CMS Expands Coverage for Lung Surgery

Why This Topic Matters

CMS coverage updates can affect whether services are payable, whether diagnostic criteria are recognized, and whether coverage is being reconsidered through national processes or advisory review. Organizations that bill Medicare need to track these changes because they can influence documentation, claims handling, and participation in public comment processes.

Article Sections

1. Laboratory services coverage correction

   This section discusses a correction to a prior CMS coverage issue involving laboratory testing policy and diagnosis inclusion. It also notes an expanded coverage concept related to atherosclerotic disease risk.

2. Lung volume reduction surgery decision memorandum

   This section summarizes CMS coverage action on lung surgery and distinguishes between covered and noncovered patient groups under the review. It places the policy in the context of emphysema and national coverage evaluation.

3. Coverage process for coagulation testing

   This section covers a new CMS review concerning two clotting-related laboratory procedures and public comment on diagnosis coverage. It highlights a specific mismatch between narrative indications and the codes under review.

4. Automatic implantable cardiac defibrillators

   This section notes a reopened CMS coverage process for implantable cardiac defibrillators in connection with national clinical trials. It indicates that the topic is being reconsidered within a formal coverage framework.

5. Radioimmunotherapy for non-Hodgkin's lymphoma

   This section describes a reopened comment period on oncology coverage review for radioimmunotherapy and related therapies. It focuses on CMS reconsideration of selected uses of these treatments.

6. Ocular photo-dynamic therapy reconsideration

   This section explains that CMS is reconsidering a prior national noncoverage determination for an eye treatment and that the issue will be reviewed by a Medicare advisory body. It references the policy history and the ongoing reconsideration process.