R4 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. ICD-9-CM code 573.5 added to the "ICD-9-CM Codes That Support Medical Necessity" for Abdominal and Pelvic Ultrasound (CPT/HCPCS Codes 76700 and 76705). No comment and notice periods required and none given.

R4 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section was revised to delete ICD-9 code 999.4 and replace it with ICD-9 code 999.49 for CPT 95180. Descriptors changed for 995.0. Minor changes were made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

Article published October 2011: Article revised for annual ICD-9-CM code updates for 2012. The "ICD-9 Codes that are Covered" section of the article is expanded with the addition of code 415.13. ICD-9-CM code 444.0 has been deleted and replaced with 444.01 and 444.09. Based on compendia review, ICD-9-CM codes 557.0 and 999.2 have been added effective for dates of service on or after 10/01/2011.

R6 (effective 10/01/2011): LCD revised to clarify facility and non-facility ICD-9 coding. The current diagnosis list was separated into two diagnosis lists. No changes were made to current ICD-9 codes to support medical necessity. No comment and notice periods required and none given.

R6 (effective 10/01/2011): Due to the annual ICD-9-CM code update for 2012, ICD-9-CM code 414.4 was added to the "Tertiary ICD-9-CM Codes" list in the "ICD-9-CM Codes that Support Medical Necessity" section for CPT codes 43644, 43645, 43770, 43845, 43846 and 43847.

Minor template changes were made to reflect current template language. No comment and notice periods required and none given.

R5 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was revised to delete ICD-9 codes 173.0 – 173.9 and replace them with ICD-9 codes 173.10, 173.11, 173.12, 173.19, 173.30, 173.31, 173.32, 173.39, 173.90, 173.91, 173.92, and 173.99 for HCPCS codes 15820-15823. Minor changes were made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

R6 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. ICD-9 code V58.68 added to the list of payable diagnoses for CPT 77080, and instruction added to use V58.68 for DXA testing while taking bisphosphonates. Indications updated to add coverage for patients receiving (or expecting to receive) aromatase inhibitors as adjuvant therapy for breast carcinoma. An additional source has been added in support of this coverage.

Article published October 2011: ICD-9 coding guidelines added DXA testing for patients taking bisphosphonates, and for patients receiving aromatase inhibitor therapy.

Carboplatin (Paraplatin®, Paraplatin-AQ®) – Related to LCD L25820 (A47583)

Article published October 2011: Based on compendia review, the "Indications" section and the "ICD-9 Codes that are Covered" section of the article has been revised as follows:

• An indication for gastric cancer, primary or metastatic and malignant neoplasm of endometrium of corpus uteri has been added;
• "Primary or metastatic" has been added to the indications for head & neck carcinoma and esophageal carcinoma (also GE junction adenocarcinomas);
• The indication for Non-Hodgkin’s lymphoma has been revised to include AIDS-related B-cell lymphomna;
• Malignant neoplasm of the pleura (mesothelioma), fallopian and peritoneal carcinomas of ovarian origin, when used in combination with paclitaxel neuroblastoma and Wilms' tumor have been moved from the "Indications Expanded by this Article" section to the "Indications" section of the article;
• Hormone refractory prostate cancer (HRPC) and stomach carcinoma have been removed from the "Indications Expanded by this Article" section as they are included n the "Indications" section;
• The "ICD-9 Codes that are Covered" section of the article has been revised to include ICD-9-CM codes 235.5, 235.9, V10.00, V10.01, V10.02, V10.03, V10.04, V10.21, V10.22 and V10.83 effective for dates of service on or after 10/01/2011; and
• A NOTE has been added to the paragraph section of the "ICD-9 Codes that are Covered" section to indicate that: For AIDS related B-cell lymphoma, ICD-9-CM code 042 should be reported in addition to ICD-9-CM codes 200.70-200.78 and 202.80-202.88.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language.

R14 (effective 10/01/2011): LCD revised for annual ICD-9 updates for 2012 with the following additions:

Article published 07/01/2011: The existing LCD and SIA were resubmitted to all NGS Part A, Part B and MAC jurisdictions for public and CAC comment from 01/13/2011-03/26/2011. The SIA was revised to accommodate the 2011 CPT coding changes for cardiac catheterization. Guidelines added for billing Pharmacologic agent administration (93463) and Physiologic exercise study (93464). Article number A48368 is replaced by article number A50603, effective July 1, 2011.

