# Octagram ivig billing - LCD for Octagram



## kathyle (Apr 20, 2015)

Is anyone have the LCD for Octagram?  I am trying to search under CMS but no luck.  
Has anyone ever bill Octagram J1568 in your office?  What is the requiresment?  ITP is it enough?
Please help.


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## rlh27 (Apr 20, 2015)

Here is the NCD.  I will send the LCD for my region momentarily.

National Coverage Decisions - CMS - Centers for Medicare & Medicaid Service
Subject: Intravenous Immune Globulin for the Treatment of Autoimmune Mucocutaneous Blistering Diseases  
Version: 2015-10-01 -  




NCD for Intravenous Immune Globulin for the Treatment of Autoimmune Mucocutaneous Blistering Diseases (250.3)
Publication Number 

100-3
 Manual Section Number 

250.3
 Manual Section Title 

Intravenous Immune Globulin for the Treatment of Autoimmune Mucocutaneous Blistering Diseases

Version Number 

1
 Effective Date of this Version 

10/1/2002
 Implementation Date 

10/1/2002




Benefit Category 

Drugs and Biologicals
Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.


Item/Service Description 

Intravenous immune globulin (IVIg) is a blood product prepared from the pooled plasma of donors. It has been used to treat a variety of autoimmune diseases, including mucocutaneous blistering diseases. It has fewer side effects than steroids or immunosuppressive agents.


Indications and Limitations of Coverage 

Effective October 1, 2002, IVIg is covered for the treatment of biopsy-proven (1) Pemphigus Vulgaris, (2) Pemphigus Foliaceus, (3) Bullous Pemphigoid, (4) Mucous Membrane Pemphigoid (a.k.a., Cicatricial Pemphigoid), and (5) Epidermolysis Bullosa Acquisita for the following patient subpopulations:

?Patients who have failed conventional therapy. Medicare Administrative Contractors (MACs) have the discretion to define what constitutes failure of conventional therapy;
?Patients in whom conventional therapy is otherwise contraindicated. Contractors have the discretion to define what constitutes contraindications to conventional therapy; or
?Patients with rapidly progressive disease in whom a clinical response could not be affected quickly enough using conventional agents. In such situations IVIg therapy would be given along with conventional treatment(s) and the IVIg would be used only until the conventional therapy could take effect.
In addition, IVIg for the treatment of autoimmune mucocutaneous blistering diseases must be used only for short-term therapy and not as a maintenance therapy. Contractors have the discretion to decide what constitutes short-term therapy.


Claims Processing Instructions 

?TN AB-02-093 (Program Memorandum Intermediaries/Carriers)
?TN AB-02-060 (Program Memorandum Intermediaries/Carriers)
?TN 1122 (One Time Notification)
?TN 1388 (One Time Notification)
?TN 1478 (One Time Notification)



Transmittal Number 

155


Coverage Transmittal Link 

http://www.cms.gov/transmittals/downloads/R155CIM.pdf


Revision History 

05/2002 - Provided limited coverage for use of IVIg for treatment of biopsy-proven (1) Pemphigus Vulgaris, (2) Pemphigus Foliaceus, (3) Bullous Pemphigoid, (4) Mucous Membrane Pemphigoid (a.k.a., Cicatricial Pemphigoid), and (5) Epidermolysis Bullosa Acquisita. Effective and implementation dates 10/01/2002. (TN 155 ) (CR 2149)

09/2012 - CMS translated the information for this policy from ICD-9-CM/PCS to ICD-10-CM/PCS according to HIPAA standard medical data code set requirements and updated any necessary and related coding infrastructure. These updates do not expand, restrict, or alter existing coverage policy.Implementation date: 01/07/2013 Effective date: 10/1/2015. (TN 1122 ) (TN 1122 ) (CR 7818)

05/2014 - CMS translated the information for this policy from ICD-9-CM/PCS to ICD-10-CM/PCS according to HIPAA standard medical data code set requirements and updated any necessary and related coding infrastructure. These updates do not expand, restrict, or alter existing coverage policy. Implementation date: 10/06/2014 Effective date: 10/1/2015. (TN 1388 ) (TN 1388 ) (CR 8691)


National Coverage Analyses (NCAs) 

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with NCAs, from the National Coverage Analyses database.

