Article Detail - JE Part B

This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV).

Effective Date: October 01, 2022

Summary of Article Changes: Updated the Group 1 Asterisk Section in the ICD-10 Codes That Support Medical Necessity to read:

• Effective 06/19/2022, L60.8 is to be billed with 11719 - trimming of non-dystrophic nails - only if one of the systemic conditions from Group 2, 3 or 4 below is present AND the patient does NOT have dystrophic nails. G0127 is the appropriate code for the trimming of dystrophic nails.
• Effective 06/19/2022, G0127 is to be billed for dystrophic nails only. It is inappropriate to bill L60.8, L84 and L98.7 with G0127.

In Group 4 ICD-10 Codes That Support Medical Necessity, added an asterisk (*) to the following codes: D68.01, D68.020, D68.021, D68.022, D68.023, D68.029, D68.03, D68.04, D68.09 effective 10/01/2022.

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