R7 (effective 10/01/2011): LCD revised for annual ICD-9 updates for 2012. ICD-9 codes 747.31, 747.32 and 747.39 replaced deleted code 747.3. No comment and notice periods required and none given.

R8 (effective 10/01/2011): LCD revised for annual ICD-9 update for 2012. ICD-9 code 414.4 added to list of payable diagnoses for CPT codes 78451-78454, 78472, 78473, 78481, 78483, 93015, 93016, 93017, and 93018. No comment and notice periods required and none given.

R6 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of ICD-9 code 379.27 for HCPCS code 66982. Minor changes were made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

R4 (effective 10/01/2011): Annual LCD review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. Content reviewed, and no changes required other than for minor formatting. No comment and notice periods required and none given.

Article published October 2011: Annual review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. Content reviewed and no changes needed.

R12 (effective 10/01/2011): Based on a provider request, ICD-9-CM codes 874.8 and 874.9 were added to the "ICD-9-CM Codes that Support Medical Necessity" section for CT Head, Neck, Face, Orbit, Jaw (CPT codes 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 76376 and 76377).

Due to the annual ICD-9-CM code update for 2012, ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4 and 173.6 were deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for CT Head, Neck, Face, Orbit, Jaw (CPT codes 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 76376 and 76377). ICD-9-CM codes 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.60, 173.61, 173.62 and 173.69 were added as replacement codes. ICD-9-CM codes 331.6, 358.30, 358.31, 358.39 and 379.27 were added. ICD-9-CM codes 323.41 and 323.42 were revised.

ICD-9-CM codes 173.5, 425.1, 512.8, 516.3, 518.5, 747.3, 793.1 and 998.0 were deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for CT Chest and Thorax (CPT codes 71250, 71260, 71270, 76376 and 76377). ICD-9-CM codes 173.50, 173.51, 173.52, 173.59, 425.11, 425.18, 512.81, 512.82, 512.83, 512.84, 512.89, 516.30, 516.31, 516.32, 516.33, 516.34, 516.35, 516.36, 516.37, 518.51, 518.52, 518.53, 747.31, 747.32, 747.39, 793.11, 793.19, 998.00, 998.01, 998.02 and 998.09 were added as replacement codes. ICD-9-CM codes 358.1, 358.30, 358.31, 358.39, 415.13, 508.2, 512.2 and 997.32 were added.

ICD-9-CM codes 596.8, 997.4 and 998.0 were deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for CT Abdomen and Pelvis (CPT codes 72192, 72193, 72194, 74150, 74160, 74170, 74176, 74177, 74178, 76376 and 76377). ICD-9-CM codes 596.81, 596.82, 596.83, 596.89, 997.41, 997.49, 998.00, 998.01, 998.02 and 998.09 were added as replacement codes. ICD-9-CM codes 573.5, 629.31, 629.32, 808.44 and 808.54 were added.

ICD-9-CM code 173.6 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for CT Upper Extremity (CPT codes 73200, 73201, 73202, 76376 and 76377). ). ICD-9-CM codes 173.60, 173.61, 173.62 and 173.69 were added as replacement codes. ICD-9-CM code 726.13 was added.

ICD-9-CM code 173.7 code was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for CT Lower Extremity (CPT codes 73700, 73701, 73702, 76376 and 76377). ICD-9-CM codes 173.70, 173.71, 72 and 173.79 were added as replacement codes.

Minor template changes were made to reflect current template language. No comment and notice periods required and none given.

R5 (effective 10/01/2011): LCD revised for annual ICD-9 update for 2012. ICD-9 codes 365.05, 365.06, 365.70-365.74 added to list of ICD-9 Codes That Support Medical Necessity. No comment or notice periods required and none given.

Article published October 2011: Based on compendia review, the "Indications" section and the "ICD-9 Codes that are Covered" section of the article has been revised as follows:

• An indication for occult primary malignancy and uterine neoplasm-uterine sarcoma have been added to the "Indications" section of the article;
• Melanoma has been removed from the "Indications Expanded by this Article" section and malignant melanoma has been added to the "Indications" section of the article;
• Fallopian tube carcinoma, primary peritoneal carcinoma and bone and articular cartilage have been removed from the "Indications Expanded by this Article" section and have been included in the "Indications" section of the article; and
• ICD-9-CM codes 235.9, V10.01, V10.02, V10.21 and V10.22 have been added to the "ICD-9 Codes that are Covered" section of the article effective for dates of service on or after 10/01/2011.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3 and 173.4 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49. Minor changes were made to reflect current template language,

