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LCD and Billing and Coding Article Update for October 2023

Billing and Coding: Autonomic Function Testing (A57024)

Due to the annual ICD-10 Code updates, ICD-10 code G20 has been deleted and the following ICD-10 codes have been added: G20.A1, G20.A2, G20.B1, G20.B2 and G20.C.

Billing and Coding: Botulinum Toxins (A52848)

Based on the annual ICD-10 code update, ICD-10 code G37.8 has been deleted from Group 8. ICD-10 codes G43.E01, G43.E09, G43.E11 and G43.E19 have been added to Group 11.

Billing and Coding: Cardiac Catheterization and Coronary Angiography (A52850)

Due to the annual ICD-10 updates for 2024, the following coding has been revised:

  • ICD-10 code E88.81 has been deleted and ICD-10 codes E88.810, E88.811, E88.818, and E88.819 were added to group 2.
  • ICD-10 codes 120.8 has been deleted and codes I20.81 and I20.89 were added to groups 2 and 3.
  • ICD-10 codes I24.8 has been deleted and codes I24.81 and I24.89 were added to groups 2 and 3.
  • I71.51, I71.52, I71.61 and I71.62 descriptors were changed in Group 6.
  • ICD-10 code I25.85 was added to groups 2 and 3.
  • ICD-10 code E74.05 was added to groups 1 and 2.

A typographical error was corrected in this statement:

Use CPT code 93541 or other appropriate right heart catheterization code (93453, 93456, 93457, 93460 or 93461) when right heart catheterization is done in a cardiac catheterization laboratory or in an interventional radiology laboratory and the procedure is done as part of a formal cardiac catheterization study.

  • I71.51 descriptor was changed in Group 6
  • I71.52 descriptor was changed in Group 6
  • I71.61 descriptor was changed in Group 6
  • I71.62 descriptor was changed in Group 6

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

Due to the annual ICD-10 updates for 2024, the following coding has been revised:

  • ICD-10 code 120.8 has been deleted and codes I20.81 and I20.89 were added.
  • ICD-10 code I25.85 was added.

Cardiovascular Nuclear Medicine (L33560)

Per Change request 13094, effective 1/1/2021, the supervision requirements for diagnostic tests were revised to allow for non-physician practitioners to supervise stress tests. The Limitations section of the LCD has been updated accordingly.

Billing and Coding: Cardiovascular Nuclear Medicine (A56743)

Due to the annual ICD-10 updates for 2024, the following coding has been revised:
For group 1:

  • ICD-10 code 120.8 has been deleted and codes I20.81 and I20.89 were added
  • ICD-10 code I24.8 has been deleted and codes I24.81 and I24.89 were added
  • ICD-10 code I47.1 has been deleted and codes I47.10, I47.11 and I47.19 were added
  • ICD-10 codes I25.85 and I21.B have been added

For group 3, ICD-10 codes I25.85 and I21.B have been added

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

Due to the annual ICD-10 code updates the code description was changed for ICD-10 code Q85.81 in Group 2.

Billing and Coding: Denosumab (Prolia ™, Xgeva ™) (A52399)

The ICD-10 code range M84.50XA – M84.58XS in Group 1 and ICD-10 code range M80.00XA - M80.88XS in Groups 2, 3, 5 and 8 and have been revised to remove all unspecified codes. The following unspecified ICD-10 codes M85.839 and M85.859 have been removed from Group 5 and Group 8. The following unspecified ICD-10 codes - C50.019, C50.119, C50.219, C50.319, C50.419, C50.519, C50.619, C50.819, C50.919, D05.00, D05.10, D05.80 and D05.90 have been removed from Group 9. The following unspecified ICD-10 codes - C40.00, C40.10, C40.20, C40.30, C40.80 and C40.90 have been removed from Group 11. Based on the annual ICD-10 code update the following ICD10 codes: M80.0B1A, M80.0B1D, M80.0B1G, M80.0B1K, M80.0B1P, M80.0B1S, M80.0B2A, M80.0B2D, M80.0B2G, M80.0B2K, M80.0B2P and M80.0B2S are included in ICD-10 code range M80.08XA - M80.0B2S in Groups 2, 3, 5 and 8. Based on Compendia review, ICD-10 code Z79.810 has been added to Group 10 effective for dates of service on or after 10/01/2023.

Billing and Coding: Ibandronate Sodium (A52421)

The ICD-10 code range M88.0 – M88.9 in Group 1 and ICD-10 code range M80.00XA - M80.88XS in Group 2 have been revised to remove all unspecified codes. Unspecified codes M85.839 and M85.859 have been removed from Group 4. Based on the annual ICD-10 code update, the following ICD-10 codes: M80.0B1A, M80.0B1D, M80.0B1G, M80.0B1K, M80.0B1P, M80.0B1S, M80.0B2A, M80.0B2D, M80.0B2G, M80.0B2K, M80.0B2P and M80.0B2S are included in ICD-10 code range M80.08XA - M80.0B2S in Group 2.