?Original consideration for Intravenous Immune Globulin for Autoimmune Mucocutaneous Blistering Diseases (CAG-00109N)


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## rlh27 (Apr 20, 2015)

Here is the LCD for Cahaba:

Source:	Part B - Cahaba MAC - J10	
Subject:	Drugs and Biologicals: Immune Globulin Intravenous (IVIg)
Version:	2014-01-01 - 
________________________________________
Contractor Information 
Contractor Name
Cahaba Government Benefit Administrators?, LLC 	Contract Number
10102
10202
10302	Contract Type
MAC - Part B
LCD Information 
Document Information 
LCD ID
L30029

LCD Title
Drugs and Biologicals: Immune Globulin Intravenous (IVIg)

AMA CPT/ADA CDT Copyright Statement
CPT only copyright 2002-2013 American Medical Association. All Rights Reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. The Code on Dental Procedures and Nomenclature (Code) is published in Current Dental Terminology (CDT). Copyright ? American Dental Association. All rights reserved. CDT and CDT-2010 are trademarks of the American Dental Association.	Jurisdiction
ALABAMA
GEORGIA
TENNESSEE
Original Effective Date
For services performed on or after 05/04/2009
Revision Effective Date
For services performed on or after 01/01/2014

Revision Ending Date
N/A
Retirement Date
N/A
Notice Period Start Date
N/A

Notice Period End Date
N/A
CMS National Coverage Policy 
•	Title XVIII of the Social Security Act, Section 1833 (e) states no payment shall be made to any provider for any claims that lack the necessary information to process the claim.
•	Title XVIII of the Social Security Act, Section 1861 (s) and (t) outlines coverage for drugs and biologicals and services and supplies.
•	Title XVIII of the Social Security Act, Section 1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and medically necessary, i.e., reasonable and necessary are those tests used in the diagnosis and management of illness or injury or to improve the function of a malformed body part.
•	Title XVIII of the Social Security Act, Section 1862(a)(7) excludes routine physical examinations.
•	Program Memorandum Intermediary/Carrier AB-02-093 outlines Coverage and Billing for Intravenous Immune Globulin (IVIG) for the Treatment of Autoimmune Mucutaneous Blistering Disease.
•	Medicare Benefit Policy Manual (Pub.100-02), Chapter 15, Section 50 outlines coverage for drugs and biologicals.
•	Medicare National Coverage Determination Manual (Pub. 100-03), Chapter 1, Section 250.3.
•	Medicare Claims Processing Manual (Pub. 100-04), Chapter 17, Section 20 outlines payment allowance limits for drugs and biologicals.
•	Medicare Program Integrity Manual (Pub. 100-08). Chapter 13. Local Coverage Determinations.
Coverage Guidance
Coverage Indications, Limitations, and/or Medical Necessity

Indications
J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, and J1599
1.	Primary Immunodeficiency
2.	Idiopathic Thrombocytopenic Purpura (ITP)
3.	Kawasaki Disease
4.	Chronic Lymphocytic Leukemia (CLL)
5.	Bone Marrow Transplantation
6.	Pediatric Human Immunodeficiency Virus (HIV)
7.	Multifocal Motor Neuropathy
8.	Chronic Inflammatory Demyelinating Polyneuropathies

Off-Label Indications:
9.	Autoimmune Mucocutaneous Blistering Diseases
10.	Dermatomyositis
11.	Pemphigus and Pemphigoid
12.	Other Specified Bullous Dermatoses
13.	Erythema Multiforme
14.	Polymyositis
15.	Guillain-Barre' Syndrome (GBS)
16.	Hyperimmunoglobulinemia E. Syndrome
17.	Lambert-Eaton Myasthenic Syndrome
18.	Myasthenia Gravis
19.	Relapsing-Remitting Multiple Sclerosis
20.	High-Risk, Preterm, Low Birth Weight Neonatal Infections
21.	Chronic Parvovirus B19 Infection with Severe Anemia secondary to bone marrow suppression
22.	Renal Transplant
A.	prophylaxis - reduction of renal transplant rejection (pre and post) by reducing HLA/ABO antibodies in highly sensitized patients
B.	acute rejection - reducing HLA/ABO antibodies
W.	Stiff man syndrome
J0850

