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NOTE Should you have landed here as a result of a search engine (or other) link be advised that these files contain material that is copyrighted by the American Medical Association You are forbidden to download the files unless you read agree to and abide by the provisions of the copyright statement Read the copyright statement now and you will be linked back to here

JJ PART B MEDICARE ADVISORY Latest Medicare News for JJ Part B

Whatrsquos Inside Administration

Get Your Medicare News Electronically 3 Unsolicited Voluntary Refunds 3 CMS Quarterly Provider Update 5 Going Beyond Diagnosis 5 Special Edition MLN Connects - Wednesday April 24 2018 6 Modifications to the Implementation of the Paperwork (PWK) Segment of the Electronic

Submission of Medical Documentation (esMD) System 8 Claims Processing Actions to Implement Certain Provisions of the Bipartisan Budget

Act of 2018 10 Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure

(PTP) Edits Version 242 Effective July 1 2018 14

Drugs and Biologicals Quarterly Healthcare Common Procedure Coding System (HCPCS) DrugBiological Code

Changes - July 2018 Update 16

Education Educational Events Where You Can Ask Questions and Get Answers 18

Ambulance Increased Ambulance Payment Reduction for Non-Emergency Basic Life Support (BLS)

Transports to and from Renal Dialysis Facilities 20 Ambulance Transportation for a SNF Resident in a Stay Not Covered by Part A - Medicare

Benefit Policy Manual Chapter 10 and Medicare Claims Processing Manual Chapter 15 22

Laboratory Proper Coding for Specimen Validity Testing Billed in Combination with Drug Testing 24 New Waived Tests 27

Continued gtgt

palmettogbacomjjb

The JJ Part B Medicare Advisory contains coverage billing and other information for Part B This information is not intended to constitute legal advice It is our ofϐicial notice to those we serve concerning their responsibilities and ob-ligations as mandated by Medicare regulations and guidelines This information is readily available at no cost on the Palmetto GBA website It is the responsibility of each facility to obtain this information and to follow the guidelines The JJ Part B Medicare Advisory includes information provided by the Centers for Medicare amp Medicaid Services (CMS) and is current at the time of publication The information is subject to change at any time This bulletin should be shared with all health care practitioners and managerial members of the provider staff Bulletins are available at no-cost from our website at httpswwwPalmettoGBAcomJJB

American Medical Association Applicable FARSDFARS Restrictions Apply to Government Use Fee schedules rel-ative value units conversion factors andor related components are not assigned by the AMA and are not part of CPTreg 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 The Code on Dental Procedures and Nomenclature is published in Current Dental Terminology (CDT) Copyright copy 2017 Ameri-can Dental Association (ADA) All rights reserved

May 2018 Volume 2018 Issue 2

Radiology Change in Type of Service (TOS) for Current Procedural Terminology (CPT) Code 77067 29

Skilled Nursing Facility Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) 31

Therapy Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) 33

Etcetera Medical Directorrsquos Desk 38 MLN ConnectsTM 49

CMS Provider Minute Videos The Medicare Learning Network has a series of CMS Provider Minute Videos (httpswwwcmsgovOutreachshyand-EducationMedicare-Learning-Network-MLNMLNProductsMLN-Multimediahtml) on a variety of topics such as psychiatry preventive services lumbar spinal fusion and much more The videos offer tips and guidelines to help you properly submit claims and maintain sufficient supporting documentation Check the site often as CMS adds new videos periodically to further help you navigate the Medicare program

CPT codes descriptors and other data only are copyright 2017 American Medical Association (or such other date of publication of CPT) All Rights Reserved Applicable FARSDFARS apply Current Dental Terminology fourth edition (CDT) (including procedure codes nomenclature descriptors and other data contained therein) is copyright by the American Dental Association copy2017 American Dental Association All rights reserved Applicable FARSDFARS apply

2 52018

Get Your Medicare News Electronically The Palmetto GBA Medicare listserv is a wonderful communication tool that offers its members the opportunity to stay informed about

bull Medicare incentive programs bull Fee Schedule changes bull New legislation concerning Medicare bull And so much more

How to register to receive the Palmetto GBA Medicare Listserv Go to httptinyurlcomPalmettoGBAListserv and select ldquoRegister Nowrdquo Complete and submit the online form Be sure to select the specialties that interest you so information can be sent

Note Once the registration information is entered you will receive a confirmationwelcome message informing you that yoursquove been successfully added to our listserv You must acknowledge this confirmation within 3 days of your registration

Unsolicited Voluntary RefundsThe acceptance of a voluntary refund as repayment for the claims specified in no way affects or limits the rights of the Federal Government or any of its agencies or agents to pursue any appropriate criminal civil or administrative remedies arising from or relating to these or any other claims

eServices Makes Asking a Medicare Question Easier

The eServices Secure eChat option allows providers to interact with designated Palmetto GBA staff so they can receive real-time assistance locating information on any topics or specialties they are searching for on the Palmetto GBA website or within the eServices online portal The Secure eChat feature also allows users

to dialogue with an online operator who can assist with patient or provider specific inquires or address questions that require the sharing of PHI information Using Secure eChat is simple This free portal is available to all Medicare providers as long as you have a signed Electronic Data Interchange (EDI) Enrollment Agreement and a processed claim history Once in the eServices portal from the bottom right corner select either Medicare Inquiries or eServices Help If you do not have an eServices account you can get started by clicking this eServices link httpswwwonlineproviderservicescomecx_improvev2The Secure eChat feature is available during business hours to assist providers

3 52018

Medicare Learning Networkreg (MLN) Want to stay informed about the latest changes to the Medicare Program Get connected with the Medicare Learning Networkreg (MLN) ndash the home for education information and resources for health care professionals

The Medicare Learning Networkreg is a registered trademark of the Centers for Medicare amp Medicaid Services (CMS) and the brand name for official CMS education and information for health care professionals It provides educational products on Medicare-related topics such as provider enrollment preventive services claims processing provider compliance and Medicare payment policies MLN products are

offered in a variety of formats including training guides articles educational tools booklets fact sheets web-based training courses (many of which offer continuing education credits) ndash all available to you free of charge

The following items may be found on the CMS web page at httpswwwcmsgovOutreach-and-EducationMedicare-Learning-Network-MLNMLNProductsindexhtml bull MLN Catalog is a free interactive downloadable document that lists all MLN products by media format To

access the catalog scroll to the ldquoDownloadsrdquo section and select ldquoMLN Catalogrdquo Once you have opened the catalog you may either click on the title of a product or you can click on the type of ldquoFormats Availablerdquo This will link you to an online version of the product or the Product Ordering Page

bull MLN Product Ordering Page allows you to order hard copy versions of various products These products are available to you for free To access the MLN Product Ordering Page scroll to the ldquoRelated Linksrdquo and select ldquoMLN Product Ordering Pagerdquo

bull MLN Product of the Month highlights a Medicare provider education product or set of products each month along with some teaching aids such as crossword puzzles to help you learn more while having fun

Other resources bull MLN Publications List contains the electronic versions of the downloadable publications These products

are available to you for free To access the MLN Publications go to httpswwwcmsgovOutreach-andshyEducationMedicare-Learning-Network-MLNMLNProductsMLN-Publicationshtml You will then be able to use the ldquoFilter Onrdquo feature to search by topic or key word or you can sort by date topic title or format

MLN Educational Products Electronic Mailing List To stay up-to-date on the latest news about new and revised MLN products and services subscribe to the MLN Educational Products electronic mailing list This service is free of charge Once you subscribe you will receive an e-mail when new and revised MLN products are released

To subscribe to the service 1 Go to httpslistnihgovcgi-binwaexeA0=mln_education_products-l and select the lsquoSubscribe or

Unsubscribersquo link under the lsquoOptionsrsquo tab on the right side of the page 2 Follow the instructions to set up an account and start receiving updates immediately ndash itrsquos that easy

If you would like to contact the MLN please email CMS at MLNcmshhsgov

4 52018

CMS Quarterly Provider Update

The Quarterly Provider Update is a comprehensive resource published by the Centers for Medicare amp Medicaid Services (CMS) on the first business day of each quarter It is a listing of all non-regulatory changes to Medicare including program memoranda manual changes and any other instructions that could affect providers Regulations and instructions published in the previous quarter are also included in the update The purpose of the Quarterly Provider Update is to bull Inform providers about new developments in the Medicare program bull Assist providers in understanding CMS programs and complying with Medicare regulations and instructions bull Ensure that providers have time to react and prepare for new requirements bull Announce new or changing Medicare requirements on a predictable schedule bull Communicate the specific days that CMS business will be published in the lsquoFederal Registerrsquo

To receive notification when regulations and program instructions are added throughout the quarter sign up for the Quarterly Provider Update listserv (electronic mailing list) at httpspublicgovdeliverycomaccountsUSCMSsubscribernewpop=tampqsp=566

We encourage you to bookmark the Quarterly Provider Update Web site at wwwcmsgovRegulations-and-GuidanceRegulations-and-PoliciesQuarterlyProviderUpdatesindex html and visit it often for this valuable information

Going Beyond Diagnosis Preventing Payment Errors by

Improving Provider-Payer Communication A failure to communicate is the number one cause of Medicare claims denials Palmetto GBArsquos Going Beyond Diagnosis (GBD) process helps reduce Medicare denials by supporting the dissemination of best practices and process improvements The GBD Blog was established to provide a platform for discussing the challenges and complexities of communicating health care encounters and to provide potential solutions to identify the root causes for specific communication errors

The GBD Blog and Twitter ID BeyondDx are part of Palmetto GBArsquos innovative strategy for increasing the capacity of Medicare providers to improve the quality of healthcare records and effectively decrease the claims payment error rate The success of this social media approach to communicating with healthcare stakeholders depends on your active participation

True innovation requires collaboration Please join the on-line GBD community by visiting the GBD Blog at httppalmgbacomgbd or signing-up to follow us on Twitter BeyondDx

5 52018

Special Edition MLN Connects - Wednesday April 24 2018 CMS Proposes Changes to Empower Patients and Reduce Administrative Burden

Changes in IPPS and LTCH PPS would advance price transparency and interoperability

On April 24 CMS proposed changes to empower patients through better access to hospital price information improve patientsrsquo access to their electronic health records and make it easier for providers to spend time with their patients The proposed rule proposes updates to Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS)

ldquoWe seek to ensure the health care system puts patients firstrdquo said Administrator Seema Verma ldquoTodayrsquos proposed rule demonstrates our commitment to patient access to high quality care while removing outdated and redundant regulations on providers We envision a system that rewards value over volume and where patients reap the benefi ts through more choices and better health outcomes Secretary Azar has made such a value-based transformation in our health care system a top priority for HHS and CMS is taking important concrete steps toward achieving itrdquo

The policies in the IPPS and LTCH PPS proposed rule would further advance the agencyrsquos priority of creating a patient-driven health care system by achieving greater price transparency and interoperability ndash essential components of value-based care ndash while also significantly reducing the burden for hospitals so they can operate with better flexibility and patients have the information they need to become active health care consumers

While hospitals are already required under guidelines developed by CMS to either make publicly available a list of their standard charges or their policies for allowing the public to view a list of those charges upon request CMS is updating its guidelines to specifically require that hospitals post this information The agency is also seeking comment on what price transparency information stakeholders would find most useful and how best to help hospitals create patient-friendly interfaces to make it easier for consumers to access relevant health care data so they can more readily compare providers

The proposed policies begin implementing core pieces of the government-wide MyHealthEData initiative through steps to strengthen interoperability or the sharing of health care data between providers Specifi cally CMS is proposing to overhaul the Medicare and Medicaid Electronic Health Record Incentive Programs (also known as the ldquoMeaningful Userdquo program) to bull Make the program more flexible and less burdensome bull Emphasize measures that require the exchange of health information between providers and patients bull Incentivize providers to make it easier for patients to obtain their medical records electronically

To better reflect this new focus we are renaming the Meaningful Use program ldquoPromoting Interoperabilityrdquo In addition the proposed rule reiterates the requirement for providers to use the 2015 Edition of certified electronic health record technology in 2019 as part of demonstrating meaningful use to qualify for incentive payments and avoid reductions to Medicare payments This updated technology includes the use of application programming interfaces which have the potential to improve the flow of information between providers and