Billing and Coding: Magnetic Resonance Angiography (MRA) (A56747)

For the following ICD-10 codes, descriptions were changed in the in the Covered ICD-10 Codes field:

  • I71.61 descriptor was changed in Group 3
  • I71.62 descriptor was changed in Group 3
  • I71.61 descriptor was changed in Group 4
  • I71.62 descriptor was changed in Group 4
  • Q87.410 descriptor was changed in Group 4
  • Q87.418 descriptor was changed in Group 4
  • Q87.42 descriptor was changed in Group 4
  • Q87.43 descriptor was changed in Group 4

Billing and Coding: Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor (A57435)

Due to the annual ICD-10 Code updates, ICD-10 code G20 has been deleted and the following ICD-10 codes have been added: G20.A1, G20.A2, G20.B1, G20.B2 and G20.C.

Billing and Coding: Molecular Pathology Procedures (A56199)

Effective for services rendered on or after 10/1/2023, due to the annual ICD-10-CM update, the ICD-10-CM That Supports Medical Necessity section- Group 7 was updated with the following: diagnosis codes I20.8 was deleted and replaced by I20.81 and I20.89. Diagnosis code I24.8 was deleted and replaced by I24.81 and I24.89.

The ICD-10-CM That Supports Medical Necessity section- Groups 14 and 19 was updated with the following: diagnosis codes: D48.1 was deleted and replaced by code range D48.110 through D48.19.

Billing and Coding: Nerve Conduction Studies and Electromyography (A57668)

Due to the annual ICD-10 updates for 2024, these changes have been made in Group 1:

  • G20 was deleted and replaced by G20.A1, G20.A2, G20.B1, G20.B2 and G20.C.
  • G37.8 was deleted and replaced by G37.81 and G37.89.

Billing and Coding: Non-Invasive Vascular Studies (A56758)

Effective for services rendered on or after 10/1/2023, due to the annual ICD-10 updates for 2024, the following updates were made:

The following ICD-10 codes were added to Group 2: D57.04, D57.414, D57.434, and D57.454.
The following updates were made to Group 7:

  • I20.8 was deleted and replaced by I20.81 and I20.89.
  • I24.8 was deleted and replaced by I24.81 and I24.89.
  • I21.B and I25.85 were added.

Billing and Coding: Nonvascular Extremity Ultrasound (A56787)

Due to the annual ICD-10 Code updates, ICD-10 code D48.1 has been deleted and the following ICD-10 codes have been added: D48.110, D48.111, D48.112, D48.113, D48.114, D48.115, D48.116, D48.117, D48.118, D48.119, and D48.19.

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

Due to the annual ICD-10 updates for 2024, the following coding has been revised:

  • ICD-10 code H36 has been deleted and codes H36.811, H36.812, H36.813, H36.821, H36.822, H36.823, and H36.89 have been added to group 1.
  • ICD-10 code D57.04 was added to group 3.
  • Q85.81 descriptor was changed in Group 1
  • Q87.410 descriptor was changed in Group 1
  • Q87.418 descriptor was changed in Group 1
  • Q87.42 descriptor was changed in Group 1
  • Q87.43 descriptor was changed in Group 1

Billing and Coding: Outpatient Physical and Occupational Therapy Services (A56566)

Due to the annual ICD-10 updates for 2024, ICD-10 code J44.81 has been added to diagnoses not covered for CPT code 97035.

Billing and Coding: Pain Management (A52863)

Based on the annual ICD-10 code update, ICD-10 code D48.1 has been deleted from Group 2.

Billing and Coding: Percutaneous Coronary Intervention (A56823)

Effective for services rendered on or after 10/1/2023, due to the annual ICD-10 updates for 2024, the following updates were made to Group 1:

  • I20.8 was deleted and replaced by I20.81, I20.89, and I21B.
  • I24.8 was deleted and replaced by I24.81 and I14.89.
  • I25.85 was added.

Billing and Coding: Peripheral Nerve Blocks (A57452)

Due to the annual ICD-10 code updates, ICD-10 codes D13.9 and D48.1 have been deleted and the following ICD-10 codes have been added to Group 1 and Group 2: D13.91, D13.99, D48.110, D48.111, D48.112, D48.113, D48.114, D48.115, D48.116, and D48.117.

ICD-10 code M53.3 has also been added to Group 2.

Billing and Coding: Psychiatry and Psychology Services (A56937)

Effective for services rendered on or after 10/1/2023, due to the annual ICD-10 updates for 2024, ICD-10 code G20 was deleted from Group 2 and was replaced by G20.A1, G20.A2, G20.B1, G20.B2, and G20.C.

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

Effective for services rendered on or after 10/1/2023, due to the annual ICD-10-CM update, ICD-10-CM code H36 was deleted and replaced by the following ICD-10-CM diagnosis codes in ICD-10-CM That Supports Medical Necessity section- Group 3: H36.811, H36.812, H36.813, H36.821, H36.822, H36.823 and H36.89.

Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (A54909)

Based on the annual ICD-10 code update, ICD-10 code I47.1 has been deleted from Group 2 and is being replaced with ICD-10 codes I47.10, I47.11 and I47.19.