Cytomegalovirus Immune Globulin Intravenous (Human) is indicated for the prophylaxis of cytomegalovirus disease associated with Medicare approved transplantation of kidney, lung, liver, pancreas and heart. In transplants of these organs other than kidney from CMV seropositive donors into seronegative recipients, prophylactic CMV-IGIV should be considered in combination with ganciclovir.


Limitations
J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, and J1599

IVIg for the treatment of autoimmune mucocutaneous blistering diseases must be used only for short-term therapy and not as a maintenance therapy.
Coding Information 
Bill Type Codes:
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
999x	Not Applicable
Revenue Codes:
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.
99999	Not Applicable
CPT/HCPCS Codes

Group 1 Paragraph: N/A
Group 1 Codes:
J0850	INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS (HUMAN), PER VIAL
J1459	INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
J1556	INJECTION, IMMUNE GLOBULIN (BIVIGAM), 500 MG
J1557	INJECTION, IMMUNE GLOBULIN, (GAMMAPLEX), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
J1561	INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G. LIQUID), 500 MG
J1566	INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, LYOPHILIZED (E.G. POWDER), NOT OTHERWISE SPECIFIED, 500 MG
J1568	INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
J1569	INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G. LIQUID), 500 MG
J1572	INJECTION, IMMUNE GLOBULIN, (FLEBOGAMMA/FLEBOGAMMA DIF), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG
J1599	INJECTION, IMMUNE GLOBULIN, INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), NOT OTHERWISE SPECIFIED, 500 MG

ICD-9 Codes that Support Medical Necessity

Group 1 Paragraph: The correct use of an ICD-9-CM code listed in the “ICD-9 Codes that Support Medical Necessity” section does not guarantee coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this LCD.

ICD-9 codes must be coded to the highest level of specificity. Consult the ‘Official ICD-9-CM Guidelines for Coding and Reporting’ in the current ICD-9-CM book for correct coding guidelines. This LCD does not take precedence over the Correct Coding Initiative (CCI).

