LCD Associated Billing and Coding Article - Billing and Coding: Treatment of Ulcers and Symptomatic Hyperkeratoses - R1

The following Local Coverage Determination (LCD) associated Billing and Coding Article (LCA) has been revised under contract number: 02102 (AK), 03102 (AZ), 02202 (ID), 03202 (MT), 03302 (ND), 02302 (OR), 03402 (SD), 03502 (UT), 02402 (WA), and 03602 (WY).

Medicare Coverage Database Number LCD Title and Revision Number
L34199 Treatment of Ulcers and Symptomatic Hyperkeratoses

 

Medicare Coverage Database Number Billing and Coding Article Title and Revision Number
A57460 Billing and Coding: Treatment of Ulcers and Symptomatic Hyperkeratoses

 

Effective Date: June 29, 2020
Summary of Changes: No updates were made to the LCD. The following language updates were made to the associated Billing and Coding Article.

  • In the Article Text, added the statement “Other treatment modalities not discussed here will be included in the soon-to-be released for comment, Noridian Wound Care policy” in the second paragraph under Coding Guidelines.
  • Added the statement “If the coverage conditions for the treatment of Symptomatic Hyperkeratoses are not met, the claims will be adjudicated based off Noridian’s Billing and Coding: Routine Foot Care LCA” in the Group 2 Paragraph.
  • Updated the Group 2 and 3 Paragraph sections to indicate when billing claims for 11055-11057 providers must use at least one diagnosis code listed in Group 2 and at least one diagnosis code listed in Group 3.
  • Removed the redundant diagnosis codes from the Group 2 and Group 3 Medical Necessity ICD-10 Codes Asterisk Explanation sections.

Visit the Noridian Active LCDs webpage or Noridian Medicare Coverage Articles webpages to view the locally hosted document or access it via the CMS MCD.

            Last Updated Tue, 13 Oct 2020 19:45:21 +0000