Continued gtgt CPT codes descriptors and other data only are copyright 2017 American Medical Association (or such other date of publication of CPT) All Rights Reserved Applicable FARSDFARS apply Current Dental Terminology fourth edition (CDT) (including procedure codes nomenclature descriptors and other data contained therein) is copyright by the American Dental Association copy2017 American Dental Association All rights reserved Applicable FARSDFARS apply

6 52018

patients In the proposed rule CMS is requesting stakeholder feedback through a Request for Information on the possibility of revising Conditions of Participation to revive interoperability as a way to increase electronic sharing of data by hospitals

As part of its commitment to burden reduction CMS is proposing in the FY 2019 IPPSLTCH PPS proposed rule to remove unnecessary redundant and process-driven quality measures from a number of quality reporting and pay-for-performance programs The proposed rule would eliminate a significant number of measures acute care hospitals are currently required to report and remove duplicative measures across the 5 hospital quality and value-based purchasing programs This would remove 19 measures from the programs and de-duplicate another 21 measures while still maintaining meaningful measures of hospital quality and patient safety Additionally CMS is proposing a variety of other changes to reduce the number of hours providers spend on paperwork CMS is proposing this new flexibility so that hospitals can spend more time providing care to their patients thereby improving the quality of care their patients receive

In sum this results in the elimination of 25 measures across the 5 programs with well over 2 million burden hours reduced for hospital providers impacted by the IPPS proposed rule saving them $75 million

For More Information bull Proposed Rule httpswwwfederalregistergovdocuments201805072018-08705medicare-programsshy

hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-long bull Fact Sheet httpswwwcmsgovNewsroomMediaReleaseDatabase

Fact-sheets2018-Fact-sheets-items2018-04-24 htmlDLPage=1ampDLEntries=10ampDLSort=0ampDLSortDir=descendingampwb48617274=2137737B

See the full text of this excerpted CMS Press Release (issued April 24) at httpswwwcms govNewsroomMediaReleaseDatabasePress-releases2018-Press-releases-items2018-04-24 htmlDLPage=1ampDLEntries=10ampDLSort=0ampDLSortDir=descending

7 52018

Modifications to the Implementation of the Paperwork (PWK) Segment of the Electronic Submission of Medical

Documentation (esMD) System MLN Matters Number MM10397 Revised Related CR Release Date April 3 2018 Related CR Transmittal Number R2050OTN Related Change Request (CR) Number 10397 Effective Date July 1 2018 Implementation Date July 2 2018

Note This article was revised on April 4 2018 to reflect a revised CR issued on April 3 In the article the CR release date transmittal number and the Web address of the CR are revised All other information is the same

PROVIDER TYPE AFFECTED This MLN Matters Article is intended for physicians suppliers and providers submitting electronic med ical documentation to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

PROVIDER ACTION NEEDED Change Request (CR) 10397updates the business requirements to enable MACs to receive unsolicited documentation (also known as paperwork (PWK)) via the Electronic Submission of Medical Documentation (esMD) system CR10397 is for esMD purposes only Please make sure your billing staffs are aware of these updates

BACKGROUND CR10397 also contains attachments that include cover sheets that must be used for electronic fax or mail submissions of documentation There are three cover sheets one each for Part A and Part B providers as well as one for durable medical equipment (DME) suppliers In addition there are two companion guides attached to CR10397 one for institutional claims and one for professional claims A link to CR10397 is available in the Additional Information section of this article

With CR10397 MACs will modify PWK also known as unsolicited documentation procedures to include electronic submission(s) via esMD Also Medicare systems will accept PWK 02 values ldquoELrdquo and ldquoFTrdquo for those MACs in a CMS-approved esMD system This mechanism will suppress initial auto letter generation if applicable when PWK 02 is ldquoELrdquo or ldquoFTrdquo and is present at any level of the claim or line

Providers will receive communication from MACs via companion documents for 5010 X12 837 to include bull The value ldquoELrdquo (electronic) in PWK 02 to represent an esMD submission for sending the documentation

using X12 Standards (6020 X12 275) bull The value ldquoFTrdquo (file transfer) in PWK 02 to represent an esMD submission for sending the documentation

in PDF format using XDR specifications

MACs will allow 7 calendar ldquowaiting daysrdquo (from the date of receipt) for additional information to be submitted when the PWK 02 value is ldquoELrdquo or ldquoFTrdquo

8 52018

MACs will use RC Client to reject the PWK data submissions as administrative error(s) when the received cover sheet (via esMD) is incomplete or incorrectly filled out as applicable to current edits Providers can expect to see new generic reason statements introduced to convey these errors as follows (Codes for these statements will be finalized and sent along with the RC implementation guide) bull The date(s) of service on the cover sheet received is missing or invalid bull The NPI on the cover sheet received is missing or invalid bull The state where services were provided is missing or invalid on the cover sheet received bull The Medicare ID on the cover sheet received is missing or invalid bull The billed amount on the cover sheet received is missing or invalid bull The contact phone number on the cover sheet received is missing or invalid bull The beneficiary name on the cover sheet received is missing or invalid bull The claim number on the cover sheet received is missing or invalid bull The Attachment Control Number (CAN) on the cover sheet is missing or invalid

Once again examples of the cover sheet are included as an attachment to CR10397

ADDITIONAL INFORMATION The official instruction CR 10397 issued to your MAC regarding this change is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR2050OTNpdf

The X12 837 Companion Guides are available at httpswwwcmsgovMedicareBillingElectronicBillingEDITransCompanionGuideshtml

DOCUMENT HISTORY Date of Change Description April 3 2018 The article was revised to reflect a revised CR In the article the CR release

date transmittal number and the Web address of the CR are revised All other information is the same

February 16 2018 Initial article released

9 52018

Claims Processing Actions to Implement Certain Provisions of the Bipartisan Budget Act of 2018

MLN Matters Number MM10531 Revised Related CR Release Date April 4 2018 Related CR Transmittal Number R2051OTN Related Change Request (CR) Number 10531 Effective Date January 1 2018 Implementation Date April 2 2018 ndash date to begin reprocessing claims

Note This article was revised on April 5 2018 to refl ect a revised CR10531 which was revised on April 4 to include page 2 of Attachment B - Rural Add on Rate Tables In the article the CR release date transmittal number and the Web address for CR10531 are revised All other information remains the same

PROVIDER TYPE AFFECTED This MLN Matters Article is intended for physicians providers and suppliers billing Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

WHAT YOU NEED TO KNOW Change Request (CR) 10531 provides direction to MACs to reprocess claims related to several provisions of the Bipartisan Budget Act of 2018 referred to as Medicare Extenders Specifically the CR provides guidance to MACs regarding Medicare Fee For Service (FFS) claims reprocessing requirements and timeframes Make sure your billing staffs are aware of these changes

BACKGROUND On February 9 2018 Congress passed the Bipartisan Budget Act of 2018 which contains a number of provisions that extend certain Medicare FFS policies including Ambulance add-on payment provisions the Work Geographic Practice Cost Index (GPCI) Floor and the three percent Home Health (HH) Rural Add-on Payment In addition the Act permanently repeals the outpatient therapy caps beginning on January 1 2018 while retaining the requirement to submit the KX modifier for services in excess of the prior cap amounts Due to the retroactive effective dates of these provisions your MAC will reprocess various Medicare FFS claims impacted by this legislation

Section 421(a) of the Medicare Modernization Act (MMA) as amended by Section 50208 of the Social Security Act provides an increase of 3 percent of the payment amount otherwise made under Section 1895 of the Social Security Act for home health services furnished in a rural area (as defined in Section 1886(d)(2)(D) of the Act) with respect to episodes and visits ending on or after April 1 2010 and before January 1 2019 The statute waives budget neutrality related to this provision

As a result of the Work GPCI floor changes certain Federally Qualified Health Center (FQHC) Geographic Adjustment Factors (GAFs) will change which may result in a change to some FQHC payments For Inpatient Prospective Payment System (IPPS) hospitals temporary changes to the low-volume hospital payment adjustment and the Medicare-Dependent Hospital (MDH) program have been extended In addition for the Long-Term Care Hospital Prospective Payment (LTCH PPS) the blended payment rate for site neutral payment

10 52018

rate cases is extended for certain LTCH hospital discharges Separate instructions addressing these payment updates are forthcoming

On January 25 2018 the Centers for Medicare amp Medicaid Services (CMS) instructed MACs to release for processing held therapy claims with the KX modifier with dates of receipt January 1- 10 2018 CMS also instructed the MACs to institute a ldquorolling holdrdquo for all new therapy claims with the KX modifi er On February 12 2018 CMS provided direction regarding new Medicare Physician Fee Schedule (MPFS) files and abstract files due to the extension of the Work GPCI Floor as well as a revised 2018 Ambulance Fee Schedule (AFS) file CMS also instructed the MACs to ensure legislative effective indicators were set correctly in Medicare systems to apply therapy policies Given that legislation has been enacted CMS is instructing the MACs to reprocess effected claims that were processed using the previous MPFS files

As stipulated in Section 421(a) of the MMA the 3 percent rural add-on is applied to the national standardized episode rate national per-visit payment rates Low-Utilization Payment Adjustment (LUPA) add-on payments and the Non-Routine Supplies (NRS) conversion factor when home health services are provided in rural (non-CBSA) areas for episodes and visits ending on or after April 1 2010 and before January 1 2019 Refer to Tables 1 through 4 of the attachment to CR10531 for the Calendar Year (CY) 2018 rural payment rates CR10531 is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR2047OTNpdf

Section 1848(e)(1)(E) of the Social Security Act stipulates that after calculating the work geographic index for purposes of MPFS payment for services furnished the Secretary shall increase the work geographic index to 100 for any locality for which such work geographic index is less than 100 This provision expired on December 31 2017 and the locality-specific anesthesia conversion factors for CY 2018 were calculated without this work geographic index floor of 100 in place

Section 50201 of the Bipartisan Budget Act of 2018 restored the work geographic index floor of 100 and retroactively dated this restoration to January 1 2018 In accordance with the law CMS has updated the locality-specific anesthesia conversion factors for CY 2018 to include the work geographic index floor of 100 These updated locality-specific anesthesia conversion factors also have a retroactive effective date of January 1 2018

CR10531 reminds the MACs to be aware that Section 1848(b)(4) of the Social Security Act limits MPFS payment for the technical portion of most imaging procedures to the amount paid under the Outpatient Prospective Payment System (OPPS) system This policy applies to the technical component (and technical portion of global payment) of imaging services including X-ray ultrasound nuclear medicine MRI CT and fluoroscopy services The MPFS payment rates for some of these services does not reflect the most recent updates to the OPPS rates that were updated in December of 2017 CMS corrected these rates in new MPFS files and informed the MACs of the corrections on February 12 2018 These MPFS files also contain the updates for the GPCI This correction is unrelated to the passage of this Act but CMS is taking the opportunity to address this issue now since new MPFS files are required as a result of the Act

11 52018

The instructions to the MACs to reprocess claims contain the following specifics bull The MACs will reprocess therapy claims with the KX modifier containing Dates of Service in Calendar

Year 2018 which were denied prior to the implementation of the updated legislative effective dates issued on January 25 2018 NOTE For institutional claims these claims will include revenue codes 042x 043x or 044x and modifiers GN GO or GP

bull The MACs will reprocess therapy claims with the KX modifier which were denied due to an invalid date provided by CMS on February 12 2018

bull The MACs will reprocess 2018 therapy claims which cannot be automatically reprocessed only if you bring such claims to the attention of your MAC

bull The MACs reprocess MPFS claims for localities and States impacted by the Work GPCI Floor fee increase for Dates of Service in CY 2018 Please refer to the chart in Attachment A - Localities and States Impacted by the Work GPCI Floor ndash 2018 ndash in CR10531

bull The MACs will reprocess 2018 MPFS claims for localities and States impacted by the Work GPCI Floor fee increase for Dates of Service in CY 2018 which cannot be automatically reprocessed only if you bring such claims to your MACrsquos attention Please refer to the chart in Attachment A - Localities and States Impacted by the Work GPCI Floor ndash 2018

bull The MACs will reprocess ground AFS claims using the revised 2018 AFS file for Dates of Service in Calendar Year 2018

bull The MACs will reprocess claims which cannot be automatically reprocessed only if you bring such claims to your MACrsquos attention

bull MACs will reprocess home health claims with the following criteria bull Type of Bill 32X bull Claim ldquoThroughrdquo dates on or after January 1 2018 bull Value code 61 amounts in the range 999xx bull Receipt dates prior to the installation of the revised home health Pricer which reflects the extension of

the 3 rural add-on for CY 2018 bull MACs will automatically reprocess claims impacted by the OPPS cap for Dates of Service in Calendar