For J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, and J1599

Group 1 Codes:
042	HUMAN IMMUNODEFICIENCY VIRUS (HIV) DISEASE
204.10 - 204.12	CHRONIC LYMPHOID LEUKEMIA, WITHOUT MENTION OF HAVING ACHIEVED REMISSION - CHRONIC LYMPHOID LEUKEMIA, IN RELAPSE
273.1	MONOCLONAL PARAPROTEINEMIA
279.00	HYPOGAMMAGLOBULINEMIA UNSPECIFIED
279.03 - 279.06	OTHER SELECTIVE IMMUNOGLOBULIN DEFICIENCIES - COMMON VARIABLE IMMUNODEFICIENCY
279.09	OTHER DEFICIENCY OF HUMORAL IMMUNITY
279.12	WISKOTT-ALDRICH SYNDROME
279.2	COMBINED IMMUNITY DEFICIENCY
279.3*	UNSPECIFIED IMMUNITY DEFICIENCY
279.41	AUTOIMMUNE LYMPHOPROLIFERATIVE SYNDROME
279.49	AUTOIMMUNE DISEASE, NOT ELSEWHERE CLASSIFIED
282.0 - 282.9	HEREDITARY SPHEROCYTOSIS - HEREDITARY HEMOLYTIC ANEMIA UNSPECIFIED
283.0 - 283.9	AUTOIMMUNE HEMOLYTIC ANEMIAS - ACQUIRED HEMOLYTIC ANEMIA UNSPECIFIED
284.11	ANTINEOPLASTIC CHEMOTHERAPY INDUCED PANCYTOPENIA
284.12	OTHER DRUG INDUCED PANCYTOPENIA
284.19	OTHER PANCYTOPENIA
284.81 - 284.89	RED CELL APLASIA (ACQUIRED) (ADULT) (WITH THYMOMA) - OTHER SPECIFIED APLASTIC ANEMIAS
284.9	APLASTIC ANEMIA UNSPECIFIED
287.30	PRIMARY THROMBOCYTOPENIA,UNSPECIFIED
287.31	IMMUNE THROMBOCYTOPENIC PURPURA
287.32	EVANS’ SYNDROME
287.33	CONGENITAL AND HEREDITARY THROMBOCYTOPENIC PURPURA
287.41	POSTTRANSFUSION PURPURA
287.49	OTHER SECONDARY THROMBOCYTOPENIA
288.1	FUNCTIONAL DISORDERS OF POLYMORPHONUCLEAR NEUTROPHILS
333.91	STIFF-MAN SYNDROME
340	MULTIPLE SCLEROSIS
356.0	HEREDITARY PERIPHERAL NEUROPATHY
356.2 - 356.4	HEREDITARY SENSORY NEUROPATHY - IDIOPATHIC PROGRESSIVE POLYNEUROPATHY
356.9	UNSPECIFIED IDIOPATHIC PERIPHERAL NEUROPATHY
357.0 - 357.9	ACUTE INFECTIVE POLYNEURITIS - UNSPECIFIED INFLAMMATORY AND TOXIC NEUROPATHIES
358.00	MYASTHENIA GRAVIS WITHOUT (ACUTE) EXACERBATION
358.01	MYASTHENIA GRAVIS WITH (ACUTE) EXACERBATION
358.1	MYASTHENIC SYNDROMES IN DISEASES CLASSIFIED ELSEWHERE
358.30	LAMBERT-EATON SYNDROME, UNSPECIFIED
358.31	LAMBERT-EATON SYNDROME IN NEOPLASTIC DISEASE
358.39	LAMBERT-EATON SYNDROME IN OTHER DISEASES CLASSIFIED ELSEWHERE
446.1	ACUTE FEBRILE MUCOCUTANEOUS LYMPH NODE SYNDROME (MCLS)
446.6	THROMBOTIC MICROANGIOPATHY
694.4	PEMPHIGUS
694.5	PEMPHIGOID
694.60	BENIGN MUCOUS MEMBRANE PEMPHIGOID WITHOUT OCULAR INVOLVEMENT
694.61	BENIGN MUCOUS MEMBRANE PEMPHIGOID WITH OCULAR INVOLVEMENT
694.8	OTHER SPECIFIED BULLOUS DERMATOSES
695.10 - 695.19	ERYTHEMA MULTIFORME, UNSPECIFIED - OTHER ERYTHEMA MULTIFORME
710.3	DERMATOMYOSITIS
710.4	POLYMYOSITIS
795.79	OTHER AND UNSPECIFIED NONSPECIFIC IMMUNOLOGICAL FINDINGS
996.81	COMPLICATIONS OF TRANSPLANTED KIDNEY
996.85	COMPLICATIONS OF TRANSPLANTED BONE MARROW
996.88	COMPLICATIONS OF TRANSPLANTED ORGAN, STEM CELL
V42.81	BONE MARROW REPLACED BY TRANSPLANT
V42.82	PERIPHERAL STEM CELLS REPLACED BY TRANSPLANT
Group 1 Medical Necessity ICD-9 Codes Asterisk Explanation: **279.3 (unspecified immunity deficiency) is to be used for normal total IgG levels with polysaccharide non-responsiveness.

Group 2 Paragraph: For J0850

Group 2 Codes:
V07.2	NEED FOR PROPHYLACTIC IMMUNOTHERAPY

Group 3 Paragraph: AND one of the following ICD-9 codes

Group 3 Codes:
V42.0	KIDNEY REPLACED BY TRANSPLANT
V42.1	HEART REPLACED BY TRANSPLANT
V42.6	LUNG REPLACED BY TRANSPLANT
V42.7	LIVER REPLACED BY TRANSPLANT
V42.83	PANCREAS REPLACED BY TRANSPLANT

ICD-9 Codes that DO NOT Support Medical Necessity
Paragraph: Any ICD-9 code that is not listed in the "ICD-9 Codes that Support Medical Necessity" section of this LCD.