Doxorubicin HCl – Related to LCD L25820 (A47584)

Article published October 2011: Based on compendia review, the article has been revised as follows:

• An indication for colorectal cancer, ocular malignant melanoma, neuroendocrine tumor and solitary plasmacytoma; smoldering multiple myeloma, multiple myeloma have been added to the "Indications" section of the article;

• The following paragraph has been added to the "Coding Guidelines" section of the article:

Doxorubicin is approved for the treatment of metastatic malignancy. Correct Coding requires the use of the secondary cancer code (196, 197, 198 and 199 series of ICD-9-CM codes) as the primary diagnosis and the original cancer site (V10 series of ICD-9-CM codes) as the secondary diagnosis. The secondary cancer sites will not be listed in the drug article, only the appropriate "History of", V10-codes are listed.

• ICD-9-CM codes, 182.1, 182.8, 190.0, 190.6, 203.10, 203.12, 203.80, 203.82, 204.90, 204.92, 209.31-209.35, 209.75, 235.5, 238.77, 251.1, 251.4, 251.8, V10.3, V10.51, and V10.88, have been added to the "ICD-9 Codes that are Covered" section of the article and ICD-9-CM codes 197.6 and 198.5 have been removed effective for dates of service on or after 10/01/2011.
• A NOTE has been added to the paragraph section of the "ICD-9 Codes that are Covered" section to indicate that: For AIDS related B-cell lymphoma, ICD-9-CM code 042 should be reported in addition to ICD-9-CM codes 200.20-200.28, 200.70-200.78, 200.80-200.88 and 202.80-202.88.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language.

R4 (effective 10/01/2011): LCD updated for annual ICD-9 updates for 2012. The following codes were added:

• 282.40, 282.43-282.47, 414.4, 415.13
• 425.11 and 425.18 to replace deleted code 425.1
• 444.01, 444.09 to replace deleted code 444.0
• 488.81, 488.82, 488.89, 512.2
• 518.51, 518.52, 518.53 to replace deleted code 518.5
• 747.31, 747.32, 747.39 to replace deleted code 747.3
• 996.88
• 998.00, 998.01, 998.02, 998.09 to replace deleted code 998.0
• 999.41, 999.42, 999.49 to replace deleted code 999.4
• 999.51, 999.52, 999.59 to replace deleted code 999.5

No comment or notice periods required and none given

R4 (effective 10/01/2011): Due to the annual ICD-9-CM code update for 2012, ICD-9-CM code 793.1 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section. ICD -9-CM code 793.11 was added as a replacement code.

The following explanatory note in the "ICD-9-CM Codes that Support Medical Necessity" section was revised for dates of service prior to October 1, 2011:

For dates of service prior to October 1, 2011, ICD-9-CM code 793.1 (Nonspecific abnormal findings on radiological and other examination of lung field) should be used to designate other non-specific pulmonary nodules.

Minor changes made to reflect current template language. No comment or notice periods required and none given.

Due to the annual ICD-9-CM code update for 2012, ICD-9-CM code 793.1 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section of the LCD. ICD -9-CM code 793.11 was added as a replacement code.

The following coding guideline was revised for dates of service prior to October 1, 2011:

For dates of service prior to October 1, 2011, ICD-9-CM code 793.1 (Nonspecific abnormal findings on radiological and other examination of lung field) should be used to designate other non-specific pulmonary nodules.

R8 (effective 10/01/2011): Annual LCD review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. The entire policy was reviewed. Minor changes made to reflect current template language. No additional comment or notice periods required and none given.

R17 (effective 10/01/2011): ): Due to the annual ICD-9-CM code update for 2012, ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 were deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for HCPCS codes J0881 and J0885. ICD -9-CM codes 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92 and 173.99 were added as replacement codes.

No comment or notice periods required and none given.

R11 (effective 10/01/2011): Due to the annual ICD-9-CM code update for 2012, ICD-9-CM code 997.4 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for CPT codes 43200-43228, 43234-43236, 43239-43241, 43243-43251, 43255, 43256, 43258, 74235 and 74360. ICD-9-CM code 997.49 was added as a replacement code. ICD-9-CM code V58.68 was added.

