LCD Reference Article Response To Comments Article

Response to Comments: Homocysteine Level, Serum

A59635

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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Source Article ID
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Article ID
A59635
Original ICD-9 Article ID
Not Applicable
Article Title
Response to Comments: Homocysteine Level, Serum
Article Type
Response to Comments
Original Effective Date
01/25/2024
Revision Effective Date
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The comment period for the Homocysteine Level, Serum DL34419 Local Coverage Determination (LCD) began on 8/31/23 and ended on 10/14/23. The notice period for L34419 begins on 01/25/24 and will become effective on 03/10/24. The comment below was received from the provider community.

Response To Comments

Number Comment Response
1

We appreciate the opportunity to comment on draft policy and respectfully request the scope of coverage be expanded to support the following diagnoses codes: D53.9, D69.6, D81.818, D81.819, E41, E43, E45, E46, E53.8, E64.0, E72.10, E72.11, E72.12, E72.19, F03.90, F03.A0, F03.A11, F03.A18, F03.A2, F03.A3, F03.A4, F03.B0, F03.B11, F03.B18, F03.B2, F03.B3, F03.B4, F03.C0, F03.C11, F03.C18, F03.C2, F03.C3, F03.C4, F10.20, G25.70, G25.71, G25.79, G25.89, G25.9, G26, G30.0, G30.1, G30.8, G30.9, G60.3, G60.9, K14.0, K14.6, K31.83, K50.00, K50.011, K50.012, K50.013, K50.014, K50.018, K50.019, K50.10, K50.111, K50.112, K50.113, K50.114, K50.118, K50.119, K50.80, K50.811, K50.812, K50.813, K50.814, K50.818, K50.819, K50.90, K50.911, K50.912, K50.913, K50.914, K50.918, K50.919, K90.0, K90.1, K90.2, K90.3, K90.49, K90.81, K90.89, K90.9, K91.2, R20.0, R20.1, R20.2, R20.3, R20.8, R20.9, R26.0, R26.1, R26.81, R26.89, R26.9, R27.0, R27.8, R27.9, R41.1, R41.2, R41.3, R41.82, R41.9, R45.84, Z51.11, Z79.3, Z79.891, Z79.899, Z86.39, Z98.0, Z99.2.

Thank you for considering this request.

Thank you for your comment. This LCD describes the limited coverage criteria for serum homocysteine levels. As stated in the LCD under the limited indications, “Medicare will cover homocysteine levels to confirm vitamin B12 or folate deficiency. In the absence of evidence that treatment of hyperhomocysteinemia reduces CV or cerebrovascular events, this test can only be covered in patients with known vascular disease or risk thereof (based upon abnormal lipid metabolism, high blood pressure (BP) or diabetes mellitus (DM)) for the purpose of risk stratification. In this circumstance it will be covered only once per lifetime.” In reviewing the numerous ICD-10-CM codes submitted we find E53.8 as a valid code to add to the coverage article under its limited coverage criteria. In view of the constrictions of the LCD we cannot expand the scope of coverage as requested.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L34419 - Homocysteine Level, Serum
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Public Versions
Updated On Effective Dates Status
01/19/2024 01/25/2024 - N/A Currently in Effect You are here

Keywords

  • Homocysteine