Codes: 
XX000*	Not Applicable
General Information 
Associated Information
Documentation Requirements
1.	Medical records should indicate the order, the route of administration, amount of medication, and the clinical information supporting the indication for use and frequency of usage.
2.	All coverage criteria must be clearly documented in the patient’s medical record and made available to Medicare upon request.
3.	Documentation must support CMS 'signature requirements' as described in the Medicare Program Integrity Manual (Pub. 100-08), Chapter 3.


Utilization Guidelines 

The dose and frequency of administration should be consistent with the FDA approved package insert.
Sources of Information and Basis for Decision
•	Consultation with Cahaba GBA Part A, Part B, representatives to the Intermediary Advisory Committee, the Carrier Advisory Committee and other Medicare Contractors.
•	FDA approved package insert.
•	Marinkovich MP. Electronic Textbook of Dermatology, Blistering Diseases Telemedicine 12/17/01, pg.19/27
•	Medicare Part B Template LMRP for Intravenous Immune Globulin (IVIG) developed by the CMD New Technology Medicare Workgroup Revised April 2000
•	Zvartau-Hind, Marina, M.D., PhD, Director, Department of Neurosciences, UK, Chronic Inflammatory Demyelinating Polyradiculoneuropathy. eMedicine
Revision History Information 
Please note: The Revision History information included in this LCD prior to 1/24/2013 will now display with a Revision History Number of "R1" at the bottom of this table. All new Revision History information entries completed on or after 1/24/2013 will display as a row in the Revision History section of the LCD and numbering will begin with "R2".
Revision History Date	Revision History Number	Revision History Explanation	Reason(s) for Change
01/01/2014	R4	What's New Posted: February 2014
Effective Date: January 01, 2014

Stiff Man Syndrome was added to the list of Off-label Indications. Therefore, the LCD is being updated effective January 1, 2014 to reflect this status.	•	Provider Education/Guidance
•	Other (Addition of Stiff Man Syndrome to Off Label Indications.)
01/01/2014	R3	What’s New Posted: December 2013
Effective Date: January 1, 2014

This LCD was updated as a result of the Annual CPT/HCPCS Update for 2014. The code revisions reflect services which are currently addressed in the LCD and do not further restrict the current coverage. The following revision was made:
•	C9130 is invalid after December 31, 2013 and is being removed from the LCD. J1556 is effective January 1, 2014 and is being added to the LCD.

Updated Sources of Information: AHFS 2004 was removed as this is outdated.	•	Other (Updated Sources of Information)
09/01/2013	R2	What’s New Posted Date: August 2013
Effective Date: September 1, 2013

HCPCS Code C9130 (Injection, Immune Globulin (Bivigam), 500 mg) is being added to the ‘CPT/HCPCS Codes’ section of this LCD for billing by Ambulatory Surgical Centers (ASCs). This code reflects services which are currently addressed in the LCD and does not change the current coverage.

Additionally, the LCD 'Indications' are being updated to accurately delineate between the FDA indications and the Off-label uses.	•	Revisions Due To CPT/HCPCS Code Changes
•	Other (Format update)
01/01/2012	R1	Revision 8

What’s New Posted Date: December 2011
Effective Date: January 1, 2012

This LCD has been updated as a result of the Annual CPT/HCPCS Update for 2012. The following revision was made:

C9270 is invalid after December 31, 2011 and is replaced with J1557 (Injection, Immune Globulin (Gammaplex), Intravenous, Non-Lyophilized (e.g., liquid), 500 mg).

Revision 7

What's New Posted Date: September 2011
Effective Date: October 1, 2011

This LCD was updated based on the 2012 ICD-9 Coding Update. For CPT J1459, J1561, J1566, J1568, J1569, J1572, J1599, C9270: ICD-9 Code 284.1 is invalid and replaced with 284.11, 284.12, 284.19. The following codes were added: 282.40, 282.43 – 282.47, 358.30, 358.31, 358.39, 996.88.

