Monday, June 29, 2015

2015 HCPCS local coverage determination changes


First Coast Service Options Inc. has revised local coverage determinations (LCDs) impacted by the 2015 Healthcare Common Procedure Coding System (HCPCS) annual update. Procedure codes have been added, revised, replaced and deleted accordingly:



LCD Title
Changes
Allergy Testing
Descriptor change for CPT® code 84600
Deleted HCPCS codes G0461 and G0462
Added CPT® codes 88341, 88342, and 88344
Arthrocentesis
Added code CPT® codes 20604, 20606, and 20611
Developed LCD “Coding Guidelines” attachment
Biventricular Pacing/Cardiac Resynchronization Therapy
Descriptor changes for CPT® codes 33217, 33224, 33225, 33230, 33231, 33240, and 33249
Bone Mineral Density Studies
Deleted CPT® code 77082
Added CPT® codes 77085 and 77086
Cardiovascular Nuclear Imaging Studies
Deleted HCPCS code J0151
Added HCPCS code J0153
Colorectal Cancer Screening
Added HCPCS code G0464
Added language pertaining to CPT® code 00810 and Modifier 33 (Related to change request (CR) 8874)
Revised LCD to re-state the utilization parameters and ordering requirements (Related to CR 8881)
Diagnostic and Therapeutic Esophagogastroduodenoscopy
Descriptor change for CPT® codes 43247 and 43250
Diagnostic Colonoscopy
Descriptor change for CPT® codes 44388, 44390, 44391, 44392, 45378, 45379, 45380, 45381, 45382, 45384, 45385, 45386, 45391, and 45392
Deleted CPT® codes 44393, 44397, 45355, 45383, and 45387
Added HCPCS codes G6019, G6020, G6021, G6024, and G6025
Erythropoiesis Stimulating Agents
Removed HCPCS code J0890 based on the nationwide recall and revisions in language were made throughout the LCD for clarification
Added HCPCS codes J0887 and J0888
Ferrlecit® and Venofer®
Added HCPCS code J1439
Changed LCD Title to Parenteral Iron Supplementation for Patients Receiving ESA Therapy for Anemia of Chronic Kidney Disease or Iron Deficiency Anemia
Gene Expression Profiling Panel for use in the Management of Breast Cancer Treatment
Removed unlisted CPT® code 84999 and replaced with CPT® code 81519
Genetic Testing for Lynch Syndrome
Deleted HCPCS code G0461 and G0462
Added CPT® codes 81288, 88341, 88342, and 88344
Hemophilia Clotting Factors
Descriptor change for HCPCS code J7195
Deleted HCPCS codes C9133 and C9135
Removed unlisted HCPCS code C9399 and replaced with HCPCS code C9136
Added HCPCS codes J7182, J7200 and J7201
Hyperbaric Oxygen Therapy (HBO Therapy)
Added HCPCS code G0277
Implantable Infusion Pump for the Treatment of Chronic Intractable Pain (Coding Guidelines only)
Deleted HCPCS code J2275
Added HCPCS code J2274
Independent Diagnostic Testing Facility (IDTF) (Coding Guidelines only)
Deleted CPT® codes 74291, 76645, and 77082
Added CPT® codes 76641, 76642, 77063, 77085, 77086, 93260, 93261, and HCPCS code G0279
Intensity Modulated Radiation Therapy (IMRT)
Deleted CPT® codes 0073T, 76950, 77305, 77310 ,77315, 77326, 77327, 77328, 77402, 77403, 77404, 77406, 77407, 77408, 77409, 77411, 77412, 77413, 77414, 77416, 77418 , and 77421 
Added HCPCS codes G6001, G6002, G6003, G6004, G6005, G6006, G6007, G6008, G6009, G6010, G6011, G6012, G6013, G6014, G6015, G6016 and CPT® codes 77306, 77307, 77316, 77317, and 77318
Mohs Micrographic Surgery (MMS)
Deleted HCPCS codes G0461 and G0462
Added CPT® codes 88341, 88342, and 88344
Molecular Pathology Procedures
Descriptor change for CPT® code 81245 
Added CPT® codes 81246, 81288, and 81313
Noncovered Services
Descriptor change for CPT® code 22856 
Deleted CPT® code 0059T (replaced with CPT® codes 0357T and 89337), CPT® code 0092T (replaced with CPT® code 0375T), CPT® code 0181T (replaced with CPT® code 92145), CPT® code 0199T (replaced with unlisted CPT® code 95999 – Tremor measurement with accelerometer(s) and/or gyroscope(s), CPT® code 0226T (replaced with HCPCS code G6027), CPT® code 0227T (replaced with HCPCS code G6028), CPT® code 0239T (replaced with CPT® code 93702), CPT® code 0334T (replaced with CPT® code 27279), unlisted CPT® codes 53899/55899 - Urethral lift (replaced with CPT® codes 52441/52442), and CPT® codes 87620/87622 (replaced with CPT® codes 87623,87624, and 87625)
Deleted CPT® code 88349
Removed HCPCS code P9019 from the “Coding Guidelines” attachment and replaced with HCPCS code P9020 (Not related to HCPCS update)
Added CPT® code 22858
Paclitaxel (Taxol®)
Deleted HCPCS code J9265
Added HCPCS code J9267
Psychiatric Diagnostic Evaluation and Psychotherapy Services
Deleted HCPCS code M0064
Qualitative Drug Screen
Deleted CPT® code 80102
Added HCPCS code G6058
Qutenza® (capsaicin) 8% patch
Deleted HCPCS code J7335
Added HCPCS code J7336
Radiation Therapy for T1 Basal Cell and Squamous Cell Carcinomas of the Skin
Descriptor change for CPT® code 77401 
Deleted CPT® codes 77402, 77403, 77404, 77406, 77407, 77408, 77409, 77411, 77412, 77413, 77414, 77416, and 77418
Added HCPCS codes G6003, G6004, G6005, G6006, G6007, G6008, G6009, G6010, G6011, G6012, G6013, G6014, G6015
Screening and Diagnostic Mammography
Descriptor change for HCPCS codes G0204 and G0206
Added CPT® code 77063 and HCPCS code G0279
Skin Substitutes
Added HCPCS codes C9349, Q4150, Q4151, Q4152, Q4153, Q4154, Q4155, Q4156, Q4157, Q4158, Q4159, and Q4160 to “The following HCPCS codes are not separately payable and are considered not medically reasonable and necessary products” section of the LCD
Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (Coding Guidelines only)
Deleted HCPCS codes G0173 and G0251
Transesophageal Echocardiogram
Added CPT® code 93355
Vertebroplasty, Vertebral Augmentation; Percutaneous
Deleted CPT® code 22520, 22521, 22522, 22523, 22524, 22525, 72291, and 72292
Added CPT® codes 22510, 22511, 22512, 22513, 22514, and 22515
Viscosupplementation Therapy for Knee
Descriptor change for CPT® codes 20610 and 27370 
Removed unlisted HCPCS codes C9399/J3490 (Monovisc) and replaced with HCPCS code J7327

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