Part B Insider (Multispecialty) Coding Alert

Published on Fri Jul 18, 2003 PDF

CMS Announces 4 New Coverage Actions

The Centers for Medicare & Medicaid Services is hard at work to decide which services you'll be able to bill in the future. Recently CMS:
 

 opened a tracking sheet for coverage of bacterial urine culture for patients with renal failure. CMS is reviewing whether to include ICD-9 Codes 584.x (Acute renal failure), 585 (Chronic renal failure) and 586 (Renal failure, unspecified). Currently, Medicare covers urine cultures for 585 and 586, and CMS is reconsidering whether these three codes "flow from the narrative indications." Providers have until Aug. 6 to comment.
 

unveiled a technology assessment from the Agency for Healthcare Quality Research for acupuncture for osteoarthritis. The assessment concluded that acupuncture might be a good third- or fourth-line treatment for osteoarthritis but that no studies currently available show a clear benefit. Three new studies currently under way may clarify the issue.
 

posted a decision on coverage for electrodiagnostic sensory nerve conduction threshold in which CMS decided that using a "current output" or "voltage input" device to diagnose sensory neuropathies or radiculopathies in Medicare beneficiaries isn't reasonable or necessary.
 

posted a decision on coverage for arthroscopy of an osteoarthritic knee in which CMS decided arthroscopic lavage alone isn't reasonable or necessary. Also, arthroscopic debridement isn't reasonable or necessary for patients with knee pain alone or severe osteoarthritis. Other coverage for debridement will remain at carrier discretion.