March 19, 2018 - National Coverage Determination (NCD) 110.21, Erythropoiesis Stimulating Agents (ESAs) in Cancer and Change Request (CR) 10318

Change Request (CR) 10318, Transmittal 2005 titled, "ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs)," released on January 18, 2018, contains the latest coding instructions to Centers for Medicare & Medicaid Services (CMS) NCDs. Business Requirement 10 specifically addresses coding changes for NCD 110.21, Erythropoiesis Stimulating Agents (ESAs) in Cancer.
 
CMS is in the process of re-reviewing the coding changes for NCD 110.21. Until this review is complete, and CMS makes a final determination, the A/B Medicare Administrative Contractors (MACs) will not implement the edits contained in CR 10318. The A/B MACs will also reprocess any claims that were processed in error from January 1, 2018, that were processed with the additional codes included in CR 10318 as not payable with the -EC modifier.

Important Changes in the NCD 110.21 ESA

UPDATE on the IMPORTANT Changes in the NATIONAL COVERAGE DETERMINATION 110.21 -ERYTHROPOESIS STIMULATING AGENTS

To read the complete article CLICK HERE

March 2018 Local Coverage Determination (LCD)/Coverage Article Updates 

The following is a summary of the Local Coverage Determination (LCD) and Coverage Article updates made by WPS GHA for March 2018. Additional details about these updates are available in the full article on our website.
 
Please note: These changes will not be reflected in the LCDs and coverage articles until March 1, 2018.
 
Revised Policies/Articles - Effective as Indicated

• MolDX: Decipher® Prostate Cancer Classifier Assay - Effective 03/01/2018
• MolDX: ThermoFisher Oncomine Dx Target Test for Non-Small Cell Lung Cancer, Coding and Billing Guidelines - Effective 04/15/2018