Coding Analysis for Labs (CAL) Tracking Sheet

Glycated Hemoglobin/Glycated Protein (Addition of ICD-9-CM 271.3, Intestinal disaccharidase deficiencies and disaccharide malabsorption)

CAG-00336N

Issue

CMS received an external request to addICD-9-CM 271.3, Intestinal disaccharidase deficiencies and disaccharide malabsorption, as a covered indication for the Glycated Hemoglobin/Glycated Protein NCD at 190.21 of the NCD Manual.

The narrative covered indications for Glycated Hemoglobin/Glycated Protein NCD state that the test is valuable to assess hyperglycemia, a history of hyperglycemia or dangerous hypoglycemia.  One manifestation of Intestinal disaccharidase deficiencies and disaccharide malabsorption may be abnormal serum glucose.  We are seeking public comment on the addition of code 271.3, Intestinal disaccharidase deficiencies and disaccharide malabsorption, to the ICD-9-CM Codes Covered By Medicare list for the Glycated Hemoglobin/Glycated Protein NCD. 

The regulation for maintaining code lists in the negotiated NCDs for clinical diagnostic laboratory services states that codes on the covered list flow from the existing NCD narratives of covered indication.  The regulation was published February 25, 2005 in the Federal Register, Vol.70, No. 37 and can be viewed at http://www.cms.hhs.gov/Medicare/Coverage/CoverageGenInfo/LabNCDsICD10.html#TopOfPage.

Benefit Category

Diagnostic Laboratory Tests

Requestor Information

Requestor Name Requestor Letter
Lori Cushing, Coding Supervisor, HRS Redington Fairview General Hospital, Skowhegan, Maine N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
07/20/2006
Expected CAL Completion Date
10/20/2006
Public Comment Period
07/20/2006 - 08/19/2006
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
10/19/2006

Contacts

Lead Analysts
Maria Ciccanti
Lead Medical Officers
Beth Koller, MD, FACE

Medicare Benefit Category Determination Date

Actions Taken

July 20, 2006

CMS accepts a request to add ICD-9-CM code 271.3 Intestinal disaccharidase deficiencies and disaccharide malabsorption to the Glycated Hemoglobin/Glycated Protein national coverage determination list of covered indications.

The initial 30-day public comment period begins with this acceptance date, and ends after 30 calendar days. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the test under consideration.

Instructions for submitting comments can be found at http://www.cms.hhs.gov/Medicare/Coverage/InfoExchange/publiccomments.html#TopOfPage

October 19, 2006