ICD-9-CM code 793.1 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for CPT codes 43231, 43232, 43237, 43238, 43242 and 43259. ICD -9-CM codes 793.11 and 793.19 were added as replacement codes.

No comment and notice periods required and none given.

Article published October 2011: Based on compendia review, the "Indications" section and the "ICD-9 Codes that are Covered" section of the article has been revised as follows:

• An indication for lung neuroendocrine tumors, solitary plasmacytoma; smoldering multiple myeloma’ multiple myeloma, thymoma carcinomas, acute myeloid leukemia (AML) and occult primary for inguinal nodes have been added to the "Indications" section of the article;
• Fallopian tube carcinoma and primary peritoneal carcinoma have been removed from the "Indications Expanded by this Article" section and have been added to ovarian cancer in the "Indications" section of the article along with germ cell tumors;
• Metastatic breast cancer – invasive has been removed from the "Indications" section of the article and has been added to breast cancer in the "Indications Expanded by this Article" section of the article; and
• ICD-9-CM codes 199.0 and 209.75 have been added to the "ICD-9 Codes that are Covered" section of the article effective for dates of service on or after 10/01/2011.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language,

Filgrastim, Pegfilgrastim (e.g., Neupogen®, Neulasta ^TM) - Related to LCD L25820 (A48208)

Article published October 2011: Based on compendia review, the article has been revised as follows:

• harvesting of peripheral blood stem cells, prior to autologous stem-cell transplantation has been added as an indication for pegfilgrastim in the "Indications" section of the article;
• ICD-9-CM code V07.8 has been added to the following statements in the "Coding Guidelines" section of the article:

• ICD-9-CM code V07.8 or V15.9 should be reported when filgrastim is used for the prevention of infection, as manifest by febrile neturopenia in patients treated with cytotoxic chemotherapy, for which a high incidence of associated febrile neutropenia, can be anticipated in a given patient.
• ICD-9-CM code V07.8 or V15.9 should be reported when pegfilgrastim is used to decrease the incidence of infection, as manifested by febrile neutropenia in patients with non-myeloid malignancies receiving myelosuppressive cancer drugs.
• Only the following ICD-9-CM codes, 288.03, 284.11, V07.8, V15.9, V42.82, V58.11, V58.12 and V66.2, support medical necessity for pegfilgrastim.

• ICD-9-CM codes 288.03, 284.11, V07.8 and V42.82 have been added to the table for ICD-9 codes that support medical necessity for pegfilgrastim in the "ICD-9 Codes that are Covered" section of the article and ICD-9-CM code V07.8 has been added to the table for ICD-9-CM codes that support medical necessity for any other indication for filgrastim (i.e., other than febrile neutropenia, neutropenia of eclampsia or neutropenia associated with HIV disease) effective for dates of service on or after 10/01/2011.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM code 284.1 has been deleted and replaced with 284.11, 284.12 and 284.19 in the table for ICD-9-CM codes that support medical necessity for any other indication for filgrastim (i.e., other than febrile neutropenia, neutropenia of eclampsia or neutropenia associated with HIV disease). Minor changes were made to reflect current template language

R5 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. For CPT codes 86355, 86356, 86357, 86359, 86360, 86361, 86367, 88182, 88184, 88185, 88187, 88188, and 88189, "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of code 996.8. ICD-9 code 284.1 was deleted and replaced by ICD-9 codes 284.11, 284.12 and 284.19. ICD-9 codes 173.4 – 173.8 were deleted and replaced by ICD-9 codes173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82 and 173.89. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

Article published October 2011: Due to the annual ICD-9-CM code update for 2011, ICD-9-CM code 310.8 was deleted from the ICD-9-CM Codes that are NOT Covered" section. ICD -9-CM codes 310.81 and 310.89 were added as replacement codes.

ICD-9-CM codes 294.20, 294.21 and 331.6 were added to the "ICD-9-CM Codes that are NOT Covered" section. ICD-9-CM codes 317, 318.0, 318.1, 318.2 and 319 were revised.

