    
Final Comments Avail
Board Administrator
Username: Admin
Post Number: 70
Registered: 10-2002
| | Posted on Wednesday, February 04, 2009 - 10:53 am: | 
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Comments:
WPS received a few requests for the addition of multiple ICD-9 codes. All of the suggested ICD-9 codes were carefully evaluated for scientific merit based on current literature.
Response:
The following ICD-9 codes were deemed medially necessary and were already included in this LCD or were added to this LCD.
780.4 Dizziness and giddiness
782.3 Symptoms involving skin and other integumentary tissue, edema
V58.11 Encounter for chemotherapy) cancer
V58.83 Encounter for therapeutic drug monitoring
V67.1 Follow-up exam following radiotherapy
V67.2 Follow-up examination post chemotherapy
V71.7 Observation for suspected cardiovascular disease
Comment:
Can you define when an echo may be covered when assessing pre-operative risk?
Response:
By national regulations, screening is not covered. The criteria of medical necessity are addressed within the LCD and its related billing and coding document. Please refer to these documents for information related to coverage, limitations and utilization. In general, this service requires documentation that the indication for this service impacts treatment. and/or outcome. TTE should not be a duplicative effort in the event other similar services are provided.
Comments:
The American Society of Echocardiography (ASE) requests a statement in this LCD linking Medicare payment to echocardiographic accreditation.
Response:
The following statement has been added to CV-026;
Training Requirements: It is not this Contractor's intention to credential providers for TTE. However, Medicare does expect a satisfactory level of competence from providers who submit claims for services rendered. It is well known that substandard studies often lead to repetition of studies and overutilization of services. It is expected that based on their experience and/or training, that such images will be submitted for interpretation. Providers of the technical component must provide high quality images that allow proper interpretation. If the quality of the technical component is a poor quality and/or does not lead to an appropriate professional interpretation, it is not a medically necessary service and thus not payable. Similarly, providers of the professional component must provide proper interpretations, based on their experience and/or training,
Comment:
Frequency of testing is not addressed in the indications section, making it difficult to understand the coding guidelines.
Response:
Frequency of any service is determined by medical necessity. It is not appropriate to arbitrarily list frequencies. Utilization and frequency standards, where applicable, are outlined in the Indications and Limitations Section of this LCD.
Comment:
Will the new 2009 CPT code 93306 be included in this LCD? CPT code 93306 seems to address the color flow components that were previously included CPT 93307.
Response:
As a result of 2009 CPT/HCPCS coding updates, new for 2009 CPT code 93306 is included in this LCD. You are correct that the description of this code was formerly included within the description of CPT code 93307. Therefore, inclusion of CPT code 93306 does not establish any new indications within this LCD, nor restrict the current coverage.
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