Year 2018 The MACs will reprocess claims which cannot be automatically reprocessed only if you bring such claims to your MACrsquos attention

bull The MACs will automatically reprocess anesthesia claims for localities and States impacted by the Work GPCI Floor fee increase for Dates of Service in CY 2018 Please refer to the chart in Attachment A - Localities and States Impacted by the Work GPCI Floor - 2018 The MACs will reprocess claims which cannot be automatically reprocessed only if you bring such claims to your MACrsquos attention

bull MACs shall ensure all reprocessing actions have been initiated within 6 months of the issuance of CR10531 bull For therapy and MPFS adjustments bull For ground ambulance service claims with a date of service on or after 112018 bull For OPPS adjustments bull For anesthesia adjustments

bull MACs shall ensure all reprocessing actions have been initiated within 6 months of the implementation date of the Pricer for HH rural add-on adjustments

12 52018

ADDITIONAL INFORMATION The official instruction CR10531 issued to your MAC regarding this change is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR2051OTNpdf

DOCUMENT HISTORY Date of Change Description April 5 2018 The article was revised to reflect a revised CR10531 which was revised to include

of Attachment B - Rural Add on Rate Tables In the article the CR release date transmittal number and the Web address for CR10531 are revised All other information remains the same

March 26 2018 Initial article released

13 52018

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits Version 242

Effective July 1 2018 MLN Matters Number MM10593 Related CR Release Date April 13 2018 Related CR Transmittal Number R4022CP Related Change Request (CR) Number 10593 Effective Date July 1 2018 Implementation Date July 2 2018

PROVIDER ACTION NEEDED Change Request (CR) 10593 includes the normal update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits This update applies to Chapter 23 Section 209 of the Medicare Claims Processing Manual Please make sure your billing staffs are aware of these updates

BACKGROUND The Centers for Medicare amp Medicaid Services (CMS) developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment in Part B claims

Version 242 will include all previous versions and updates from January 1 1996 to the present In the past NCCI was organized in two tables Column 1Column 2 Correct Coding Edits and Mutually Exclusive Code (MEC) Edits To simplify the use of NCCI edit files (two tables) on April 1 2012 CMS consolidated these two edit files into the Column OneColumn Two Correct Coding edit file Separate consolidations have occurred for the two practitioner NCCI edit files and the two NCCI edit files used for the Outpatient Code Editor (OCE) It will only be necessary to search the Column OneColumn Two Correct Coding edit file for active or previously deleted edits

CMS no longer publishes a Mutually Exclusive edit file on its website for either practitioner or outpatient hospital services since all active and deleted edits will appear in the single Column OneColumn Two Correct Coding edit file on each website You should note that the edits previously contained in the Mutually Exclusive edit file are NOT being deleted but are being moved to the Column OneColumn Two Correct Coding edit file Please refer to the CMS NCCI webpage for additional information at httpwwwcmsgovMedicareCodingNationalCorrectCodInitEdindexhtml

The coding policies developed are based on coding conventions defined in the American Medical Associationrsquos Current Procedural Terminology manual national and local policies and edits coding guidelines developed by national societies analysis of standard medical and surgical practice and review of current coding practice

14 52018

ADDITIONAL INFORMATION The official instruction CR10593 issued to your MAC regarding this change is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR4022CPpdf

DOCUMENT HISTORY Date of Change Description April 13 2018 Initial article released

EDI Enrollment Instructions Guide Module Do you need help completing your EDI Enrollment packet This interactive guide will give you all the information you need to get started including which forms to complete and the fields that must be completed on each form Access the EDI Enrollment Instructions Guide Module under FormsTools on the home page

15 52018

Quarterly Healthcare Common Procedure Coding System (HCPCS) DrugBiological Code Changes - July 2018 Update

MLN Matters Number MM10624 Related CR Release Date April 20 2018 Related CR Transmittal Number R4025CP Related Change Request (CR) Number 10624 Effective Date July 1 2018 Implementation Date July 2 2018

PROVIDER TYPES AFFECTED This MLN Matters Article is intended for physicians providers and suppliers billing Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

PROVIDER ACTION NEEDED Change Request (CR) 10624 informs MACs of updated drugbiological HCPCS codes The HCPCS code set is updated on a quarterly basis The July 2018 HCPCS file includes 4 new HCPCS codes Q9991 Q9992 Q9993 and Q9995 Please make sure your billing staffs are aware of these updates

BACKGROUND The July 2018 HCPCS file includes four new HCPCS codes which are payable by Medicare effective for claims with dates of service on or after July 1 2018 These codes are bull Q9991

bull Short Description Buprenorph xr 100 mg or less bull Long Description Injection buprenorphine extended-release (sublocade) less than or equal to 100 mg bull Type of Service (TOS) Code 1 bull Medicare Physician Fee Schedule Data Base (MPFSDB) Status Indicator E

bull Q9992 bull Short Description Buprenorphine xr over 100 mg bull Long Description Injection buprenorphine extended-release (sublocade) greater than 100 mg bull TOS Code 1 bull MPFSDB Status Indicator E

bull Q9993 bull Short Description Inj triamcinolone ext rel bull Long Description Injection triamcinolone acetonide preservative-free extended-release microsphere

formulation 1 mg bull TOS Code 1P bull MPFSDB Status Indicator E

bull Q9995 bull Short Description Inj emicizumab-kxwh 05 mg bull Long Description Injection emicizumab-kxwh 05 mg bull TOS Code 1 bull MPFSDB Status Indicator E

16 52018

ADDITIONAL INFORMATION The official instruction CR 10624 issued to your MAC regarding this change is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR4025CPpdf

Wersquod Love Your Feedback Palmetto GBA is committed to continuously improve your customer experience We welcome your feedback on your experiences with the PalmettoGBAcom website and the eServices portal As a visitor to the Palmetto GBAs website you may be presented with an opportunity to take the website satisfaction survey

The next time the survey is offered to you please agree to participate and provide us with your feedback You have the opportunity to explain your comments share your honest opinions and tell us what you like and what you would like to see us improve If you find a feature or tool specifically helpful let us know including any suggestions for making them simpler to use

We continuously analyze your feedback and develop enhancements plans to better assist you with your experience We value your opinion and look forward to hearing from you

17 52018

Educational Events Where You Can Ask Questions and Get Answers from Palmetto GBA

Donrsquot Miss this Wonderful Opportunity If you are in search of an opportunity to interact with and get answers to your Medicare billing coverage and documentation questions from Palmetto GBArsquos Provider Outreach and Education (POE) department please see these educational offerings which have a question and answer session

Event Title DateTime Address (or link if Webinar)

Top 10 Medical Review Denials for Medicare Part B Jurisdictions JJ and JM

May 3 2018 1100 am ET

httpseventon24comwccr1644786 FDF078B14757637C06B6048ED50B9E31

Physicians - Are You Ordering DMEPOS for Your Patient Documentation Requirements - A Collaboration Between Physicians and DME Suppliers Webcast

May 3 2018 11 am ET

httpsregistergotowebinarcomregister7967528936983823873

May 3 2018 4 pm ET

JJJM June Medicare Part B Updates Changes and Reminders

June 6 2018 10 am ET

httpseventon24comwccr1585285 C35C73FBCA519D39FDE01D8FAE4C326A

JJJM Part B Ask the Contractor Teleconference Topic TBD

June 12 2018 11 am ET

Dial in Number 866-745-0425 Access Code 4298248

Check out these resources Quarterly Ask the Contractor Teleconferences (ACTs)

httptinyurlcomjkb4458

ACTs are intended to open the communication channels between providers and Palmetto GBA which allows for timely identification of problems and information-sharing in an informal and interactive atmosphere These teleconferences will be held at least quarterly via teleconference

Proceding the presentation providers are given an opportunity to ask questions both on the topics discussed as well as any other question they may have While we encourage providers to submit questions prior to the call this is not required Just fill out the Ask the Contractor Teleconference (ACT) Submit A Question form (httptinyurlcomhjq84dg) Once the form is completed please fax it to (803) 935-0140 Attention Ask-the-Contractor Teleconference

18 52018

Quarterly Updates Webcasts

httptinyurlcomgsrb8gt

Event Registration Portal

The Quarterly Update Webcasts are intended to provide ongoing scheduled opportunities for providers to stay up to date on Medicare requirements

Providers are able to type a question and have it responded to by the POE department throughout the webcast At the end of the presentation the moderator will also read and respond to questions submitted by attendees in order to share the responses with the group at large Visit our Event Registration Portal to find information on upcoming educational events and seminars

This is a complete listing of both our face-to-face outreach opportunities as well as our teleconference and webcast listings Providers are able to dialogue with POE and get answers to their questions at all of these educational events

If you have a question that you need an answer to today or a claims specific question which requires the disclosure of PII or PHI for response please contact the Provider Contact Center (PCC) at 1-855-696-0705 for Jurisdiction M or 877-567-7271 for Jurisdiction J

19 52018

Increased Ambulance Payment Reduction for Non-Emergency Basic Life Support (BLS) Transports to and from

Renal Dialysis Facilities MLN Matters Number MM10549 Related CR Release Date April 6 2018 Related CR Transmittal Number R4017CP Related Change Request (CR) Number 10549 Effective Date October 1 2018 Implementation Date October 1 2018

PROVIDER TYPES AFFECTED This MLN Matters Article is intended for providers and suppliers billing Medicare Administrative Contractors (MACs) for ambulance transport services provided to Medicare beneficiaries

PROVIDER ACTION NEEDED Change Request (CR) 10549 provides instructions regarding Section 53108 of the Bipartisan Budget Act of 2018 This section reduces the ambulance payment by 23 percent for non-emergency Basic Life Support (BLS) transports of individuals with End-Stage Renal Disease (ESRD) to and from renal dialysis treatment (at both hospital-based and freestanding renal dialysis treatment facilities) Please make sure your billing staffs are aware of these changes

BACKGROUND Payment for ambulance transports (including items and services furnished in association with such transports) are based on the Ambulance Fee Schedule (AFS) and include a base rate payment plus a separate payment for mileage This raised payment reduction for non-emergency BLS transports to and from renal dialysis treatment applies to both the base rate and the mileage reimbursement

CR8269 issued May 10 2013 implemented Section 637 of the American Taxpayer Relief Act of 2012 which for transports occurring on and after October 1 2013 required a 10-percent reduction in fee schedule payments for non-emergency (BLS transports of beneficiaries with ESRD) to and from both hospital-based and freestanding renal dialysis treatment facilities for non-emergent dialysis services The MLN Matters article associated with this CR is available at httpswwwcmsgovOutreach-and-EducationMedicare-LearningshyNetwork-MLNMLNMattersArticlesDownloadsMM8269pdf

CR10549 provides instructions regarding Section 53108 of the Bipartisan Budget Act of 2018 (signed into law on February 9 2018) which requires that effective October 1 2018 the reduction of fee schedule payments for BLS transports to and from renal dialysis treatments be increased to 23 percent

Non-emergency BLS ground transports are identified by Healthcare Common Procedure Coding System (HCPCS) code A0428 (Ambulance service basic life support non-emergency transport (bls)) Ambulance transports to and from renal dialysis treatment are further identified by origindestination modifier codes ldquoGrdquo (hospital-based ESRD) and ldquoJrdquo (freestanding ESRD facility) in either the origin or destination position of an ambulance modifi er

