Medical Director Articles

The term "article" is used to describe any bulletin article, web site article, educational handout or any other non-LCD document intended for public release that contains coverage/coding statements or medical review related billing or claims considerations.

Articles address local coverage, coding or medical review related billing and claims considerations, and may include any newly developed educational materials, coding instructions or clarification of existing medical review related billing or claims policy.

The article listing will continue to expand as additions are made.

Last Updated Jan 30 , 2024
Articles Source Posted
Billing and Coding: Implantable Infusion Pumps for Chronic Pain (A55239) - R16 - Effective January 1, 2024 Jan 04, 2024
2024 CPT/HCPCS Local Coverage Article (LCA) Updates Dec 28, 2023
Micro-Invasive Glaucoma Surgery (MIGS) Dec 28, 2023
Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A58865) - R2 - Effective November 12, 2023 Dec 28, 2023
Billing and Coding: Cataract Surgery in Adults (A57195) - R7 - Effective January 1, 2024 Dec 28, 2023
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (A58720) - R14 - Effective October 1, 2023 Dec 21, 2023
Billing and Coding: Dental Services (A59447) Retirement - Effective December 19, 2023 Dec 20, 2023
Multiple Local Coverage Determinations (LCDs) Finalized - Effective January 28, 2024 Dec 15, 2023
Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) Article A58236 - Effective November 1, 2023 Dec 07, 2023
Pegfilgrastim (Neulasta) J2505 and Q5122 - (Injection, pegfilgrastim-apgf, biosimilar, (Nyvepria))Article A52889 Retirement - Effective November 1, 2023 Dec 04, 2023
Billing and Coding: Positron Emission Tomography Scans Coverage (A54666) Retirement - Effective October 1, 2023 Dec 04, 2023
Proteomics Nov 28, 2023
2023 ICD-10 Local Coverage Article (LCA) Updates Nov 27, 2023
Parenteral Iron Administration Coverage in Non-Dialysis Usage (A55653) Retirement - Effective November 1, 2023 Nov 27, 2023
Respiratory Care (L34149) - R14 - Effective November 5, 2023 Nov 16, 2023
Micro-Invasive Glaucoma Surgery (MIGS) (LCDs) Finalized - Effective December 24, 2023 Nov 09, 2023
Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma (A59179) - R2 - Effective August 06, 2023 Nov 07, 2023
Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer (A58718) - R1 - Effective November 02, 2023 Nov 07, 2023
Billing and Coding: Treatment with Yttrium-90 Microspheres (A54072) Retirement - Effective November 1, 2023 Nov 06, 2023
Billing and Coding: Posterior Tibial Nerve Stimulation Coverage (A55104) Retirement - Effective November 1, 2023 Nov 06, 2023
Billing and Coding: Remote Imaging of the Retina to Screen for Retinal Diseases (A58384) Retirement - Effective November 1, 2023 Nov 02, 2023
Billing and Coding: Physician Supervision of Dialysis for Acute Kidney Injury (A55992) Retirement - Effective November 1, 2023 Nov 02, 2023
Billing and Coding: Outpatient Cardiac Rehabilitation (A54068) Retirement - Effective November 1, 2023 Nov 02, 2023
Billing and Coding: Artificial Hearts and Percutaneous Endovascular Cardiac Assist Procedures and Devices (A52966) Retirement - Effective November 1, 2023 Nov 02, 2023
Billing and Coding: Botulinum Toxin Types A and B Policy (A57185) - R6 - Effective October 1, 2023 Oct 26, 2023
Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors (A58973) - R2 - Effective October 01, 2023 Oct 19, 2023
Billing and Coding: MolDX: Pharmacogenomics Testing (A57384) - R11 - Effective October 01, 2023 Oct 19, 2023
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (A58720) - R12 - Effective October 01, 2023 Oct 19, 2023
Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma (A59179) - R1 - Effective August 06, 2023 Oct 19, 2023
Billing and Coding: Urine Drug Testing (A55001) - R20 - Effective October 1, 2023 Oct 12, 2023
Respiratory Care Local Coverage Determination (LCD) Finalized - Effective November 5, 2023 Oct 12, 2023
Self-Administered Drug Exclusion List - R31 - Effective October 1, 2023 Oct 09, 2023
Billing and Coding: Pulmonary Rehabilitation Services (A56152) - R6 - Effective May 11, 2023 Oct 05, 2023
Multiple Local Coverage Determinations (LCDs) Finalized - Effective November 12, 2023 Sep 28, 2023
Billing and Coding: Implantable Infusion Pumps for Chronic Pain (A55239) - R14 - Effective October 1, 2023 Sep 28, 2023
Billing and Coding: MolDX: Pharmacogenomics Testing (A57384) - R10 - Effective September 21, 2023 Sep 26, 2023
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers - Coding and Billing (A54929) - R10 - Effective October 1, 2019 Sep 21, 2023
Billing and Coding: Billing Limitations for Pharmacies (A56119) - R5 - Effective October 1, 2023 Sep 21, 2023
Billing and Coding: Routine Foot Care (A57954) - R13 - Effective October 1, 2022 Sep 21, 2023
Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer (A58679) - R4 - Effective October 1, 2023 Sep 19, 2023
Billing and Coding: MolDX: Blood Product Molecular Antigen Typing (A57124) - R2 - Effective October 1, 2023 Sep 19, 2023
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis (L39467) Final LCD - Effective October 15, 2023 Sep 05, 2023
2023 ICD-10 Local Coverage Article (LCA) Updates Aug 31, 2023
MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DL39686) and Billing and Coding: MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers (DA59513) - Published for Review and Comments Aug 31, 2023
MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy (DL39678) and Billing and Coding: MolDX: Molecular Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules Following Bronchoscopy (DA59505) - Published for Review and Comments Aug 31, 2023
MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules (DL39682) and Billing and Coding: MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules (DA59509) - Published for Review and Comments Aug 31, 2023
Billing and Coding: MolDX: ApoE Genotype (A55094) - R2 - Effective August 31, 2023 Aug 31, 2023
MolDX: Next-Generation Sequencing for Solid Tumors (L38119) - R2- Effective June 08, 2023 Aug 30, 2023
Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection (A58168) - R4 - Effective March 31, 2023 Aug 30, 2023
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (A58720) - R11 - Effective October 01, 2023 Aug 25, 2023