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: 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
MolDX: Pharmacogenomics Testing (L38335) - R1 - Effective August 24, 2023 Aug 25, 2023
Final Urine Drug Testing LCD and Associated Billing and Coding: Urine Drug Testing - Effective October 08, 2023 Aug 24, 2023
Billing and Coding: MolDX: FDA-Approved BRAF Tests (A54418) - R7 - Effective July 27, 2023 Aug 22, 2023
Billing and Coding: MolDX: FDA-Approved KRAS Tests (A54498) - R7 - Effective July 14, 2022 Aug 22, 2023
Proposed LCDs - Published for Review and Comments Aug 17, 2023
MolDX: Molecular Testing for Solid Organ Allograft Rejection (DL38629) and Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection (DA58168) - Published for Review and Comments Aug 15, 2023
Billing and Coding: MolDX: myPath® Melanoma Assay (A57626) Retirement - Effective August 06, 2023 Aug 01, 2023
MolDX: myPath® Melanoma Assay L37879 Retirement - Effective August 06, 2023 Aug 01, 2023
MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) (L36155) - R5 - Effective July 20, 2023 Jul 28, 2023
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer (L38327) - R2 - Effective July 20, 2023 Jul 27, 2023
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer (L39005) - R1 - Effective July 27, 2023 Jul 27, 2023
Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (A58720) - R10 - Effective July 01, 2023 Jul 27, 2023
Transcranial Magnetic Stimulation (TMS) Local Coverage Determination (LCD) Finalized - Effective August 20, 2023 Jul 27, 2023
Billing and Coding: High Compression Bandage System Clarification (A53287) Retirement - Effective July 19, 2023 Jul 27, 2023
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease (L36180) - R12 - Effective July 06, 2023 Jul 07, 2023
Billing and Coding: MolDX: Repeat Germline Testing (A57331) - R7 - Effective July 01, 2023 Jul 07, 2023
Billing and Coding: MolDX: Minimal Residual Disease Testing for Solid Tumor Cancers (A58454) - R4 - Effective July 06, 2023 Jul 07, 2023