20 52018

Specifi c Details bull Effective for claims with dates of service on and after October 1 2018 payment for non-emergency BLS

transports to and from renal dialysis treatment facilities will be reduced by 23 percent The reduced rate will be calculated after the normal payment rate (including any applicable add-on payments) is calculated and will be applied to the base rate for non-emergency BLS transports (identified by HCPCS code A0428 when billed with the indicated modifier codes) and the associated separate mileage payment (identified by HCPCS code A0425)

bull Payment for emergency transports and non-emergency BLS transports to other destinations (rural and urban) will remain unchanged The AFS will also remain unchanged

bull For ambulance services suppliers and hospital-based ambulance providers must report an accurate origin and destination modifier for each ambulance trip provided Origin and destination modifiers used for ambulance services are created by combining two alpha characters Each alpha character with the exception of ldquoXrdquo represents an origin code or a destination code The pair of alpha codes creates a modifi er The fi rst position alpha code equals origin the second position alpha code equals destination

bull The reduction will be applied on claim lines containing HCPCS code A0428 with modifier code ldquoGrdquo or ldquoJrdquo in either the first position (origin code) or second position (destination code) within the two-digit ambulance modifier code and HCPCS code A0425

bull MACs will keep in place all existing edits and logic (implemented previously via CMS CR 8269) that currently apply to the reduced AFS payment rates however effective for claims with dates of service on or after October 1 2018 will increase the reduction from 10 percent to 23 percent Additionally they will continue to use the claim adjustment reason code group code and Medicare Summary Notice messages that are currently used for the reduced AFS payment methodology

Note This 23-percent reduction applies to beneficiaries with ESRD that are receiving a non-emergency BLS transport to and from renal dialysis treatment While it is possible that a beneficiary who is not diagnosed with ESRD will require routine transport to and from renal dialysis treatment it is highly unlikely However MACs have the discretion to override or reverse the reduction on appeal if they deem it appropriate based on supporting documentation

21 52018

Ambulance Transportation for a SNF Resident in a Stay Not Covered by Part A - Medicare Benefit Policy Manual Chapter

10 and Medicare Claims Processing Manual Chapter 15 MLN Matters Number MM10550 Related CR Release Date April 13 2018 Related CR Transmittal Number R243BP and R4021CP Related Change Request (CR) Number 10550 Effective Date July 16 2018 Implementation Date July 16 2018

PROVIDER TYPES AFFECTED This MLN Matters Article is intended for Skilled Nursing Facilities (SNF) ambulance providers and suppliers providing ambulance services to patients and billing Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries who are not in a covered Part A stay

PROVIDER ACTION NEEDED Change Request (CR) 10550 provides clarification on coverage of an ambulance transport for a SNF resident in a stay not covered by Part A who has Part B benefits to the nearest supplier of medically necessary services not available at the SNF including the return trip These clarifications relate to Chapter 10 of the Medicare Benefit Policy Manual and Chapter 15 of the Medicare Claims Processing Manual The revised manual sections are attachments to CR10550 Make sure your billing staffs are aware of these clarifications

BACKGROUND In the June 17 1997 ambulance proposed rule (62 FR 32720) the Centers for Medicare amp Medicaid Services (CMS) proposed a provision under Part B that permits ambulance transportation from a SNF to the nearest supplier of medically necessary services not available at the SNF where the beneficiary is an inpatient including the return trip CMS finalized this proposal in the January 25 1999 final rule (64 FR 3648) at 42 CFR 41040(e)(3)

CMS is revising the Medicare Benefit Policy Manual and Medicare Claims Processing Manual to clarify that a medically necessary ambulance transport fr om an SNF to the nearest supplier of medically necessary services not available at the SNF where the beneficiary is a resident (including the return trip) may be covered under Part B This applies to beneficiaries who are in an SNF stay not covered by Part A but who has Part B benefits

For example this includes ambulance transport of such residents from the SNF (modifier N) to the nearest diagnostic or therapeutic site other than a physicianrsquos office or hospital such as an Independent Diagnostic Testing Facility (IDTF) cancer treatment center radiation therapy center or wound care center as reported with ambulance modifier D For SNF residents receiving Part A benefits this type of ambulance service is subject to SNF consolidated billing

22 52018

ADDITIONAL INFORMATION The official instruction CR10550 issued to your MAC regarding this change consists of two transmittals The first updated the Medicare Claims Processing Manual and it is available at httpswwwcmsgovRegulations-and-uidanceGuidanceTransmittals2018DownloadsR4021CPpdf The second transmittal updates the Medicare Benefit Policy Manual and it is at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR243BPpdf

New Targeted Probe amp Educate (TPE) Process Module H ave questions about TPE This interactive module will give you an overview of the Targeted Probe amp Educate Process and link you to additional TPE resources on the Centers for Medicare amp Medicare Services website Access the Targeted Probe amp Educate Process Module and other TPE resources on our Medical Review Targeted Probe and Educate page at httpstinyurlcomJJBTPE

23 52018

Proper Coding for Specimen Validity Testing Billed in Combination with Drug Testing

MLN Matters Number SE18001 Article Release Date March 29 2018 Related CR Transmittal Number NA Related Change Request (CR) Number NA Effective Date NA Implementation Date NA

PROVIDER TYPES AFFECTED This MLN Matters Article is intended for laboratories and other providers billing Medicare Administrative Contractors (MACs) for urine drug test services provided to Medicare beneficiaries

PROVIDER ACTION NEEDED This MLN Matters Special Edition article reminds laboratories and other providers about how to properly bill for specimen validity testing done in conjunction with drug testing This article contains no policy changes but serves as a reminder to laboratories and providers of current Medicare requirements Please make sure your billing staffs are aware of these instructions

BACKGROUND The Centers for Medicare amp Medicaid Services (CMS) is issuing SE18001 to remind laboratories and other providers about the correct coding and instructions for billing specimen validity testing when done as a part of drug testing

Section 1862(a)(1)(A) of the Social Security Act provides that Medicare payment may not be made for services that are not reasonable and necessary Clinical laboratory services must be ordered and used by the physician who is treating the beneficiary as described in 42 CFR 41032(a) or by a qualified nonphysician practitioner as described in 42 CFR 431032(a)(3)

Current coding for testing for drugs of abuse relies on a structure of ldquoscreeningrdquo (known as ldquopresumptiverdquo testing) and ldquoquantitativerdquo or ldquodefinitiverdquo testing that identifies the specific drug and quantity in the patient

Beginning January 1 2017 presumptive drug testing may be reported with CPT codes 80305-80307 These codes differ based on the level of complexity of the testing methodology Only one code from this code range may be reported per date of service

The descriptors for Presumptive Drug Testing codes are bull 80305 Drug tests(s) presumptive any number of drug classes any number of devices or procedures

(eg immunoassay) capable of being read by direct optical observation only (eg dipsticks cups cards cartridges) includes sample validation when performed per date of service

bull 80306 Drug tests(s) presumptive any number of drug classes any number of devices or procedures (eg immunoassay) read by instrument-assisted direct optical observation (eg dipsticks cups cards cartridges) includes sample validation when performed per date of service

24 52018

bull 80307 Drug tests(s) presumptive any number of drug classes qualitative any number of devices or procedures by instrument chemistry analyzers (eg utilizing immunoassay [eg EIA ELISA EMIT FPIA IA KIMS RIA]) chromatography (eg GC HPLC) and mass spectrometry either with or without chromatography (eg DART DESI GC-MS GC-MSMS LC-MS LC-MSMS LDTD MALDI TOF) includes sample validation when performed per date of service

As mentioned in the National Correct Coding Initiative Policy Manual Chapter 10 Section E beginning January 1 2016 definitive drug testing may be reported with HCPCS codes G0480-G0483 These codes differ based on the number of drug classes including metabolites tested Only one code from this code range may be reported per date of service

The descriptors for Definitive Drug Testing codes are bull G0480 Drug test(s) definitive utilizing (1) drug identification methods able to identify individual drugs

and distinguish between structural isomers (but not necessarily stereoisomers) including but not limited to GCMS (any type single or tandem) and LCMS (any type single or tandem and excluding immunoassays (eg IA EIA ELISA EMIT FPIA) and enzymatic methods (eg alcohol dehydrogenase)) (2) stable isotope or other universally recognized internal standards in all samples (eg to control for matrix effects interferences and variations in signal strength) and (3) method or drug-specific calibration and matrix-matched quality control material (eg to control for instrument variations and mass spectral drift) qualitative or quantitative all sources includes specimen validity testing per day 1-7 drug class(es) including metabolite(s) if performed

bull G0481 Drug test(s) definitive utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers) including but not limited to GCMS (any type single or tandem) and LCMS (any type single or tandem and excluding immunoassays (eg IA EIA ELISA EMIT FPIA) and enzymatic methods (eg alcohol dehydrogenase)) (2) stable isotope or other universally recognized internal standards in all samples (eg to control for matrix effects interferences and variations in signal strength) and (3) method or drug-specific calibration and matrix-matched quality control material (eg to control for instrument variations and mass spectral drift) qualitative or quantitative all sources includes specimen validity testing per day 8-14 drug class(es) including metabolite(s) if performed

bull G0483 Drug test(s) definitive utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers) including but not limited to GCMS (any type single or tandem) and LCMS (any type single or tandem and excluding immunoassays (eg IA EIA ELISA EMIT FPIA) and enzymatic methods (eg alcohol dehydrogenase)) (2) stable isotope or other universally recognized internal standards in all samples (eg to control for matrix effects interferences and variations in signal strength) and (3) method or drug-specific calibration and matrix-

25 52018

matched quality control material (eg to control for instrument variations and mass spectral drift) qualitative or quantitative all sources includes specimen validity testing per day 22 or more drug class(es) including metabolite(s) if performed

In addition definitive drug testing code G0659 was created to recognize those laboratories that are performing a less sophisticated version of these tests than is usually performed in drug testing laboratories bull G0659 Drug test(s) definitive utilizing drug identification methods able to identify individual drugs and

distinguish between structural isomers (but not necessarily stereoisomers) including but not limited to GCMS (any type single or tandem) and LCMS (any type single or tandem) excluding immunoassays (eg IA EIA ELISA EMIT FPIA) and enzymatic methods (eg alcohol dehydrogenase) performed without method or drug-specific calibration without matrix-matched quality control material or without use of stable isotope or other universally recognized internal standard(s) for each drug drug metabolite or drug class per specimen qualitative or quantitative all sources includes specimen validity testing per day any number of drug classes

The work performed in this test approximates the work performed in CPT code 80307

Providers performing validity testing on urine specimens utilized for drug testing shall not separately bill the validity testing For example if a laboratory performs a urinary pH specifi c gravity creatinine nitrates oxidants or other tests to confirm that a urine specimen is not adulterated this testing is not separately billed

ADDITIONAL INFORMATION The National Correct Coding Initiative Policy Manual is available in the Downloads section of httpswwwcmsgovMedicareCodingNationalCorrectCodInitEdindexhtml

The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) recently completed a report that illustrated improper payments for specimen validity tests as part of urine drug testing To review that report visit httpsoighhsgovoasreportsregion991602034pdf

DOCUMENT HISTORY Date of Change Description March 29 2018 Initial article released

26 52018

New Waived Tests MLN Matters Number MM10586 Related CR Release Date April 6 2018 Related CR Transmittal Number R4018CP Related Change Request (CR) Number 10586 Effective Date July 1 2018 Implementation Date July 2 2018

PROVIDER TYPE AFFECTED This MLN Matters Article is intended for clinical diagnostic laboratories submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

PROVIDER ACTION NEEDED Change Request (CR) 10586 informs MACs of new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests approved by the Food and Drug Administration (FDA) Since these tests are marketed immediately after approval the Centers for Medicare amp Medicaid Servic es (CMS) must notify its MACs of the new tests so they can accurately process claims Make sure your billing staffs are aware of these CLIA-related changes

BACKGROUND CLIA regulations require a facility to be appropriately certified for each test performed To ensure that Medicare amp Medicaid only pay for laboratory tests categorized as waived complexity under CLIA in facilities with a CLIA certificate of waiver laboratory claims are currently edited at the CLIA certifi cate level

Listed below are the latest tests approved by the FDA as waived tests under CLIA The Current Procedural Terminology (CPT) codes for the following new tests must have the modifier QW to be recognized as a waived test However the tests mentioned on the first page of the list attached to CR10586 (that is CPT codes 81002 81025 82270 82272 82962 83026 84830 85013 and 85651) do not require a QW modifier to be recognized as a waived test