Billing and Coding: Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (A56874)

Due to the annual ICD-10 Code updates, ICD-10 code G20 has been deleted and the following ICD-10 codes have been added to Group 1: G20.A1, G20.A2, G20.B1, G20.B2 and G20.C.

Billing and Coding: Transesophageal Echocardiography (TEE) (A52868)

Due to the annual ICD-10 updates for 2024, the following coding has been revised:

ICD-10 code A41.54 has been added to group one.

For the following ICD-10 codes, descriptions were changed in the in the Covered ICD-10 Codes field:

  • I71.51 descriptor was changed in Group 1
  • I71.52 descriptor was changed in Group 1
  • I71.61 descriptor was changed in Group 1
  • I71.62 descriptor was changed in Group 1
  • Q87.40 descriptor was changed in Group 2
  • Q87.410 descriptor was changed in Group 2
  • Q87.418 descriptor was changed in Group 2
  • Q87.42 descriptor was changed in Group 2
  • Q87.43 descriptor was changed in Group 2

Billing and Coding: Transthoracic Echocardiography (TTE) (A56781)

Due to the annual ICD-10 updates for 2024, the following coding has been revised:

  • ICD-10 code 120.8 has been deleted and codes I20.81 and I20.89 were added to groups 1 and 3.
  • ICD-10 code I24.8 has been deleted and codes I24.81 and I24.89 were added to groups 1 and 3.
  • ICD-10 code I47.1 has been deleted and codes I47.10, I47.11 and I47.19 were added to group 1.
  • ICD-10 codes A41.54, K68.2, K68.3 and R40.2A were added to group 1.
  • For the following ICD-10 codes, descriptions were changed in the in the Covered ICD-10 Codes field:
    • I71.51 descriptor was changed in Group 1
    • I71.52 descriptor was changed in Group 1
    • I71.61 descriptor was changed in Group 1
    • I71.62 descriptor was changed in Group 1
    • Q87.40 descriptor was changed in Group 1
    • Q87.410 descriptor was changed in Group 1
    • Q87.418 descriptor was changed in Group 1
    • Q87.42 descriptor was changed in Group 1
    • Q87.43 descriptor was changed in Group 1
    • Q87.40 descriptor was changed in Group 2
    • Q87.410 descriptor was changed in Group 2
    • Q87.418 descriptor was changed in Group 2
    • Q87.42 descriptor was changed in Group 2
    • Q87.43 descriptor was changed in Group 2

Billing and Coding: Urine Drug Testing (A56761)

Effective for services rendered on or after 10/1/2023, due to the annual ICD-10 updates for 2024, ICD-10 codes I47.1, Z91.A4, A91.A5 and Z91.A9 have been deleted from Group 1 and were replaced by I47.10, I47.11, I47.19, R40.2A, Z91.A41, Z91.A48, Z91.A51, Z91.A58, Z91.A91, Z91.A98.

Billing and Coding: Urodynamics (A57455)

Due to the annual ICD-10 Code updates, ICD-10 code G20 has been deleted and the following ICD-10 codes have been added: G20.A1, G20.A2, G20.B1, G20.B2 and G20.C.

The code description was changed for ICD-10 code N35.812. 

Billing and Coding: Visual Electrophysiology Testing (A57060)

Based on the annual ICD-10 code update, ICD-10 code H36 has been deleted from Group 2 and is being replaced with ICD-10 codes: H36.811, H36.812, H36.813, H36.821, H36.822, H36.823 and H36.89.

Billing and Coding: Visual Fields Testing (A56551)

Effective for services rendered on or after 10/1/2023, due to the annual ICD-10-CM update, the ICD-10-CM That Supports Medical Necessity section- Group 1 was updated. The following diagnosis codes have been added: G43.E01, G43.E09, G43.E11, and G43.E19. ICD-10-CM code H36 was deleted and replaced by the following ICD-10-CM diagnosis codes: H36.811, H36.812, H36.813, H36.821, H36.822, H36.823 and H36.89. G37.8 was deleted.

Billing and Coding: Vitamin D Assay Testing (A57736)

The ICD-10 code range M80.00XA - M80.88XS in Group 1 has been revised to remove all unspecified codes. Based on the annual ICD-10 code update the following ICD-10 codes: M80.0B1A, M80.0B1D, M80.0B1G, M80.0B1K, M80.0B1P, M80.0B1S, M80.0B2A, M80.0B2D, M80.0B2G, M80.0B2K, M80.0B2P and M80.0B2S are included in ICD-10 code range M80.08XA - M80.0B2S in Group 1. ICD-10 code E20.8 has been deleted from Group 1 and is being replaced with ICD-10 codes E20.810, E20.811, E20.812, E20.818, E20.819 and E20.89. ICD-10 codes K90.821 and K90.822 have also been added to Group 1.

Self-Administered Drug Exclusion List: Medical Policy Article (A53021/A53022)

Based on CRs 13316 and 13339, HCPCS code J0800 has been deleted and replaced with J0801 and J0802.

Posted 9/22/2023

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