tci General Surgery Coding Alert - 2019 Issue 3

Reader Question: Prepare for LCD Changes

Question: I heard that Medicare is changing LCDs to eliminate ICD-10 codes. Does that mean we no longer need to list a diagnosis to show medical necessity for procedures and services? Virginia Subscriber Answer: No, CMS’s change to Local Coverage Determinations (LCDs) does not release you from documenting medical necessity for any medical procedure. Rather, the change involves the process for creating and presenting LCDs. According to MLN Matters 10901, CMS used recent Medicare Physician Fee Schedule (MPFS) feedback to revise the Local Coverage Determination (LCD) process. The revamp includes new timelines, more consultation options, a different request...

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