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October 23, 2018

Policy Updates: New, Retired, Annual ICD-10 Changes

CGS Administrators has updated 26 local policies based on the annual ICD-10 changes, see below for list of policies. We have released to final three policies that become active November 12, 2018 through December 3, 2018, please see list of new policies below. The date each policy becomes effective is listed beside the policy. There is also a response to comments article attached to each new policy that shows all comments received during comment period if any were received.

CGS has also retired three policies: DL 37136: MolDX: Comprehensive Genomic Profiling to Guide Treatment in Patients with Metastatic Colorectal Cancer, DL 373138: MolDX: Comprehensive Genomic Profiling to Guide Treatment in Patients with Metastatic Melanoma, and DL37128: MolDX: Comprehensive Genomic Profiling to Guide Treatment in Patients with Advanced Primary Peritoneal, Fallopian Tube and Ovarian Cancer,as they were superseded by a national coverage determination and retired draft policy DL 37132: MolDX VectraDA, a Multibiomarker Disease Activity Test for Rheumatoid Arthritis (RA)  because additional information is needed from the test sponsor before we move forward with the policy.

New Policies:

  • L37787: MolDX: Corus® CAD Assay (Effective November 12, 2018)
  • L37366: MolDX: Guardant360® Plasma-Based Comprehensive Genomic Profiling in Non-Small Cell Lung Cancer (NSCLC) (effective November 19, 2018)
  • L37348: MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels (Effective December 3, 2018)

Policies Updated from Annual ICD-10 changes:

  • L33944: Blepharoplasty
  • L33949: Botulinum Toxins
  • L33959: Cardiac Catheterization and Coronary Angiography
  • L33952: Cardiac Event Detection
  • L34005: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
  • L36029: Controlled Substance Monitoring and Drugs of Abuse Testing
  • L34032: Debridement Services
  • L34356: Erythropoiesis Stimulating Agents (ESA)
  • L34037: Flow Cytometry
  • L34195: Mohs Micrographic Surgery
  • L36139: MolDX: Biomarkers in Cardiovascular Risk Assessment
  • L35897: Nerve Conduction Studies and Electromyography
  • L34045: Non-Invasive Vascular Studies
  • L34393: Ocular Photography - External
  • L34353: Outpatient Psychiatry and Psychology Services
  • L33942: Physical Therapy - Home Health
  • L36658: Proton Beam Therapy
  • L34183: Psychiatric Inpatient Hospitalization
  • L34200: Removal of Benign Skin Lesions
  • L34246: Routine Foot Care and Debridement of Nails
  • L35906: Somatosensory Testing
  • L34084: Transcatheter Infusion Therapy
  • L34337: Transesophageal Echocardiography (TEE)
  • L34338: Transthoracic Echocardiography (TTE)
  • L34056: Urodynamics
  • L34394: Visual Fields Testing

These policies and more can be accessed from the Part A Medical Policies and the Part B Medical Policies Web pages.

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