The CPT code effective date and description for the latest tests approved by the FDA as waived tests under CLIA are the following bull 80305QW December 7 2017 Jant Pharmacal Corporation Accutest Value+Multi-Drug Urine Test Cup bull 87502QW December 19 2017 Cepheid Gene Xpert Xpress System (Xpert Flu Xpress) bull 87880QW December 21 2017 Quidel Sofia 2 (Sofia StrepA+FIA)from throat swab only bull 82044QW 82570QW January 11 2018 Medline Industries Inc Medline 120 Mini Analyzer Test System

(Medline Industries Inc Medline Urinalysis Reagent Strips) bull 80061QW 82465QW 83718QW 84478QW January 19 2018 ACON Laboratories Inc Mission

Cholesterol Pro Monitoring System (Mission Cholesterol Pro Test Cartridges) bull G0433QW January 30 2018 bioLytical Laboratories INSTI HIV-1HIV-2 Antibody Test Fingerstick

whole blood

27 52018

The attachment to CR10586 contains the test name manufacturer and use for each of the above listed CPT codes You should be aware that MACs will not search their files to either retract payment or retroactively pay claims However they should adjust claims that you bring to their attention

eServices EligibilityeServices by Palmetto GBA allows you to search for patient eligibility which is a functionality of HETS HETS requires you to enter beneficiary last name and HICN in addition to either the birth date or first name See options below

bull HICN Last Name First Name Birth Date bull HICN Last Name Birth Date bull HICN Last Name First Name

For more information about eServices and the many services it offers please visit our website at httpwwwPalmettoGBAcomeServices

28 52018

Change in Type of Service (TOS) for Current Procedural Terminology (CPT) Code 77067

MLN Matters Number MM10607 Related CR Release Date April 13 2018 Related CR Transmittal Number R2054OTN Related Change Request (CR) Number 10607 Effective Date January 1 2017 Implementation Date July 2 2018

PROVIDER ACTION NEEDED Change Request (CR) 10607 updates the Type of Service (TOS) code for Current Procedural Terminology (CPT) code 77067 CR10607 corrects the TOS indicator assigned to CPT code 77067 ndash Screening Mammography Effective for claims with dates of service on or after January 1 2017 the TOS indicator is updated to reflect ldquo1rdquo instead of ldquo4rdquo to allow for proper claim submission and adjudication Make sure your billing staffs are aware of this change

BACKGROUND The Centers for Medicare amp Medicaid Services (CMS) issued CR10181 on November 21 2017 A corresponding MLN Matters Article is available at httpswwwcmsgovOutreach-and-EducationMedicare-LearningshyNetwork-MLNMLNMattersArticlesdownloadsMM10181pdf

In part CR10181 instructed the Medicare claims processing system maintainers and MACs to implement CPT code 77067 in place of the Healthcare Common Procedure Coding System (HCPCS) screening mammography code G0202 effective for claims with dates of service on or after January 1 2018

CMS instructed the MACs to apply t he same payment methodologies and editing as applicable for CPT code 77067 as they did for G0202 As part of the instruction to apply the same editing the TOS coding for the 77067 should have remained as it was for G0202 with a ldquo1rdquo (Medical Care) indicator Correcting the TOS code for 77067 allows the screening mammography claims to be billed without referring physician information on the claim which is consistent with Medicarersquos coverage policy for screening mammograms See Chapter 18 Section 20 of the Medicare Claims Processing Manual for more information at httpswwwcmsgovRegulations-and-GuidanceGuidanceManualsDownloadsclm104c18pdf

Note MACs will automatically reprocess previously adjudicated screening mammography claims received with CPT - 77067 with a TOS code of ldquo4rdquo with dates of service on and after January 1 2018 and through July 2 2018 when the claim was denied because there was no referring provider information MACs will reprocess screening mammography claims with dates of service between January 1 2018 and July 2 2018 which cannot be automatically reprocessed only if brought to their attention

29 52018

The Medicare Claims Processing Manual Chapter 18 is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceManualsDownloadsclm104c18pdf

Receive ADRs Electronically Go Green via eServices

Providers can opt to receive Additional Documentation Requests (ADRs) through eServices If your claim is selected for review you can receive your request as it is generated ndash instead of by mail (which decreases the amount of time you have to respond)

This process is free secure and easy to use Our messaging function in eServices will send an inbox message to let users know that an lsquoeLetterrsquo is now available This new process delivers the electronic document as a link within the secure message once you sign into eServices

For more information about eServices and the many services it offers please visit our website at wwwPalmettoGBAcomeServices

30 52018

Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN)

MLN Matters Number MM10567 Related CR Release Date March 30 2018 Related CR Transmittal Number R4011CP Related Change Request (CR) Number 10567 Effective Date April 30 2018 Implementation Date April 30 2018

PROVIDER TYPE AFFECTED This MLN Matters Article is intended for Skilled Nursing Facilities (SNFs) billing Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries

PROVIDER ACTION NEEDED This article informs you about Change Request (CR) 10567 which advises you that the Centers for Medicare amp Medicaid Services (CMS) has revised the Skilled Nursing Facility Notice of Non-coverage (SNF ABN) Form CMS-10055 With this revision CMS is discontinuing the five Skilled Nursing Facility (SNF) Denial Letters (namely the Intermediary Determination of Noncoverage the UR Committee Determination of Admission the UR Committee Determination on Continued Stay the SNF Determination on Admission and the SNF Determination on Continued Stay) and the Notice of Exclusion from Medicare Benefits (NEMB-SNF) Form CMS-20014 Please ensure that your billing staffs are aware of these changes

Please note that the Notice of Medicare Non-Coverage (NOMNC) Form CMS-10123 is not being discontinued with this revised SNF ABN More information on the NOMNC is available at httpswwwcmsgovMedicare Medicare-General-InformationBNIFFS-Expedited-Determination-Noticeshtml

BACKGROUND The authorization for these requirements are Section 1879 of the Social Security Act and 42 Code of Federal Regulations (CFR) 411404(b) and (c) which specify written notice requirements These requirements are fulfilled by the SNF ABN

In order for SNFs to transfer liability to an Original Medicare beneficiary for items or services paid under Medicare Part A (SNF Prospective Payment Syste m (PPS)) the SNF must issue a SNF ABN for bull An item or service that is usually paid for by Medicare but may not be paid for in this particular instance

because it is not medically reasonable and necessary or bull Custodial care

Attached to CR10567 is a revised Chapter 30 of the Medicare Claims Processing Manual This revised manual chapter provides details on SNF ABN standards and also provides information about bull Situations in which a SNF ABN should be given bull Situations in which a SNF ABN Is not needed to transfer financial liability to the beneficiary bull SNF ABN specific delivery issues

31 52018

bull Special rules for SNF ABNs bull Establishing when beneficiary is on Notice of Non-coverage

Note Further details are available at httpswwwcmsgovMedicareMedicare-General-InformationBNI FFS-SNFABN-html You may download the revised Form CMS-10055 in the Downloads section of that webpage

SNFs will continue to use the Advance Beneficiary Notice of Non-coverage (ABN Form CMS-R-131) for items or services that Medicare may be deny under Medicare Part B

Please note that SNFs may start to implement this new notice any time up to the implementation date of CR10567 Upon the CR10567 implementation on April 30 2018 the use of the new notice is mandatory

The revised notice incorporates suggestions for changes made by users of the ABN and by benefi ciary advocates based on experience with the current form refinements made to similar liability notices through consumer testing and other means as well as related Medicare policy changes and clarifications

32 52018

Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)

MLN Matters Number MM10295 Revised Related CR Release Date April 3 2018 Related CR Transmittal Number R206NCD and R4016CP Related Change Request (CR) Number 10295 Effective Date May 25 2017 Implementation Date July 2 2018

Note The article was revised on April 11 2018 to clarify that the SET program must be provided in a physicianrsquos office (Place of Service code 11) All other information remains the same

PROVIDER ACTION NEEDED Change Request (CR) 10295 informs MACs that effective May 25 2017 the Centers for Medicare amp Medicaid Services (CMS) issued a National Coverage Determination (NCD) to cover Supervised Exercise Therapy (SET) for beneficiaries with Intermittent Claudication (IC) for the treatment of symptomatic Peripheral Artery Disease (PAD) Make sure your billing staffs are aware of these changes

BACKGROUND SET involves the use of intermittent walking exercise which alternates periods of walking to moderate-toshymaximum claudication with rest SET has been recommended as the initial treatment for patients suffering from IC the most common symptom experienced by people with PAD

Despite years of high-quality research illustrating the effectiveness of SET more invasive treatment options (such as endovascular revascularization) have continued to increase This has been partly attributed to patients having limited access to SET programs There is currently no NCD in effect

CMS issued the NCD to cover SET for beneficiaries with IC for the treatment of symptomatic PAD Up to 36 sessions over a 12-week period are covered if all of the following components of a SET program are met

The SET program must bull Consist of sessions lasting 30-60 minutes comprising a therapeutic exercise-training program for PAD

in patients with claudication bull Be conducted in a physicianrsquos office bull Be delivered by qualified auxiliary personnel necessary to ensure benefits exceed harms and who are

trained in exercise therapy for PAD bull Be under the direct supervision of a physician (as defined in Section 1861(r)(1)) of the Social Security

Act (the Act) physician assistant or nurse practitionerclinical nurse specialist (as identified in Section 1861(aa)(5) of the Act)) who must be trained in both basic and advanced life support techniques

33 52018

Beneficiaries must have a face-to-face visit with the physician responsible for PAD treatment to obtain the referral for SET At this visit the beneficiary must receive information regarding cardiovascular disease and PAD risk factor reduction which could include education counseling behavioral interventions and outcome assessments

MACs have the discretion to cover SET beyond 36 sessions over 12 weeks and may cover an additional 36 sessions over an extended period of time MACs shall accept the inclusion of the KX modifier on the claim line(s) as an attestation by the provider of the services that documentation is on file verifying that further treatment beyond the 36 sessions of SET over a 12-week period meets the requirements of the medical policy SET is non-covered for beneficiaries with absolute contraindications to exercise as determined by their primary attending physician

Coding Requirements for SET Providers should use Current Procedural Terminology (CPT) 93668 (Under Peripheral Arterial Disease Rehabilitation) to bill for these services with appropriate International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Code as follows bull I70211 ndash right leg bull I70212 ndash left leg bull I70213 ndash bilateral legs bull I70218 ndash other extremity bull I70311 ndash right leg bull I70312 ndash left leg bull I70313 ndash bilateral legs bull I70318 ndash other extremity bull I70611 ndash right leg bull I70612 ndash left leg bull I70613 ndash bilateral legs bull I70618 ndash other extremity bull I70711 ndash right leg bull I70712 ndash left leg bull I70713 ndash bilateral legs bull I70718 ndash other extremity

Medicare will deny claim line items for SET services when they do not contain one of the above ICD-10 codes using the following messages bull Claim Adjustment Reason Code (CARC) 167 ndash This (these) diagnosis (es) is (are) not covered Note Refer to

the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF) if present bull Remittance Advice Remark Code (RARC) N386 This decision was based on a National Coverage

Determination 2035 (NCD) An NCD provides a coverage determination as to whether a particular item or service is covered A copy of this policy is available at wwwcmsgovmcdsearchasp If you do not have web access you may contact the contractor to request a copy of the NCD

bull Group Code CO (Contractual Obligation) assigning financial liability to the provider if a claim is received with a GZ modifier indicating no signed ABN is on file

34 52018

MACs will accept claims for CPT 93668 only when services are provided in Place of Service (POS) code 11 MACs will deny claims for SET if services are not provided in POS 11 using the following remittance messages bull CARC 58 Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place

of service NOTE Refer to the 832 Healthcare Policy Identification Segment (loop 2110 Service payment Information REF) if present

bull RARC N386 This decision was based on a National Coverage Determination 2035 (NCD) An NCD provides a coverage determination as to whether a particular item or service is covered A copy of this policy is available at wwwcmsgovmcdsearchasp If you do not have web access you may contact the contractor to request a copy of the NCD

