05/2014 - This Change Request (CR) purpose is effective for claims with dates of service on or after January 9, 2014, PILD is covered by Medicare when provided in a clinical study under section 1862(a)(1)(E) through Coverage with Evidence Development (CED) for beneficiaries with LSS who are enrolled in an approved clinical study the necessary criteria.
Effective date: 01/09/2014. Implementation date: 10/06/2014. (TN 167) (CR8757)
05/2017 - The purpose of this Change Request (CR) is to notify contractors that effective for dates of service on or after December 7, 2016, Medicare will cover PILD under CED for beneficiaries with LSS who are enrolled in a CMS-approved prospective longitudinal study.
Effective date: 12/07/2016. Implementation date: 06/27/2017. (TN 196) (CR10089)
07/2017 - Transmittals 199, Pub. 100-03 and 3805, Pub. 100-04, dated July 11, 2017, are being rescinded and replaced by Transmittals 200 and 3811, dated, July 25, 2017, to update references in the Claims Processing Business Requirements and National Coverage Determinations Requirements documents. The reference in both business requirement documents, in the policy section to Pub.100-04, Chapter 32, Section 68 needs to be changed to Section 69. In the Claims Processing Manual, clarifying language needs to be added to indicate that CMS will cover procedure code 0275T for PILD only when the procedure is performed within any other CED approved clinical trial. All other information remains the same. (TN 200) (CR10089)
08/2021 - This Change Request (CR) constitutes a maintenance update of ICD-10 conversions and other coding updates specific to NCDs. These NCD coding changes are the result of newly available codes, coding revisions to NCDs released separately, or coding feedback received. (TN 10963) (CR12399)
09/2021 - This Change Request (CR) constitutes a maintenance update of ICD-10 conversions and other coding updates specific to NCDs. These NCD coding changes are the result of newly available codes, coding revisions to NCDs released separately, or coding feedback received. (TN 11025) (CR12399)