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Medical Review News and Publications

Topic Publication Date Revision/Review Date
MACs Resume Medical Review on a Post-Payment Basis 08.11.20  
Prior Authorization (PA) Program for Certain Hospital Outpatient Department (OPD) Services Alert 06.16.20  
Preventing Denials for Iron Sucrose (Venofer) – HCPCS Code J1756 05.27.20  
Prevent Inpatient Rehabilitation Facility (IRF) Denials 05.12.20  
Skilled Nursing Facility (SNF) Demand Bills 05.12.20  
CGS is Retiring Policy L34093 Chemotherapy and Biologicals 04.16.20  
Micro-Invasive Glaucoma Surgery (MIGS) L37578 Update 12.19.19  
Policy Billing and Coding Articles Updated During Annual HCPCS and ICD-10 Updates 12.19.19  
Documentation Reminder for TAVR 12.13.19  
Inpatient Rehabilitation Facility Prospective Payment System Resources 09.03.19  
Dual Diagnosis Requirements – Claims Submission 08.15.19  
UPDATE to IDE (Investigational Device Exemption) Submission Process 03.25.19  
Policy Updates: New, Retired, Annual ICD-10 Changes 10.23.18  
Portable X-Ray Benefit 09.19.18  
Major Joint Replacement (DRG 470): Preventing Denials 08.06.18 08.14.18
Billing and Coding for the Rezum® System for Benign Prostatic Hyperplasia (BPH) 08.02.18 08.14.18
The Two-Midnight Rule: Preventing Denials 07.23.18 08.14.18
Cardiac Rehabilitation: Coverage and Documentation Requirements 04.18.18 08.14.18
Additional Information Regarding NCD 80.11 – Vitrectomy 03.07.18 08.14.18
Additional Information Regarding NCD110.21 – Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions 03.07.18 08.14.18
How to Avoid Lab Errors 02.27.18 08.14.18
PRV (Patient Reason for Visit) Segment 02.09.18 08.14.18
Single Chamber and Dual Chamber Permanent Cardiac Pacemakers - Coding amd Billing (A54961) 01.31.18 08.14.18
Removal of Implantable Devices 04.12.17 04.11.19
How to Submit "Documentation" Requested by Part A Educator 01.30.18 08.14.18
Single Chamber and Dual Chamber Permanent Cardiac Pacemakers-Coding and Billing 01.11.18 08.14.18
LCDs and Claims Submission Reminders 07.29.16 08.14.18
Solesta™ Treatment for Fecal Incontinence 07.27.16 08.14.18
Hemorrhoid Artery Ligation Coverage Guidelines 07.27.16 08.14.18
CGS-MolDX: Next Generation Sequencing (NGS) and Tier 1 and Tier 2 Coding and Billing Guidelines (CM00096) 02.09.16  
2016 MoPath Tier 2 Fee Schedule (CM00094) 01.11.16  
Major Joint Replacement (DRG 470): Documenting Conservative Treatments and Medical Necessity 02.19.15 08.14.18
Cystourethroscopy with Insertion of Indwelling Ureteral Stent (CPT Code 52332): Documenting Urinalysis to Support Medical Necessity 02.10.15 08.14.18
Additional Documentation Requests (ADRs): What to Send 11.04.14 08.14.18
Electronic Medical Record Tips 09.06.12 08.14.18

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