Institutional claims for SET must be submitted on Type of Bills (TOB) 13X or 85X MACs will deny line items on institutional claims that are not submitted on TOB 13X or 85X using the following messages bull CARC 58 ldquoTreatment was deemed by the payer to have been rendered in an inappropriate or invalid place

bull RARC N386 ldquoThis decision was based on a National Coverage Determination 2035 (NCD) An NCD provides a coverage determination as to whether a particular item or service is covered A copy of this policy is available at wwwcmsgovmcdsearchasp If you do not have web access you may contact the contractor to request a copy of the NCD

Medicare will pay claims for SET services containing CPT code 93668 on Types of Bill (TOBs) 13X under OPPS and 85X on reasonable cost except it will pay claims for SET services containing CPT 93668 with revenue codes 096X 097X or 098X when billed on TOB 85X Method II Critical Access Hospitals (CAHs) based on 115 of the lesser of the fee schedule amount or the submitted charge

Medicare will reject claims with CPT 93668 which exceed 36 sessions within 84 days from the date of the first session when the KX modifier is not included on the claim line OR any SET session provided after 84 days from the date of the first session and the KX modifier is not included on the claim and use the following messages bull CARC 96 Non-covered charge(s) At least one Remark Code must be provided (may be comprised of

either the NCPDP Reject Reason [sic] Code or Remittance Advice Remark Code that is not an ALERT) Note Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF) if present

bull RARC N640 Exceeds numberfrequency approvedallowed within time period bull Group Code CO (Contractual Obligation) assigning financial liability to the provider if a claim is received

with a GZ modifier indicating no signed ABN is on file bull Group Code PR (Patient Responsibility) assigning financial liability to the beneficiary if a claim is received

with a GA modifier indicating a signed ABN is on file

MACs will denyreject claim lines for SET exceeding 73 sessions using the following codes bull CARC 119 Benefit maximum for this time period or occurrence has been reached

35 52018

bull Group Code PR (Patient Responsibility) assigning financial liability to the beneficiary if a claim is received with a GA modifier indicating a signed ABN is on file

Medicarersquos Common Working File (CWF) will display remaining SET sessions on all CWF provider query screens (HIQA HIQH ELGH ELGA and HUQA) The Multi-Carrier System Desktop Tool will also display remaining SET sessions in a format equivalent to the CWF HIMR screen(s)

ADDITIONAL INFORMATION The official instruction CR10295 was issued to your MAC via two transmittals The first updates the Medicare Claims Processing Manual and it is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR4016CPpdf The second updates the NCD Manual and it is available at httpswwwcmsgovRegulations-and-GuidanceGuidanceTransmittals2018DownloadsR206NCDpdf

DOCUMENT HISTORY Date of Change Description April 11 2018 The article was revised to clarify that the SET program must be provided in a

physicianrsquos office (Place of Service code 11) All other information remains the same

April 5 2018 The article was revised to reflect a revised CR The MAC implementation date CR release date transmittal numbers and the Web addresses of the transmittals were revised In addition the article and CR were revised to delete place of service codes 19 and 22 as acceptable places of service for CPT 93668 All other information remains the same

March 5 2018 The article was revised to reflect a revised CR The MAC implementation date CR release date transmittal numbers and the Web addresses of the transmittals were revised All other information remains the same

36 52018

Interactive Tools

These guides provide instruction on how to complete or interpret the following forms They are available on the home page under FormsTools

Remittance Advice

EDI Agreement

EDI Application

EDI Provider Authorization

CMS 1500 Claim Form

37 52018

Medical Directorrsquos Desk Medical Affairs publishes Medicare Local Coverage Determination (LCDs) and medically related articles in this special section of the Medicare Advisory We encourage you to help us maintain accurate LCDs Please review LCDs and address your comments and concerns to your Carrier Advisory Committee specialty representative or contact the Medical Affairs Department

Medical articles are published in the Medicare Advisory to provide education and alert Medicare providers of billingcoding issues Remember physicians and non-physician practitioners (NPPs) who bill Medicare are responsible for accurate service coding Errors may result in overpayment requests or Recovery Auditor (RA) referrals If you purchase a new device or need to submit claims for a new procedure please review applicable service codes and descriptions in the current CPT and HCPCS manuals If you question the recommended service procedures received from other sources such as manufacturers send your inquiry and the device description to the Medical Affairs Department

To contact the Medical Affairs Department

e-mail BPolicyPalmettoGBAcom

Mail JJ Part B Medical Affairs Palmetto GBA PO Box 100305 Columbia SC 29202-3305

Continued gtgt

Part B Local Coverage Determinations Policy Title LCD Revisions Effective Date Hyaluronate

Polymers L33432 Rev 10

Under CMS National Coverage Policy deleted CMS Internet Only Manual Pub 100-09 as no specific section was cited Under Coverage Indication Limitations andor Medical Necessity in the fourth paragraph revised ldquoMedicarerdquo to now read AB MAC Under Associated Information ndash Documentation Requirements changed Medicare to now read AB MAC in the second bullet Under Bibliography on the fourth cited article moved ORTHVISC Study Group after list of authors On the fifth cited article corrected verbiage to now read ldquoGuidelines for the Medical Management of Osetoarthritis Part II Osteoarthritis of the Knee American College of Rheumatologyrdquo

Allergy Skin Testing L33417 Rev 8

Under Bibliography revisions were made to the sources to reflect AMA citation guidelines 41218

Nonobstetric Pelvic Ultrasound

L37636 Rev 2

Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes N3001 N3011 N3021 N3031 N3041 N3081 N3091 N8300 N8301 N8302 N8310 N8311 N8312 N83201 N83202 N83291 and N83292

38 52018

Article Title Billing and

Coding Guidance for Anti-Inhibitor

Coagulant Complex

(AICC) National Coverage

Determination (NCD) 1103

A55947 NEW

New Articles Per the CMS Internet-Only Manual Publication 100-03 Medicare National Coverage Determinations Manual Chapter 1 Part 2 sect 1103 ldquoAnti-inhibitor coagulant complex (AICC) is a drug used to treat hemophilia in patients with factor VIII inhibitor antibodies AICC has been shown to be safe and effective and has Medicare coverage when furnished to patients with hemophilia A and inhibitor antibodies to factor VIII who have major bleeding episodes and who fail to respond to other less expensive therapiesrdquo

Medicare provides coverage for the following Group 1 ndash CPTHCPCS Codes J7180 Injection Factor XIII (antihemophilic factor human) 1 IU J7181 Injection Factor XIII-A-subunit (recombinant) per IU

Group 1 ICD-10 Diagnosis Codes D66 Hereditary factor VIII deficiency D682 Hereditary deficiency of other clotting factors

Group 2 CPTHCPCS Codes J7183 Injection von Willebrand factor complex (human) Wilate 1IU vWFRCo J7187 Injection von Willebrand factor complex (Humate-P) per IU VWF RCO

Group 2 ICD-10 Diagnosis Codes D680 Von Willebrandrsquos disease

Group 3 CPTHCPCS Codes J7189 Factor VIIa (antihemophilic factor recombinant) per 1mcg

Group 3 ICD-10 Diagnosis Codes D66 Hereditary factor VIII deficiency D67 Hereditary factor IX deficiency D682 Hereditary deficiency of other clotting factors

Group 4 CPTHCPCS Codes J7182 Injection Factor VIII (antihemophilic factor recombinant) (NovoEight) per IU J7190 Factor VIII (antihemophilic factor human) per IU J7191 Factor VIII (antihemophilic factor (porcine)) per IU J7192 Factor VIII (antihemophilic factor recombinant) per IU not otherwise specified J7205 Injection Factor VIII Fc fusion protein (recombinant) per IU

Group 5 CPTHCPCS Codes J7193 Factor IX (antihemophilic factor purified nonrecombinant) per IU J7194 Factor IX complex per IU J7195 Injection Factor IX (antihemophilic factor recombinant) per IU not otherwise specified J7200 Injection Factor IX (antihemophilic factor recombinant) Rixubis per IU J7201 Injection Factor IX Fc fusion protein (recombinant) Alprolix 1 IU

Effective Date 51418

39 52018

Billing and Coding Guidance for Anti-Inhibitor

Coagulant Complex

A55947 NEW

continued

Article Title

Intraoperative Radiation

Therapy (IOERT) A53414 Retire

Group 5 ICD-10 Diagnosis Codes D67 Hereditary factor IX deficiency D681 Hereditary factor XI deficiency D682 Hereditary deficiency of other clotting factors D68311 Acquired hemophilia D68312 Antiphospholipid antibody with hemorrhagic disorder D68318 Other hemorrhagic disorder due to intrinsic circulating anticoagulants antibodies or inhibitors

Group 6 CPTHCPCS Codes J7196 Injection antithrombin recombinant 50 IU

Group 6 ICD-10 Diagnosis Codes D682 Hereditary deficiency of other clotting factors

Group 7 CPTHCPCS Codes J7197 Antithrombin III (human) per IU J7198 Antiinhibitor per IU

Group 7 ICD-10 Diagnosis Codes D65 Disseminated intravascular coagulation [defi brination syndrome] D66 Hereditary factor VIII deficiency D67 Hereditary factor IX deficiency D680 Von Willebrandrsquos disease D681 Hereditary factor XI deficiency D682 Hereditary deficiency of other clotting factors D68311 Acquired hemophilia D68312 Antiphospholipid antibody with hemorrhagic disorder D68318 Other hemorrhagic disorder due to intrinsic circulating anticoagulants antibodies or inhibitors D6832 Hemorrhagic disorder due to extrinsic circulating anticoagulants D684 Acquired coagulation factor deficiency D688 Other specified coagulation defects

Retired Articles

The Intraoperative Radiation Therapy (IOERT) Article A53414 is being retired effective 040418 as Medical Affairs is developing a coverage article

Date of Retirement

40 52018

AB MAC Local Coverage Determinations Policy Title LCD Revisions Effective

Date White Cell Colony Stimulating Factors

L37176 Rev 5

Under Coverage Indications Limitations andor Medical Necessity in the fi rst sentence added the word ldquogranulocyterdquo in front of ldquocolony stimulating factorsrdquo to define the acronym ldquoG-CSFrdquo The following three revisions are due to Change Request 10515 Transmittal 3988 and Change Request 10454 Transmittal 3997 Under CPTHCPCS Codes Group 1 Paragraph removed the verbiage ldquoEffective for dates of service on or after January 1 2016 claims for Q5101 must use the ZA modifier (Q5101ZA)rdquo and replaced with the verbiage ldquoEffective for dates of service on or after January 1 2016 through March 31 2018 claims for Q5101 must use the ZA modifi er (Q5101ZA) On or after April 1 2018 no modifier is required to report Q5101rdquo Under ICD-10 Codes that Support Medical Necessity Group 1 Codes added D701 and D702 Under Group 8 Paragraph added J2505 Under Group 1-11 Paragraphs deleted the ldquoZArdquo modifier on HCPC code ldquoQ5101ZArdquo These three revisions are effective on 04012018 Under Sources of Information ndash Bibliography corrected a title and capitalization to various references

Application of Skin Substitutes

L36466 Rev 9

Under Coverage Indications Limitations andor Medical Necessity in the fi rst paragraph deleted the second and third sentence Under Bioengineered SkinCultured Epidermal Autografts (CEA) corrected ldquowidespreadrdquo Under Regulatory Status- US Food and Drug Administration (FDA) Governing Skin Substitute Products revised AHRS in the 7th

paragraph to now read AHRQ and in the second and fourth sentences of the eleventh paragraph corrected the spelling of re-epithelialization Under Indications in the second sentence of the fifth paragraph revised ldquosystematicrdquo to now read ldquosystemicrdquo Under Limitations-Note added the second sentence ldquoThe coding in this policyhelliprdquo Under Limitations in the last paragraph italicized manual verbiage Under Associated Information-Documentation Requirements 6 corrected the section of the LCD cited Under Utilization Guidelines in the seventh paragraph corrected ldquoincluderdquo to now read ldquoincludesrdquo Under Bibliography author initials and punctuation was corrected for Greer N Foman NA MacDonald R et al Advanced Wound Care Therapies for Nonhealing Diabetic Venous and Arterial Ulcers A Systematic Review Annals of Internal Medicine 2013159(8)532-542

