Changes to Lab Coverage Software Announced

Changes to the Laboratory National Coverage Determination Edit Software, effective Oct. 1, 2011 are available. The changes, announced in Transmittal 2257, reflect changes to ICD-9-CM codes made in national coverage decisions (NCDs).

The changes, as outlined in official communications, are:

For Codes That Are Denied By Medicare For All 23 Lab NCDs:

  • Delete ICD-9-CM code V19.1 Family history of other eye disorders from the list of ICD-9-CM codes that are denied by Medicare for all 23 Lab NCDs.
  • Add ICD-9-CM codes V19.11 and V19.19 to the list of ICD-9-CM codes that are denied by Medicare for all 23 Lab NCDs.

For Codes That Do Not Support Medical Necessity For The Blood Counts

  • Add ICD-9-CM code V54.82 Aftercare for healing traumatic fracture of lower leg to the list of ICD-9-CM codes that do not support medical necessity for the Blood Counts (190.15) NCD.

For Partial Thromboplastin Time

  • Delete ICD-9-CM codes 286.5, 444.0, and 596.8 from the list of ICD-9-CM codes that are covered by Medicare for the Partial Thromboplastin Time (PTT) (190.16) NCD.
  • Add ICD-9-CM codes 286.52, 286.53, 286.59, 444.01, 444.09, 596.81, 596.82, 596.83, and 596.89 to the list of ICD-9-CM codes that are covered by Medicare for the Partial Thromboplastin Time (PTT) (190.16) NCD.

For Prothrombin Time

  • Delete ICD-9-CM codes 286.5, 444.0, 596.8, and 997.4 from the list of ICD-9-CM codes that are covered by Medicare for the Prothrombin Time (PT) (190.17) NCD.
  • Add ICD-9-CM codes 286.52, 286.53, 286.59, 415.13, 444.01, 444.09, 596.81, 596.82, 596.83, 596.89, 997.41, 997.49, and V12.55 to the list of ICD-9-CM codes that are covered by Medicare for the Prothrombin Time (PT) (190.17) NCD.

For Serum Iron Studies

  • Delete ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8, 173.9, and 286.5 from the list of ICD-9-CM codes that are covered by Medicare for the Serum Iron Studies (190.18) NCD.
  • Add ICD-9-CM codes 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, 173.99, 286.52, 286.53, and 286.59 to the list of ICD-9-CM codes that are covered by Medicare for the Serum Iron Studies (190.18) NCD.

For Blood Glucose Testing

  • Add ICD-9-CM codes V23.42 and V23.87 to the list of ICD-9-CM codes that are covered by Medicare for the Blood Glucose Testing (190.20) NCD.

For Glycated Hemoglobin/Glycated Protein

  • Delete ICD-9-CM code V12.2 Personal history of endocrine metabolic and immunity disorders from the list of ICD-9-CM codes that are covered by Medicare for the Glycated Hemoglobin/Glycated Protein (190.21) NCD.
  • Add ICD-9-CM codes V12.21 and V12.29 to the list of ICD-9-CM codes that are covered by Medicare for the Glycated Hemoglobin/Glycated Protein (190.21) NCD.

For Thyroid Testing

  • Delete ICD-9-CM code V12.2 from the list of covered ICD-9-CM codes for the Thyroid Testing (190.22) NCD.
  • Add ICD-9-CM codes V12.21 and V12.29 to the list of ICD-9-CM codes that are covered by Medicare for the Thyroid Testing (190.22) NCD.

For Lipids Testing

dec-clearance-sale

  • Delete ICD-9-CM code 444.0 Embolism and thrombosis of abdominal aorta from the list of ICD-9-CM codes that are covered by Medicare for the Lipids Testing (190.23) NCD.
  • Add ICD-9-CM codes 444.01 and 444.09 to the list of ICD-9-CM codes that are covered by Medicare for the Lipids Testing (190.23) NCD.

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One Response to “Changes to Lab Coverage Software Announced”

  1. Karen says:

    I am working on genittg my groove back. The last 12-months have been tough dealing with the dying and death of my step-mom on top of all the regular special-needs mom things.I have been fortunate to have been asked to be a part of team of women who will do a women’s retreat in October (Walk to Emmaus). One of my responsibilities will be to give a talk. I will be able to talk about my journey with Luke, and his journey in with life.

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