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01/01/2020
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R13
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12/26/2019 Removed 0057U effective 6/30/2019 Per CR 11318. Change Request 10901 Local Coverage Determinations (LCDs): it will no longer be appropriate to include Current Procedure Terminology (CPT)/Health Care Procedure Coding System (HCPCS) codes or International Classification of Diseases Tenth Revision-Clinical Modification (ICD-10-CM) codes in the LCDs. All CPT/HCPCS, ICD-10 codes, and Guidelines have been removed from this LCD and placed in Billing and Coding MolDX: Molecular Diagnostic Tests (MDT) article linked to this LCD. Review completed 11/21/2019. Under CMS National Coverage Policy added regulation 45 CFR §162.1002 (a)(5). Under Coverage Indications, Limitations and/or Medical Necessity changed the third bullet to read, “defines the payment rules applied to covered tests that are not reported with specific codes from a code set recognized in 45 CFR §162.1002 (a)(5), and termed “HIPAA compliant code sets” throughout the remainder of this LCD”. Under Applicable tests/Assays subheading changed verbiage under the third bullet to read, “All tests/assays billed with more than one code from a HIPAA compliant code set to identify the service, including combinations of method-based, serology-based, and anatomic pathology codes”. Under Unique Test Identifier Requirement subheading changed verbiage in the first two sentences to read, “Because the available language in the current HIPAA compliant code sets used to describe the pathology and laboratory categories and the tests included in those categories are not specific to the actual test results provided, all MDT services must include an identifier as additional claim documentation. Test providers must receive an identifier specific to the applicable test and submit the test assigned identifier with the claim for reimbursement” and deleted the verbiage, “Laboratory providers who bill MDT services must register test services on the DEX Diagnostics Exchange”. Under Covered Tests subheading deleted the verbiage, “To obtain a unique identifier for a test and, to submit information for a technical assessment go to DEX Diagnostics Exchange https://app.dexzcodes.com/login”.
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- Other (Change Request 10901)
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01/01/2019
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R9
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01/01/2019 Code update-Added 81162-81167, 81171-81174, 81177-81190, 81204, 81233, 81234, 81236, 81237, 81239, 81271, 81274, 81284-81286, 81289,81305, 81306, 81312,81320, 81329, 81333,81336, 81337, 81343-81345, 81443, 81518, 062U-0079U. Removed deleted codes 81211, 81213, 81214, 0001M. Long Description change 81120, 81121, 81162, 81170, 81175, 81176, 81201-81203, 81205, 81209, 81212, 81215-81219, 81225-81227, 81235, 81240, 81242, 81244, 81250-81254, 81260, 81263, 81272, 81273, 81276, 81283, 81287, 81291-81297, 81314, 81321-81328, 81330, 81332, 81350, 81361-81364, 81370, 81371, 81374, 81378, 81433, 81434, 81437, 81438, 81506, 81508-81512. Removed G0452-effective 09/28/2017.
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- Revisions Due To CPT/HCPCS Code Changes
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01/01/2018
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R3
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01/01/2018-Code update added 81175, 81176, 81230-81232, 81238,81247-81249, 81258, 81259, 81269, 81105-81112, 81120, 81121, 81283,81328, 81334, 81335, 81346, 81361-81364, 81448, 81520, 81521 & description change 81257, 81400, 81401, 81403-81406, 81432, 81439. Added 0001M, 87631-87633, 87149-87150 effective 02/15/2018.
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- Revisions Due To CPT/HCPCS Code Changes
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