Cosmetic and Under ICD-10 Codes that Support Medical Necessity Group 6 Paragraph added CPT 10117 Reconstructive code 21235 Under ICD-10 Codes that Support Medical Necessity Group 7 Paragraph

Surgery removed the existing verbiage and replaced with ldquoNOTE The CPT code and following L33428 diagnoses limit the use of reconstructive surgeries of the head and neck to the repair of Rev 15 injuries due to trauma or ablative surgeryrdquo These revisions are retroactive on or after

100117 Minimally Invasive

Treatment for Benign Prostatic Hyperplasia Involving Prostatic

Urethral Lift (Uroliftreg) L36109 Rev 9

Under Associated Information- Documentation Requirements removed the verbiage ldquoAbsence of obstructive median loberdquo

41 52018

Noncovered Services other than CPTreg Category III

Noncovered Services L36954 Rev 9

Total Joint Arthroplasty

L33456 Rev 14

Somatosensory Testing L34433 Rev 10

Wireless Capsule Endoscopy

L36427 Rev 8

Retroperitoneal Ultrasound

L34577 Rev 19

Under CMS National Coverage Policy in the first paragraph the second and third sentences were deleted Under Coverage Indications Limitations andor Medical Necessity in the second set of bullet points ldquoArdquo was added at the beginning of the sentence in the fourth bullet In the seventh paragraph the word ldquoanrdquo was changed to ldquoardquo in the last sentence In the eighth paragraph the acronym for ldquoMedicare Administrative Contractorsrdquo was added In the last sentence of the tenth paragraph J was added as a Jurisdiction Corrections were made to the bullet points after the twelfth paragraph Cormatrix was changed to CorMatrix Gliasite was changed to GliaSite Under CPTHCPCS Codes ndash Group 1 ndash Not Proven Effective Not Medically Reasonable and Necessary ldquomyringectomyrdquo was changed to ldquomyringotomyrdquo and ldquoRezumregrdquowas removed as this is now a covered service Under CMS National Coverage Policy corrected the title for CMS Internet-Only Manual Pub 100-08 Ch 6 Sec 652 Under Coverage Indications Limitations andor Medical Necessity removed verbiage ldquoandrdquo and ldquoorrdquo after multiple bullets throughout the section In the fourth paragraph replaced ldquototal knee replacementrdquo with (TKR) and moved before the word ldquosurgeryrdquo Replaced ldquototal knee replacementrdquo with TKR in the last sentence In the fifth paragraph replaced ldquoactivities of daily livingrdquo with ADLs in the fourth sentence Replaced ldquototal hip replacementrdquo with THR in all applicable areas of the paragraph Under Total Knee Arthroplasty (TKA) removed ldquoactivities of daily livingrdquo from the third bullet of the second paragraph In the first sentence of the third paragraph added the acronym ADLs and removed ldquoactivities of daily livingrdquo Under Total Hip Arthroplasty (THA) removed ldquoactivities of daily livingrdquo in the third bullet in the second set of bullets Under ICD-10 Codes that Support Medical Necessity added codes Z4732 to groups 1 and 2 Z4733 to groups 3 and 4 and Z89621 and Z89622 to groups 1 and 2 Under Associated Information ndash Documentation Requirements added a comma in the first sentence after ldquoprovider servicesrdquo Under Bibliography made changes to citations to refl ect AMA citation guidelines Changed the access date to 412018 on all URLs listed (this includes the second fifth tenth and eleventh source listed) Changed InterQualreg procedures criteria and Milliman Care Guidelinesreg from 2011 to 2017 Corrected the URL link for the last citation Under CMS National Coverage Policy deleted the second and third sentences ldquoNCDs and coverage provisions in interpretive manuals are not subject to the Local Coverage Determination (LCD) Review Process (42 CFR 405860[b] and 42 CFR 426 [Subpart D]) In addition an administrative law judge may not review a NCD See Section 1869(f)(1)(A) (i) of the Social Security Actrdquo Under Coverage Indications Limitations andor Medical Necessity added (GI) after the word ldquogastrointestinalrdquo in the first sentence and subsequently replaced this word with ldquoGIrdquo each time the word was used Under Coverage Indications Limitations andor Medical Necessity ndash Indications for wireless capsule endoscopy replaced ldquoEGDrdquo with ldquoesophagogastroduodenoscopy (EGD)rdquo and removed ldquoorrdquo from the end of each bullet with the exception of the seventh bullet Under Coverage Indications Limitations andor Medical Necessity - Limitations of use corrected the spelling for intussusception Under Bibliography changes were made to citations to refl ect AMA citation guidelines The first reference was replaced with the current citation information The authorsrsquo names were corrected on the fourth and eighth reference and the titles were corrected on the fi fth sixth and seventh reference Under ICD-10 Codes That Support Medical Necessity added ICD-10 codes N3001 N3011 N3021 N3031 N3041 N3081 and N3091

42 52018

Policy Title

Noninvasive Peripheral Arterial and Venous Studies

L37639 Retired

Intensity Modulated Radiation Therapy

(IMRT) L37640 Retired

Article Title

Self-Administered Drug Exclusion List

A53066 Rev 14

Billing Requirements for Application of

Skin Substitutes (Part B Only Services)

A55035 Rev 8

Article Title Billing and Coding for

the Rezumreg System for Benign Prostatic Hyperplasia (BPH)

A55944 NEW

Retired LCDs

The Noninvasive Peripheral Arterial and Venous Studies Local Coverage Determination (LCD) L37639 is being retired effective 040318 as the information in the LCD is no longer the current standard of practice and major coding updates are required

The Intensity Modulated Radiation Therapy (IMRT) Local Coverage Determination (LCD) L37640 is being retired effective 040318 as the information in the LCD is no longer the current standard of practice and major coding updates are required

Articles

Under Excluded CPTHCPCS Codes-Table Format added J0604 Sensiparreg (cinacalcet)

Under CPTHCPCs Codes - Group 1 Codes we are adding the CPT Codes included in the article text

New Articles

On August 27 2015 the FDA cleared for marketing the Rezumreg System to relieve lower urinary tract symptoms secondary to benign prostatic hyperplasia This procedure involves the transurethral injection of steam into the prostate Once injected the steam condenses to water imparting convective energy to the tissue causing cell death and damage The technology uses radiofrequency (RF) to boil the water to create the steam that is injected but does not impart radiofrequency directly to the prostate tissue

Claims for procedures involving Rezumreg steam injection should NOT be coded as CPT 53852 because the technology does not apply radiofrequency energy to the prostate Prostatic tissue destruction is accomplished via steam generated by RF not by the RF itself Rezumreg received FDA 510(k) clearance on February 27 2018 Available evidence has shown that the Rezumreg procedure for treatment of BPH is reasonable and necessary The procedure is covered for FDA approved indications if the appropriate criteria are met

Reportedly a new CPT code for this procedure (proposed 538x3 Water Vapor Thermotherapy for destruction of prostate tissue) will be released in the 2019 Update

For Medicare Billing Hospital Outpatient Setting or Ambulatory Surgical Center Effective January 1 2018 claims billed for procedures involving Rezumreg should be coded as HCPCS C9748

Date of Retirement 4318

Effective Date 5918

Effective Date 5718

43 52018

Billing and Coding for the Rezumreg System for Benign Prostatic Hyperplasia (BPH)

A55944 NEW

continued

Accreditation and Credentialing

Requirements for Polysomnography

LCD L36593 A55945

Documentation must be included in the remarks field (Field Locator 80) on the UB-04 (CMS 1450 form) or the equivalent 5010 electronic claims field to indicate the Rezumreg

procedure was performed

Physicianrsquos Office Claims billed for procedures involving Rezumreg should be coded as CPT 53899

Until the 2019 updates become effective when submitting a Not Otherwise Classified (NOC) claim documentation must be included in Box 19 on the CMS 1500 form or the electronic equivalent to indicate that the Rezumreg procedure was performed

Sources of Information 1 McVary KT Gange SN Gittelman MC et al Erectile and Ejaculatory Function Preserved With Convective Water Vapor Energy Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia Randomized Controlled Study J Sex Med 201613(6)924-933 2 McVary KT Gange SN Gittelman MC et al Minimally Invasive Prostate Convective Water Vapor Energy Ablation A Multicenter Randomized Controlled Study for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia J Urol 2016195(5)1529-1538 3 Dixon CM Rijo Cedano E Pacik D et al Efficacy and Safety of Rezūm System Water Vapor Treatment for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia Urology 201586(5)1042-1047 4 Mynderse LA Hanson D Robb RA et al Rezūm System Water Vapor Treatment for Lower Urinary Tract SymptomsBenign Prostatic Hyperplasia Validation of Convective Thermal Energy Transfer and Characterization With Magnetic Resonance Imaging and 3-Dimensional Renderings Urology 201586(1)122-127 5 Dixon CM Rijo Cedano E Pacik D et al Two-year results after convective radiofrequency water vapor thermal therapy of symptomatic benign prostatic hyperplasia Research and Reports in Urology 20168207ndash216 Revision effective date For services performed on or after 07012018

Accreditation and credentialing requirements Please be aware of the following changes to accreditation and credentialing requirements Palmetto GBA Local Coverage Determination L36593 sets forth the following standards for sleep centers that perform the technical component (TC) of polysomnography (PSG) and sleep testing (including home sleep testing)

1 The sleep center or laboratory must maintain documentation on file that indicates it is accredited by either the American Academy of Sleep Medicine (AASM) or the Accreditation Commission for Health Care (ACHC) or the Ambulatory Care Accreditation Program of the Joint Commission

This documentation must be available on request The AASM ACHC or Joint Commission accreditation applies to the hospital and freestanding facilities (including sleep clinics that are part of a physicianrsquos office and all other non-hospital-based facilities where sleep studies are performed Diagnostic testing performed in an Independent Diagnostic Testing Facility (IDTF) must follow the supervision and credentialing guidelines set forth by CMS andor Palmetto GBA

44 52018

LCD L36593 A55945

The sleep laboratory or testing facility must be affiliated with a hospital or be under the direction and control of a physician (MDDO) who meets one of the following requirements even though the diagnostic test may be performed in the absence of direct physician supervision The raw data from all sleep tests must be reviewed and the tests must be interpreted by a physician who meets at least one of the following requirements

New continued

o Certification in Sleep Medicine by the American Board of Sleep Medicine (ABSM) or by a member board of either the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA)

o A completed fellowship in sleep medicine through an Accreditation Council for Graduate Medical Education (ACGME)ndashaccredited program Following the completed fellowship certification in sleep medicine is completed within two examination cycles through the American Board of Sleep Medicine (ABSM) or a member board of either the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA)

Sleep centers in Jurisdiction M have been subject to these regulations since the implementation of the LCD on October 1 2015 and similar regulations that appeared in previous versions of the Polysomnography LCD

Sleep centers in Jurisdiction J prior to February 26 2018 were not required to meet similar standards by the previous contractor All sleep centers in Jurisdiction J must now obtain accreditation by one of the three organizations listed above by July 1 2018 in order to continue to render services to Medicare beneficiaries and submit claims to Palmetto GBA

Revision effective date For services performed on or after 10012018

2 As noted above in section 1 outpatient sleep centers affiliated with a hospital which is currently accredited by The Joint Commission (formerly JCAHO) through the hospitalrsquos accreditation will now be required to obtain separate ambulatory care accreditation for the sleep center if ambulatory services accreditation for the sleep center is not currently in place This accreditation must be obtained by October 1 2018 in order to continue to render services to Medicare beneficiaries and submit claims to Palmetto GBA

3 There is a new physician-credentialing standard published by The Joint Commission (formerly JCAHO) for ambulatory care organizations providing sleep center services that reduces quality variation and aligns credentialing requirements for all sleep testing facilities defined by the Polysomnography LCD Specifically as of January 1 2018 the Joint Commission requires that organizations verify that physicians have at least one of the following qualifications before granting initial or revised privileges to physicians responsible for interpreting sleep studies

45 52018

LCD L36593 A55945

New continued

o Certification in Sleep Medicine by the American Board of Sleep Medicine (ABSM) or by a member board of either the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) OR

o A completed fellowship in sleep medicine through an Accreditation Council for Graduate Medical Education (ACGME)-accredited program Following the completed fellowship certification in sleep medicine is completed within two examination cycles through the American Board of Sleep Medicine (ABSM) or a member board of either the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA)

