support Medical Necessity Group 5: Codes added ICD-10 codes C49.A5, N99.840 and N99.841. This revision is due to the Annual ICD-10 Code Update and becomes effective 10/01/16.
|
- Provider Education/Guidance
- Revisions Due To ICD-10-CM Code Changes
|
01/22/2016
|
R3
|
Under CMS National Coverage Policy in the reference to CMS Internet-Only Manual Pub 100-03, Chapter 1, Part 4 removed “220.3” and “(replaced with section 220.2)”and under CMS Internet-Only Manual Pub 100-04, Chapter 13 removed “40 Magnetic Resonance Imaging (MRI) Procedures” as these references are not valid to the MRA policy. Under Associated Information corrected grammar and removed “for services on or after July 7, 2011”. Under Sources of Information and Basis for Decision updated the reference for American College of Radiology- Blunt Chest Trauma-Suspected Aortic Injury-ACR Appropriateness Criteria to show 2014 (latest version).
|
- Provider Education/Guidance
- Public Education/Guidance
- Other (Annual Validation)
|
10/01/2015
|
R2
|
Per CMS Internet-Only Manual, Pub 100-08, Medicare Program Integrity Manual, Chapter 13, §13.1.3 LCDs consist of only “reasonable and necessary” information. All bill type and revenue codes have been removed.
|
- Other (Bill type and/or revenue code removal)
|
10/01/2015
|
R1
|
Under Coverage Indications, Limitations and/or Medical Necessity changed Manual system to Internet-Only Manual in the first sentence. Added the verbiage MRA is considered appropriate when it can replace a more invasive test (e.g., contrast angiography) and reduce risk for beneficiaries. In addition, the services must be reasonable and necessary for the diagnosis or treatment of the specific patient involved.
Under Bill Type Codes,, added 023x Skilled Nursing Outpatient.
Under Sources of Information and Basis for Decision added individual citations for the American College of Radiology ACR Appropriateness Criteria for Blunt Chest trauma-Suspected Aortic injury; Blunt Chest Trauma; Sudden Onset of Cold, painful Leg; Follow up of lower extremity Arterial Bypass Surgery; Cerebrovascular Disease; and recurrent Symptoms following Lower Extremity Angioplasty.
|
- Provider Education/Guidance
- Other (Annual Validation)
|