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  • Posting Date: 05/03/2022
    Vein Ablation and Related Services

    General Documentation Requirements for Vein Ablation and Related Services Checklist of prior authorization request (PAR) information to include: Doppler ultrasound results Documentation stating presence or absence of DVT (deep vein [...]

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  • Posting Date: 03/17/2016
    Electrical Stimulation Therapy: Important Coverage and Documentation Reminders

    Electrical Stimulation Therapy: Important Coverage and Documentation Reminders Table of Contents CPT/HCPCS: 97032 Coverage and Documentation Provider Actions Related Content [Return to Top] CPT/HCPCS: 97032 National Government [...]

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  • Posting Date: 02/26/2016
    Documentation Reminder: Psychiatry and Psychology Services

    Documentation Reminder: Psychiatry and Psychology Services Table of Contents Documentation Reminder: Psychiatry and Psychology Services Submitting Documentation Provider Actions Related Content [Return to Top] Documentation [...]

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  • Posting Date: 05/03/2022
    Botulinum Toxin Injections

    General Documentation Requirements for Botulinum Toxin Injections Prior authorization is only required when one of the required Botulinum Toxin codes (J0585, J0586, J0587, or J0588) is used in conjunction with one of the required CPT injection [...]

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  • Posting Date: 11/09/2023
    Processing Issue Botulinum Toxin Claims Returned to Provider with 5PRIA

    Part A claims that have been submitted with Botulinum J codes (J0585, J0586, J0587, J0588) have incorrectly RTP with reason code 5PRIA.

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  • Posting Date: 08/04/2022
    Medicare Part B Coverage and Billing Guidance for Breast Ultrasound

    Medicare Part B Coverage and Billing Guidance for Breast Ultrasound Breast ultrasound uses sound waves to produce pictures of the inside of the breast and can show changes that are more difficult to see on a mammogram. Breast ultrasound is not [...]

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  • Posting Date: 04/27/2023
    KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims

    KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims Reminders Providers report KX modifier on a claim line(s) to confirm the medical records contain specific required documentation that meets [...]

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  • Posting Date: 03/29/2023
    LCD, Billing and Coding Article Updates for March and April 2023

    LCD, Billing and Coding Article Updates for March and April 2023 Pain Management (L33622) Effective 3/19/2023 The LCD has been revised to remove all references to sacroiliac joint injections. Please refer to LCD L39455 Sacroiliac Joint [...]

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  • Posting Date: 06/29/2023
    National Government Services Proposed LCDs for Comment (6/22/2023-8/5/2023) - Update

    National Government Services Proposed LCDs for Comment (6/22/2023-8/5/2023) - Update The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from [...]

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  • Posting Date: 10/05/2023
    National Government Services Proposed LCDs for Comment

    National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 10/5/2023–11/18/2023. These proposed [...]

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  • Posting Date: 04/07/2022
    Panniculectomy Best Practices

    Panniculectomy Best Practices Table of Contents Panniculectomy, Excision of Excess Skin and Subcutaneous Tissue (including Lipectomy) and Related Services Coverage Documentation Requirements Best practice/documentation [...]

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  • Posting Date: 05/03/2022
    Botulinum Toxin Best Practices

    Botulinum Toxin Best Practices Table of Contents Botulinum Toxin Injections Coverage Documentation Requirements Best Practice/Documentation Feedback/Tips and Help Related Content [Return to Top] Botulinum Toxin [...]

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  • Posting Date: 10/29/2021
    Implantation of Spinal Neurostimulator

    Implantation of Spinal Neurostimulator Table of Contents Implantation of Spinal Neurostimulator Coverage Documentation Requirements Best Practice/Documentation Feedback/Tips Related Content [Return to Top] Implantation of [...]

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  • Posting Date: 06/14/2023
    Facet Joint Interventions for Pain Management Best Practices

    Facet Joint Interventions for Pain Management Best Practices Table of Contents Indications and/or Medical Necessity Coverage Documentation Requirements Diagnostic Facet Joint Injections (IA or MBB) Therapeutic Facet Joint Injection [...]

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  • Posting Date: 01/03/2022
    Respiratory Pathogen Panel Testing

    Respiratory Pathogen Panel Testing N/A L39027 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39027 A58741 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58741 A58890 [...]

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  • Posting Date: 10/05/2023
    Cardiovascular Nuclear Medicine

    Cardiovascular Nuclear Medicine cardiac scan, stress test, heart, coronary, ejection, perfusion, blood pool L33560 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33560 A56743 [...]

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  • Posting Date: 10/05/2023
    Epidural Steroid Injections for Pain Management

    Epidural Steroid Injections for Pain Management spine, pain, transforaminal, sacral, steroid, spinal L39036 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39036 A58745 [...]

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  • Posting Date: 09/30/2021
    Visual Fields Testing

    Visual Fields Testing eyes, ophthalmology, vision L33574 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33574 A56551 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56551 92081, 92082, 92083

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  • Posting Date: 04/19/2021
    Visual Electrophysiology Testing

    Visual Electrophysiology Testing N/A L36831 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=36831 A57060 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57060 A55475 [...]

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  • Posting Date: 06/01/2023
    Urodynamics

    Urodynamics cystometrogram, uroflowmetry, urethral pressure profile, sphincter electromyogram, sphincter electromyogram, incontinence, voiding dysfunction L33576 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33576 A57455 [...]

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