Annual LCD Review: Template language in the 'ICD-9 Codes that Support Medical Necessity' section was clarified regarding correct coding guidelines. (What’s New April 8, 2011). Added to Documentation Requirements: ‘Documentation must support CMS 'signature requirements' as described in the Medicare Program Integrity Manual (Pub. 100-08), Chapter 3. (Change Request 6698).
Revision 6

What's New Posted Date: December 2010
Effective Date: January 1, 2011

This LCD has been updated as a result of the Annual CPT/HCPCS Update for 2011. The code revisions reflect services which are currently addressed in this LCD and do not establish any new indications within nor restrict the current coverage.

J1599 is added to the LCD and included in the Indications and Limitations for J1459, J1561, J1566, J1568, J1569, and J1572.

C9270 is added to the LCD and included in the Indications and Limitations for J1459, J1561, J1566, J1568, J1569, and J1572. NOTE: This code is for billing under Hospital OPPS and Ambulatory Surgery Centers.

Revision 5

What's New Posted Date: September 2010
Effective Date: October 1, 2010

This LCD was updated based on the 2011 ICD-9 Coding Update. For J1459, J1561, J1566, J1568, J1569, J1572, ICD-9 Code 287.4 was removed and the following codes were added : 287.41, 287.49.

Revision 4

What's New Posted Date: August 2010
Effective Date: September 1, 2010

As the next step in the consolidation of J10 MAC LCDs, the Part A and Part B LCDs on the same topic will be consolidated into a single document effective September 1, 2010. These LCDs are identical in content; therefore, consolidation will not alter the content or coverage of the LCDs.

Retired Part A LCD L29996 will be incorporated into this Part B LCD effective September 1, 2010. For dates of service prior to September 1, 2010, please refer to the retired Part A LCD which can be accessed through ‘Related Documents’ found below.

Revision 3
Posted: What's New - Part B, September 2009
Effective Date: October 1, 2009
This LCD was updated based on the 2010 ICD-9 Coding Update. The following ICD-9 codes were added for J1459, J1561, J1566, J1568, J1569, J1572: 279.41, 279.49.

Revision 2
Start Date of Notice Period: July 14, 2009
Effective Date: August 29, 2009

As part of the J10 MAC transition, LCD effective for contractor number 10302 – Tennessee Part B.

Revision 1
Start Date of Notice Period: June 17, 2009
Effective Date: August 1, 2009

As part of the J10 MAC transition, LCD effective for contractor number 10202 – Georgia Part B.

Original
Start Date of Notice Period: March 20, 2009
Effective Date: May 4, 2009

As part of the J10 MAC transition, LCD effective for contractor number 10102 – Alabama Part B.

09/06/2010 - This policy was updated by the ICD-9 2010-2011 Annual Update.

08/27/2011 - This policy was updated by the ICD-9 2011-2012 Annual Update.

11/21/2011 - For the following CPT/HCPCS codes either the short description and/or the long description was changed. Depending on which description is used in this LCD, there may not be any change in how the code displays in the document:
J1561 descriptor was changed in Group 1

11/21/2011 - The following CPT/HCPCS codes were deleted:
C9270 was deleted from Group 1

11/25/2012 - For the following CPT/HCPCS codes either the short description and/or the long description was changed. Depending on which description is used in this LCD, there may not be any change in how the code displays in the document:
J1561 descriptor was changed in Group 1
J1569 descriptor was changed in Group 1
(LCD approved 12/5/2012 with the 11/25/2012 descriptions changes). 	•	Narrative Change
Associated Documents 
Attachments
N/A
Related Local Coverage Documents
LCD(s)
L29996 - (MCD Archive Site)
Related National Coverage Documents
N/A
Public Version(s)
Updated on 01/24/2014 with effective dates 01/01/2014 - N/A
Updated on 12/31/2013 with effective dates 01/01/2014 - N/A
Updated on 08/16/2013 with effective dates 09/01/2013 - 12/31/2013
Updated on 12/05/2012 with effective dates 01/01/2012 - 08/31/2013
Updated on 12/05/2011 with effective dates 01/01/2012 - N/A
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.


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## kathyle (Apr 28, 2015)

thank you very much.


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