tci General Surgery Coding Alert - 2020 Issue Q1

Reader Question: Find the Missing ‘Payable Diagnoses’

Question: We’ve always turned to our Medicare contractor’s LCDs to find a list of payable diagnoses for procedures, but now we can’t find that information. What happened? SuperCoder Subscriber Answer: CMS recently modernized the process for Local Coverage Determinations (LCDs) based on requirements of the 21st Century Cures Act. The process has resulted in changes to LCD content, including the decision to no longer include CPT® or ICD-10 codes in the LCDs. To implement the changes, CMS modified LCD instructions in chapter 13 of the Medicare Program Integrity Manual (100-08) and issued Change Request (CR) 10901...

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