The above language is not a new requirement under the Polysomnography LCD 36593 Since its implementation on October 1 2015 this LCD has required and continues to require regardless of the standards put forth by any of the three listed accrediting organizations that the sleep laboratory or testing facility be affi liated with a hospital or be under the direction and control of a physician (MDDO) who meets one of the above requirements The raw data from all sleep tests must be reviewed and the tests must be interpreted by a physician who meets at least one of the above requirements This documentation must be available upon request Please review the entire LCD (L36593) for complete information regarding polysomnography testing and billing requirements

MolDX Local Coverage Determinations

Policy Title LCD Revision Effective Date

Controlled Substance Monitoring and Drugs of Abuse Testing L35724 15

The effective date of M5412 was erroneously stated as 10115 in Revision History 14 The correct effective date is 1117 DX coverage was not applied until dates of service on and after 1117 The effective date of M5412 is 1117

Added M25511 and M25512 to ICD-10 Group 1 Codes This code was inadvertently left off during the ICD-10 transition The effective date of M25511 and M25512 is 1117

032218

MolDX Chromosome 1p19q Deletion Analysis L36483 Retire

In reviewing our LCD L36483 - MolDX Chromosome 1p19q Deletion Analysis we have found a number of operational issues The policy is scientifically correct Physician FISH codes 8836X-88373 are appropriate service codes for the analysis However the use of these generic FISH codes has expanded to include a number of additional conditions and the edits generated by the LCD are causing problems with appropriate use of the codes Therefore we are retiring this policy The effective date will be January 1 2018

022718

MolDX Molecular Diagnostic Tests (MDT) L35025 18

The following CPTHCPCS codes were deleted 0008M was deleted from Group 1 This deletion was effective 1252018 as part of the 2018 Q1 Update The DEX web address was updated to httpsappdexzcodescomlogin Removed G0452 88380 88381 from CPTHCPCS Group 1 because they do not require Z-Codes The removal of CPTHCPCS codes G0452 88380 88381 is effective 112018

040518

MolDX HLA-B1502 Genetic Testing L36033 6

Corrected bullets and reference numbering No changes in policy content 041218

Coenzyme Q10 (CoQ10) L37022 4

Removed reference 9 in the Bibliography section because it was withdrawn Also removed the content referencing 9 Corrected bibliography numbering and references 10-15 throughout the policy

041218

46 52018

MolDX Oncotype DXreg Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer L37262 7-8

Removed reference 7 from the LCD Removed content referenced to 7 under ldquoTest Performancerdquo

041218

MolDX NSCLC Comprehensive Genomic Profile Testing L36143 11-12

Removed reference to M00118 in the Under the section ldquoMolDX CGP Analysis Coveragerdquo M00118 has been retired Removed ldquoandrdquo from last bullet under MolDX CGP Analysis Coverage

041218

MolDX Prolaristrade Prostate Cancer Genomic Assay L35869 7

Palmetto GBA is removing 81479 from CPTHCPCS Codes Group 1 and replacing it with 81541 This revision is effective 01012018

041218

MolDX GeneSightreg Assay for Refractory Depression L35633 8

Palmetto GBA corrected the Hamilton Rating Scale for Depression in the Background section from ldquo= 50 reduction in HAM-D17 scorerdquo to ldquoge 50 reduction in HAM-D17 scorerdquo which was erroneously changed

041218

MolDX Decipherreg Prostate Cancer Classifi er Assay L35868 7

Palmetto GBA inadvertently deleted the end of a sentence ldquoOf the men that developed metastatic disease only 16 of men received adjuvant XRT (43 received salvage XRT) and 57 of these men received adjuvant androgen deprivation Despite an imbalance between the non-metastasis and metastasis groups as would be expected in a retrospective study the Decipher GC showed that men with a high GC score (ge04) had a 8 year risk of metastatic disease of gt 50 where as those with a GC score ofrdquo and added it back ldquo lt04 had a risk of metastatic disease of approximately 10rdquo

041218

Article Title Article Revision Effective Date

Controlled Substance Monitoring and Drugs of Abuse Coding and Billing Guidelines A54799 9

Removed 2017 from the title 040518

MolDX HERmarkreg Assay by Monogram Update A53103 9

Completed the annual validation and corrected bullets 041218

MolDX GBA Genetic Testing Coding and Billing Guidelines A53542 6

MolDX Fragile X Coding and Billing Guidelines Update A53638 7

Conducted annual validation and removed an extraneous bullet that did not contain content

041218

47 52018

MolDX CYP2C9 andor VKORC1 Gene Testing for Warfarin Response Coding and Billing Guidelines A53524 8

Conducted annual validation and corrected bullet issues No change in article content 041218

MolDX ENG and ACVRL1 Gene Tests Coding and Billing Guidelines A53536 6

MolDX SULT4A1 Genetic Testing Coding and Billing Guidelines A53538 6

48 52018

MLN ConnectsTM

MLN Connects contains a weekrsquos worth of Medicare-related messages instead of many different messages being sent to you throughout the week This notification process ensures planned coordinated messages are

delivered timely about Medicare-related topics

MLN Connectstrade for March 29 2018 httpswwwcmsgovOutreach-and-EducationOutreachFFSProvPartProgDownloads2018-03-29-eNewspdf

MLN Connectstrade for April 5 2018 httpswwwcmsgovOutreach-and-EducationOutreachFFSProvPartProgDownloads2018-04-05-eNewspdf

49 52018

CMS Offers FREE Medicare Training for Providers CMS Web Training The Centers for Medicare amp Medicaid Services (CMS) has launched a series of education and training programs designed to leverage emerging Internet and satellite technologies to offer just-in-time training to Medicare providers and suppliers throughout the United States Many of these programs include free downloadable computerWeb based training courses These courses are also available on CD-ROM

httpswwwcmsgovMLNGenInfo

Palmetto GBA Medicare Customer Information and Outreach

Training Available To request a Medicare Education meetingseminar at no cost to you complete and fax the form located on the httpswwwPalmettoGBAcomJJBforms

httpwwwPalmettoGBAcomMedicare

Important Sources For You bull httpswwwcmsgov bull httpswwwcmsgovMLNGenInfo bull httpswwwcmsgovCMSformsCMSformslistasp

Important Telephone Numbers Provider Contact Center (877) 567-7271 (Toll-Free)

Electronic Data Interchange (EDI) Technical Support

(877) 567-7271

Medicare Beneficiary Call Center

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

Attention Billing Manager

50 52018

Whatrsquos Inside

Get Your Medicare News Electronically

Unsolicited Voluntary Refunds

Medicare Learning Network

Going Beyond Diagnosis

Special Edition MLN Connects - Wednesday April 24 2018

Modifications to the Implementation of the Paperwork (PWK) Segment of the Electronic Submission of Medical Documentation (esMD) System

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits Version 242 Effective July 1 2018

Educational Events Where You Can Ask Questions and Get Answers

Increased Ambulance Payment Reduction for Non-Emergency Basic Life Support (BLS) Transports to and from Renal Dialysis Facilities

Ambulance Transportation for a SNF Resident in a Stay Not Covered by Part A - Medicare Benefit Policy Manual Chapter 10 and Medicare Claims Processing Manual Chapter 15

New Waived Tests

Medical Directorrsquos Desk

MLN ConnectsTM

JJ PART B MEDICARE ADVISORY Latest Medicare News for JJ Part B

Whatrsquos Inside Administration

Get Your Medicare News Electronically 3 Unsolicited Voluntary Refunds 3 CMS Quarterly Provider Update 5 Going Beyond Diagnosis 5 Special Edition MLN Connects - Wednesday April 24 2018 6 Modifications to the Implementation of the Paperwork (PWK) Segment of the Electronic

Submission of Medical Documentation (esMD) System 8 Claims Processing Actions to Implement Certain Provisions of the Bipartisan Budget

Act of 2018 10 Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure

(PTP) Edits Version 242 Effective July 1 2018 14

Drugs and Biologicals Quarterly Healthcare Common Procedure Coding System (HCPCS) DrugBiological Code

Changes - July 2018 Update 16

Education Educational Events Where You Can Ask Questions and Get Answers 18

Ambulance Increased Ambulance Payment Reduction for Non-Emergency Basic Life Support (BLS)

Transports to and from Renal Dialysis Facilities 20 Ambulance Transportation for a SNF Resident in a Stay Not Covered by Part A - Medicare

Benefit Policy Manual Chapter 10 and Medicare Claims Processing Manual Chapter 15 22

Laboratory Proper Coding for Specimen Validity Testing Billed in Combination with Drug Testing 24 New Waived Tests 27

Continued gtgt

palmettogbacomjjb

The JJ Part B Medicare Advisory contains coverage billing and other information for Part B This information is not intended to constitute legal advice It is our ofϐicial notice to those we serve concerning their responsibilities and ob-ligations as mandated by Medicare regulations and guidelines This information is readily available at no cost on the Palmetto GBA website It is the responsibility of each facility to obtain this information and to follow the guidelines The JJ Part B Medicare Advisory includes information provided by the Centers for Medicare amp Medicaid Services (CMS) and is current at the time of publication The information is subject to change at any time This bulletin should be shared with all health care practitioners and managerial members of the provider staff Bulletins are available at no-cost from our website at httpswwwPalmettoGBAcomJJB

American Medical Association Applicable FARSDFARS Restrictions Apply to Government Use Fee schedules rel-ative value units conversion factors andor related components are not assigned by the AMA and are not part of CPTreg 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 The Code on Dental Procedures and Nomenclature is published in Current Dental Terminology (CDT) Copyright copy 2017 Ameri-can Dental Association (ADA) All rights reserved

May 2018 Volume 2018 Issue 2

2 52018

3 52018

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5 52018

6 52018

7 52018

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

2 52018

3 52018

4 52018

5 52018

6 52018

7 52018

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

3 52018

4 52018

5 52018

6 52018

7 52018

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

4 52018

5 52018

6 52018

7 52018

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

5 52018

6 52018

7 52018

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

6 52018

7 52018

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

7 52018

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

8 52018

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

9 52018

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

10 52018

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

11 52018

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

12 52018

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

13 52018

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

14 52018

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

15 52018

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

16 52018

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

17 52018

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

May 3 2018 1100 am ET

May 3 2018 11 am ET

May 3 2018 4 pm ET

June 12 2018 11 am ET

18 52018

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

19 52018

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

20 52018

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

21 52018

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

22 52018

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

23 52018

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

24 52018

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

25 52018

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

26 52018

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

whole blood

27 52018

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

28 52018

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

29 52018

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

30 52018

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

31 52018

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

32 52018

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

33 52018

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

34 52018

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

35 52018

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

36 52018

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

Interactive Tools

Remittance Advice

EDI Agreement

EDI Application

CMS 1500 Claim Form

37 52018

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

Continued gtgt

L37636 Rev 2

38 52018

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

Coagulant Complex

A55947 NEW

39 52018

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

Coagulant Complex

A55947 NEW

continued

Article Title

Retired Articles

Date of Retirement

40 52018

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

L37176 Rev 5

L36466 Rev 9

41 52018

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

L33456 Rev 14

L36427 Rev 8

L34577 Rev 19

42 52018

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

Policy Title

L37639 Retired

Article Title

A53066 Rev 14

A55035 Rev 8

A55944 NEW

Retired LCDs

Articles

New Articles

Effective Date 5918

Effective Date 5718

43 52018

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

A55944 NEW

continued

LCD L36593 A55945

44 52018

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

LCD L36593 A55945

New continued

45 52018

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

LCD L36593 A55945

New continued

032218

022718

040518

041218

46 52018

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

041218

47 52018

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

48 52018

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

49 52018

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

(877) 567-7271

1-800-MEDICARE (1-800-633-4227)

TTY 1-877-486-2048

50 52018

Whatrsquos Inside

New Waived Tests

MLN ConnectsTM

Documents

NOTE: Should you have landed here as a result of a …...Medicare-related topics, such as provider enrollment, preventive services, claims processing, provider compliance, and Medicare