LCD and Article Updates for September/October 2024

A58152 Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)

The following ICD-10-CM diagnosis codes were added to Group 1- ICD-10-CM Codes That Support Medical necessity section: G43.401, G43.409, G43.411, G43.419, G45.1, G46.0, G81.01, G81.02, G81.03, G81.04, G81.91, G81.92, G81.93, G81.94, G83.84, H53.131, H53.132, H53.133, H53.139, H53.8, H53.9, I63.511, I63.512, I69.320, I69.321, I69.322, I69.323, I69.351, I69.352, I69.353, I69.354, I69.992, R26.0, R26.2, R27.8, R27.9, R29.810, R41.4 R47.01, R47.02, R47.1, R47.81, R47.89, R47.9, effective 9/15/2024

A56793 Billing and Coding: Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases

Due to the annual ICD-10-CM update, code C88.8 has been deleted and replaced by C88.80 in the ICD-10 Codes That Support Medical Necessity section- Group 3, effective for services rendered on or after 10/1/2024.

A56199 Billing and Coding: Molecular Pathology Procedures

Due to the annual ICD-10-CM update, the ICD-10-CM code C88.8 has been deleted and replaced by C88.80 in the ICD-10-CM That Supports Medical Necessity section- Groups 13, 28, 31, 32, and 33, effective for services rendered on or after 10/1/2024.

A56726 Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

Due to the annual ICD-10-CM update, effective for services rendered on or after 10/1/2024, the descriptions of the following codes in the ICD-10-CM Codes That Support Medical Necessity section- Group 1 have been changed: H44.2A3, H44.2B3, H44.2C3, H44.2D3. H44.2E3.

A56537 Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

Due to the annual ICD-10-CM update, the descriptions of the following codes in the
ICD-10-CM Codes That Support Medical Necessity section- Group 3 have been changed: H44.2A3, H44.2B3, H44.2C3, H44.2D3, H44.2E3, effective for services rendered on or after 10/1/2024.

A56781 Billing and Coding: Transthoracic Echocardiography (TTE)

Due to the annual ICD-10-CM update, code Q23.8 has been deleted from Groups 1 and 2, effective for services rendered on or after 10/1/2024.

A59416 Billing and Coding: Urine Drug Testing

Due to the annual ICD-10-CM update, effective for services rendered on or after 10/1/2024, codes M51. 36 and M51.37 have been deleted and replaced by the following codes in the ICD-10-CM Codes That Support Medical Necessity section- Group1: M51.360, M51.361, M51.362, M51.370, M51.371, M51.372.

A56551 Billing and Coding: Visual Fields Testing

A59311 Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin

Due to the annual ICD-10 code updates, ICD-10 codes C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.2, C88.3, C88.4, C88.8, C88.9 have been deleted from Group 1 in the ICD-10-CM Codes that Support Medical Necessity Section and the following codes have been added: C83.390, C83.398, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.00, C88.01, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91.

A52850 Billing and Coding: Cardiac Catheterization and Coronary Angiography

Due to the annual ICD-10 code updates, ICD-10 code Q23.8 has been deleted from Group 4 in the ICD-10-CM Codes that Support Medical Necessity section and the following codes have been added: Q23.81, Q23.82 and Q23.88.

A56737 Billing and Coding: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

Due to the annual ICD-10 code updates, ICD-10 code Q23.8 has been deleted from Group 1 in the ICD-10-CM Codes that Support Medical Necessity section and the following codes have been added: Q23.81, Q23.82 and Q23.88.

A57026 Billing and Coding: Computed Tomographic (CT) Colonography for Diagnostic Uses

Due to the annual ICD-10 code updates, ICD-10 code Z86.010 in Group 2 of the ICD-10-CM Codes that Support Medical Necessity section has been deleted and the following ICD-10 codes have been added: Z86.0100, Z86.0101, Z86.0102 and Z86.0109

The code description for ICD-10 code K58.9 has changed.

A57668 Billing and Coding: Nerve Conduction Studies and Electromyography

Due to the annual ICD-10 updates, ICD-10 codes G90.8, M51.36 and M51.37 have been deleted from Group 1 in the ICD-10-CM Codes that Support Medical Necessity section and the following codes have been added: G90.81, G90.89, M51.360, M51.361, M51.362, M51.369, M51.370, M51.371, M51.372 and M51.379.

A57452 Billing and Coding: Peripheral Nerve Blocks

Due to the annual ICD-10 code updates, ICD-10 codes C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.2, C88.3, C88.4, C88.8, C88.9 have been deleted from Groups 1 and 2 in the ICD-10-CM Codes that Support Medical Necessity Section and the following codes have been added: C83.390, C83.398, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91.

A57427 Billing and Coding: Transrectal Ultrasound

Due to the annual ICD-10 code updates, ICD-10 codes K60.3, K60.4 and K60.5 have been deleted from Group 1 in the ICD-10-CM Codes that Support Medical Necessity section and the following codes have been added: K60.311, K60.312, K60.313, K60.321, K60.322, K60.323, K60.411, K60.412, K60.413, K60.421, K60.422, K60.423, K60.511, K60.512, K60.513, K60.521, K60.522 and K60.523.

A57736 Billing and Coding: Vitamin D Assay Testing

Due to the annual ICD-10 code update, E66.8 has been deleted from Group 1 in the ICD-10-CM Codes that support Medical Necessity section and the following codes have been added: E66.811, E66.812, E66.813, E66.89.

