LCD and Policy Article Revisions Summary for July 18, 2019 - JD DME
LCD and Policy Article Revisions Summary for July 18, 2019
Outlined below are the principal changes to the DME MAC Local Coverage Determination (LCD) and Policy Article (PA) that have been revised and posted. The policy included is Tumor Treatment Field Therapy (TTFT). Please review the entire LCD and related PA for complete information.
Tumor Treatment Field Therapy (TTFT) LCD
Revision Effective Date: 09/01/2019
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
- Added: Criteria for Initial Coverage for Newly Diagnosed Glioblastoma Multiforme
- Added: Criteria for Continued Coverage for Newly Diagnosed GBM Beyond the First Three Months of Therapy
- Added: Coverage statement for Recurrent GBM
- Added: Coverage statement for Other Uses
- Added: Beneficiaries Entering Medicare FFS requirements
SUMMARY OF EVIDENCE:
- Added: Summary of evidence reviewed
ANALYSIS OF EVIDENCE (RATIONALE FOR DETERMINATION):
- Added: Background, CAC and key question information, and Conclusion
HCPCS CODES:
- Added: HCPCS Modifiers GA, GZ, KF, and KX
SOURCES OF INFORMATION:
- Added: References to sources of information
BIBLIOGRAPHY:
- Added: Bibliography information
RELATED LOCAL COVERAGE DOCUMENTS:
- Added: Response to Comments: Tumor Treatment Field Therapy (TTFT) – DL34823
PA
Revision Effective Date: 09/01/2019
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
- Added: Documentation requirements for Initial Coverage (First Three Months)
- Added: Documentation requirements for Continued Coverage Beyond the First Three Months of Therapy
- Added: Documentation required for Equipment Retained from a Prior Payer
- Added: Proof of Delivery Requirements for Recently Eligible Medicare FFS Beneficiaries
- Added: GA, GZ, KF and KX modifier usage information
- Added: Miscellaneous information
07/18/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
Note: The information contained in this article is only a summary of revisions to the LCDs and PAs. For complete information on any topic, you must review the LCDs and/or PAs.