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Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) *January 2017. Clinical Diagnostic Laboratory Servi...

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Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) *January 2017

Clinical Diagnostic Laboratory Services U.S. Department of Health & Human Services Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 CMS Email Point of Contact: [email protected] TDD 410.786.0727 Fu Associates, Ltd.

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

NCD Manual Changes Date

Reason

Release

Change

Edit

The following section represents NCD Manual updates for January 2017 *01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Urine Culture, Bacterial (190.12) NCD.

*2017100

*190.12 Urine Culture, Bacterial

*2017100

*190.12 Urine Culture, Bacterial

*2017100

*190.15 Blood Counts

*Transmittal #3628 *01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Urine Culture, Bacterial (190.12) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of ICD-10-CM Codes that Do Not Support Medical Necessity for the Blood Counts (190.15) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 ii

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of ICD-10-CM codes that Do Not Support Medical Necessity for the Blood Counts (190.15) NCD.

*2017100

*190.15 Blood Counts

*2017100

*190.16 Partial Thromboplastin Time (PTT)

*2017100

*190.16 Partial Thromboplastin Time (PTT)

*Transmittal #3628 *01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Partial Thromboplastin Time (PTT) (190.16) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Partial Thromboplastin Time (PTT) (190.16) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 iii

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Prothrombin Time (PT) (190.17) NCD.

*2017100

*190.17 Prothrombin Time (PT)

*2017100

*190.17 Prothrombin Time (PT)

*2017100

*190.18 Serum Iron Studies

*2017100

*190.18 Serum Iron Studies

*Transmittal #3628 *01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Prothrombin Time (PT) (190.17) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Serum Iron Studies (190.18) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Serum Iron Studies (190.18) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 iv

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Blood Glucose Testing (190.20) NCD.

*2017100

*190.20 Blood Glucose Testing

*2017100

*190.20 Blood Glucose Testing

*2017100

*190.21 Glycated Hemoglobin/Glycate d Protein

*Transmittal #3628 *01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Blood Glucose Testing (190.20) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Glycated Hemoglobin/Glycate d Protein (190.21) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 v

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Glycated Hemoglobin/Glycate d Protein (190.21) NCD.

*2017100

*190.21 Glycated Hemoglobin/Glycate d Protein

*2017100

*190.22 Thyroid Testing

*2017100

*190.22 Thyroid Testing

*2017100

*190.23 Lipids Testing

*Transmittal #3628 *01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Thyroid Testing (190.22) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Thyroid Testing (190.22) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Lipids Testing (190.23) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 vi

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for Lipids Testing (190.23) NCD.

*2017100

*190.23 Lipids Testing

*2017100

*190.24 Digoxin Therapeutic Drug Assay

*2017100

*190.24 Digoxin Therapeutic Drug Assay

*2017100

*190.25 Alphafetoprotein

*Transmittal #3628 *01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Digoxin Therapeutic Drug Assay (190.24) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Digoxin Therapeutic Drug Assay (190.24) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Alphafetoprotein (190.25) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 vii

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Alpha-fetoprotein (190.25) NCD.

*2017100

*190.25 Alphafetoprotein

*2017100

*190.27 Human Chorionic Gonadotropin

*2017100

*190.27 Human Chorionic Gonadotropin

*2017100

*190.31 Prostate Specific Antigen

*Transmittal #3628 *01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Human Chorionic Gonadotropin (190.27) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Human Chorionic Gonadotropin (190.27) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Prostate Specific Antigen (190.31) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 viii

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Prostate Specific Antigen (190.31) NCD.

*2017100

*190.31 Prostate Specific Antigen

*2017100

*190.32 Gamma Glutamyl Transferase

*2017100

*190.32 Gamma Glutamyl Transferase

*Transmittal #3628 *01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Gamma Glutamyl Transferase (190.32) NCD. *Transmittal #3628

*01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Gamma Glutamyl Transferase (190.32) NCD. *Transmittal #3628

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 ix

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

*01/01/17

*Per CR 9806 delete the specified ICD10-CM codes from the list of covered ICD-10-CM codes for the Fecal Occult Blood Test (190.34) NCD.

*2017100

*190.34 Fecal Occult Blood Test

*2017100

*190.34 Fecal Occult Blood Test

Transmittal #3628 *01/01/17

*Per CR 9806 add the specified ICD10-CM codes to the list of covered ICD10-CM codes for the Fecal Occult Blood Test (190.34) NCD. *Transmittal #3628

The following section represents NCD Manual updates for October 2016 10/01/16

There were no CR updates for October 2016. The following section represents NCD Manual updates for July 2016

07/01/16

Per CR 9584 add ICD-10-CM codes E61.1, M79.641, M79.642, M79.644, and M79.645 to the list of covered ICD10-CM codes for the Serum Iron Studies (190.18) NCD.

2016300

E61.1 Iron deficiency

190.18 Serum Iron Studies

M79.641 Pain in right hand M79.642 Pain in left hand M79.644 Pain in right finger(s)

Transmittal # 3485

M79.645 Pain in left finger(s) The following section represents NCD Manual updates for April 2016 04/01/16

There were no CR updates for April 2016. *January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 x

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

Date

Reason

Release

Change

Edit

The following section represents NCD Manual updates for January 2016 01/01/16

Per CR 9352 add ICD-10-CM codes N13.1 and N13.2 to the list of covered ICD-10-CM codes for the Urine Culture, Bacterial (190.12) NCD.

2016100

N13.1 Hydronephrosis with ureteral stricture, not elsewhere classified

190.12 Urine Culture, Bacterial

N13.2 Hydronephrosis with renal and ureteral calculous obstruction

Transmittal # 3366 01/01/16

Per CR 9352 add ICD-10-CM code I48.1 to the list of covered ICD-10-CM codes for the Partial Thromboplastin Time (PTT) (190.16) NCD.

2016100

I48.1 Persistent atrial fibrillation

190.16 Partial Thromboplastin Time (PTT)

2016100

S06.9X0A Unspecified intracranial injury without loss of consciousness, initial encounter

190.17 Prothrombin Time

2016100

I48.1 Persistent atrial fibrillation

190.22 Thyroid Testing

Transmittal # 3366 01/01/16

Per CR 9352 add ICD-10-CM code S06.9X0A to the list of covered ICD-10CM codes for the Prothrombin Time (190.17) NCD. Transmittal # 3366

01/01/16

Per CR 9352 add ICD-10-CM code I48.1 to the list of covered ICD-10-CM codes for the Thyroid Testing (190.22) NCD. Transmittal # 3366

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 xi

Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM)

Date

Reason

Release

Change

Edit

The following section represents NCD Manual updates for October 2015 10/01/15

There were no CR updates for October 2015.

*January 2017 Changes ICD-10-CM Version – Red

Fu Associates, Ltd.

January 2017 xii