A52434 Health and Behavior Assessment/Intervention – Medical Policy Article

Due to the annual ICD-10 code update, F50.01, F50.02, F50.2 and F50.81 have been deleted from Group 1 in the ICD-10-CM Codes that DO NOT Support Medical Necessity section, and the following codes have been added: F50.010, F50.011, F50.012, F50.013, F50.014, F50.019, F50.020, F50.021, F50.022, F50.023, F50.024, F50.029, F50.20, F50.21, F50.22, F50.23, F50.24, F50.25, F50.810, F50.811, F50.812, F50.813, F50.814, F50.819.

Effective 1/1/2024, under the article text, coding information, the referenced CPT code range 90801-90899 has been revised to remove deleted codes 90801 and 90802, and to add CPT codes 90791 and 90792.

A52370 Billing and Coding: Bevacizumab and Biosimilars

8/13/2024: ICD 10 codes Q27.33, K31.811 were added to article. NGS received a reconsideration request to allow off label use of bevacizumab in hereditary hemorrhagic telangiectasia (HHT) with arteriovenous malformations (AVMs) causing gastrointestinal bleeding.

8/14/2024: Due to the annual ICD-10-CM update, code C83.39 has been deleted and replaced with code C83.390. Additional ICD-10-CM Codes That Support Medical Necessity section Group 1 were also added as a result of the annual update, including C83.398 and C83.3A, effective for services rendered on or after 10/1/2024.

A59101 Billing and Coding: Off-Label Use of Rituximab and Rituximab Biosimilars

Due to the annual ICD-10-CM update, codes C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.4, C88.8 was deleted from Group 2. New codes C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390 C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.AA, C84.ZA, C84.9A were added. Effective for services rendered on or after 10/1/2024.

A52450 Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)

On 8/1/2024: Due to the annual ICD-10-CM update, codes C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6 was deleted from Group 2. New codes C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61. Effective for services rendered on or after 10/1/2024.

On 9/1/2024: Due to the quarterly ICD-10-CM update code J9258 was deleted from Group 1 as it was not therapeutically equivalent to Group 1 J9264.

A52863 Billing and Coding: Pain Management - Injection of Tendon Sheaths, Ligaments, Ganglion Cysts, Carpal and Tarsal Tunnels

Due to the annual ICD-10-CM update, code M65.9 was deleted from Group 1. New codes M65.90, M65.911, M65.912, M65.919, M65.921, M65.922, M65.929, M65.931, M65.932, M65.939, M65.941, M65.942, M65.949, M65.951, M65.952, M65.959, M65.961, M65.962, M65.969, M65.971, M65.972, M65.979, M65.98, M65.99 were added to Group 1. Effective for services rendered on or after 10/1/2024.

A56850 Billing and Coding: Psychiatric Partial Hospitalization Programs

Due to the annual ICD-10-CM update, code F50.01, F50.02, F50.2 and F50.81 were deleted from Group 1. New codes F50.010, F50.011, F50.012, F50.013, F50.014, F50.019, F50.020, F50.021, F50.022, F50.023, F50.024, F50.029, F50.20, F50.21, F50.810, F50.811, F50.812, F50.813, F50.814, F50.819 were added to Group 1. Effective for services rendered on or after 10/1/2024.

A56937 Billing and Coding: Psychiatry and Psychology Services

Due to the annual ICD-10-CM update, code F50.01, F50.02, F50.2 were deleted from Group 1. New codes F50.010, F50.011, F50.012, F50.013, F50.014, F50.019, F50.020, F50.021, F50.022, F50.023, F50.024, F50.029, F50.20, F50.21, F50.810, F50.811, F50.812, F50.813, F50.814, F50.819, F50.82, F50.83, F50.84 were added to Group 1. Effective for services rendered on or after 10/1/2024.

A52423 Billing and Coding: Infliximab and Biosimilars

Due to the annual ICD-10-CM update, code M65.9 was deleted from Group 2 and replaced with codes M65.911, M65.912, M65.919, M65.921, M65.922, M65.929, M65.931, M65.932, M65.939 effective for services rendered on or after 10/1/2024.

A59105 Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)

On 8/1/2024: Due to the annual ICD-10-CM update, codes C88.2, C88.8 deleted from the ICD-10-CM from Group 2. New codes C88.21, C88.30, C88.31, C88.40, C88.41, C88.81, C88.90, C88.91 were added. Revision date effective 10/1/2024.

A56865 Billing and Coding: Psychiatric Inpatient Hospitalization

Due to the annual ICD-10-CM update, code F50.01, F50.02, F50.2 were deleted from Group 1. New codes F50.010, F50.011, F50.012, F50.013, F50.014, F50.019, F50.020, F50.021, F50.022, F50.023, F50.024, F50.029, F50.20, F50.21 were added to Group 1. Effective for services rendered on or after 10/1/2024.

A53021 Self-Administered Drug Exclusion List: Medical Policy Article

We added a JA/JB modifier for Tremfya (J1628) following a revised FDA approval effective on or after 10/3/2024. We also removed JA/JB modifiers for Secukinumab (Cosentyx™) as the drug has distinct codes for each route of administration. We also added a JB modifier to Zymfentra (J1748) which was inadvertently not added during the 7/4/2024 update.

Posted 9/27/2024

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