Urology Coding Alert

Question: I heard there are some changes in the works related to LCDs and the codes associated with them. What’s happening?

North Dakota Subscriber

Answer: You’ve heard correctly – according to MLN Matters 10901, CMS used recent Medicare Physician Fee Schedule (MPFS) feedback to revise the Local Coverage Determination (LCD) process.

The LCD process revamp includes new timelines, more consultation options, a different request mechanism, and more.

Important: Medicare Administrative Contractors (MACs) have a year to finalize or retire all LCD proposals, suggested the MLN Matters release. “Upon further notice from CMS, it will no longer be appropriate to routinely include CPT^® codes or ICD-10-CM codes in the LCDs. All codes will be removed from LCDs and placed in billing & coding articles that are linked to the LCD,” CMS said.

Resource: For more information on the LCD changes, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10901.pdf.