R5 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of codes 573.5, 996.88, 999.32, 999.33, and 999.34 for HCPCS code 80076. ICD-9-CM code 997.4 was deleted and replaced with 997.41 and 997.49. ICD-9-CM code 998.0 was deleted and replaced with 998.00, 998.01, 998.02, and 998.09. ICD-9-CM code 999.4 and 999.5 were deleted and replaced with 999.41, 999.42, 999.49, 999.51, 999.52, and 999.59. V12.2 was deleted and replaced with codes V12.21 and V 12.29. Descriptors were updated for several codes. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

Article published October 2011: Based upon compendia review, Paget’s disease, corticosteroid-induced osteoporosis and the following two paragraphs for prevention of osteoporosis in postmenopausal women have been added to the "Indications" section of the article:

National Government Services does not cover ibandronate for the prevention of osteoporosis in postmenopausal women with the exception of those women with documented osteopenia. See corresponding ICD-9 Codes that are Covered section for proper coding of these cases. Prevention of osteoporosis in postmenopausal women. Preventative services other than those payable by statute are excluded from coverage. This service should be submitted with the appropriate CPT/HCPCS code with the -GY modifier. Using the –GY modifier will result in denial of Medicare payment for this service.

In the "Coding Guidelines" section the following coding guidelines have been removed:

Claims submitted without ICD-9-CM codes 530.10, 530.19, 995.29, V12.79 or V15.89 and the primary diagnosis code will be denied as not medically necessary.

For management of hypercalcemia of malignancy, the related malignancy code as well as 530.10, 530.19, 995.29, V12.79 or V15.89 is required in addition to the primary code (275.42 or 733.09).

The following two coding guidelines have been revised to add that "when submitting claims for senile osteoporosis or other osteoporosis:

When submitting claims for senile osteoporosis or other osteoporosis, ICD-9-CM code 530.10, 530.19 or V12.79 should only be added to claims to indicate that the patient has severe esophagitis and cannot take the oral drugs.

When submitting claims for senile osteoporosis or other osteoporosis, ICD-9-CM code 995.29 or V15.89 should only be added to claims to indicate that the patient cannot tolerate oral ibandronate sodium.

The following coding guideline has been added:

For management of hypercalcemia of malignancy (275.42), the rationale for the use of the drug and the related malignancy must be documented in the patient’s medical record.

In the "ICD-9 Codes that are Covered" section, ICD-9-CM codes 198.5, 275.42 and 731.0 have been added as stand-alone diagnoses and ICD-9-CM codes 733.01 and 733.09 must be reported with a secondary diagnosis of 530.10, 530.19, 995.29, V12.79 or V15.89. For management of female patients with postmenopausal osteopenia, ICD-9-CM code 733.90 must be reported with a secondary diagnosis of 256.2, 256.31, 627.2 or V49.81 effective for dates of service on or after 10/01/2011. Minor changes were made to reflect current template language.

Article published October 2011: Based on compendia review, the "Indications" section and the "ICD-9 Codes that are Covered" section of the article has been revised as follows:

• An indication for desmoids tumors has been added to the "Indications" section of the article;
  Pancreatic carcinoma has been removed from the "Indications Expanded by this Article" section and added to the "Indications" section of the article;
• ICD-9-CM codes 200.70-200.78 and 202.80-202.88 have been added to the NOTE for AIDS related B-cell lymphoma in the ICD-9 paragraph section of the article; and
• ICD-9-CM codes 235.9, V10.01, V10.02, V10.21 and V10.22 have been added to the "ICD-9 Codes that are Covered" section of the article effective for dates of service on or after 10/01/2011.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM code 173.0 has been deleted and replaced with 173.00, 173.01, 173.02 and 173.09. Minor changes were made to reflect current template language.

R11 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of code 996.88 for HCPCS code 88342. ICD-9-CM codes 173.0 – 173.9 were deleted and replaced with codes 173.00 – 173.99. ICD-9-CM code 596.8 was deleted and replaced with codes 596.81, 596.82, 596.83, and 596.89. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

Article published October 2011: Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 358.30, 358.31 and 358.39 have been added effective for dates of service on or after 10/01/2011.

R4 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of codes 996.88 for HCPCS code 82330. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

Article published October 2011: Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language.

R4 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. ICD-9-CM code 284.1 was deleted and replaced with codes 284.11, 284.12, and 284.19. No comment and notice periods required and none given

R5 (effective 10/01/2011): Annual LCD review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. The entire policy was reviewed.

Due to the annual ICD-9-CM code update for 2012, ICD-9-CM code 995.0 was revised.

Minor changes made to reflect current template language. No comment or notice periods required and none given.

R10 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. For CPT codes 72198, 74185, C8900-C8902, and C8918-C8920 (Abdomen and Pelvis), ICD-9-CM code 444.0 was deleted and replaced with 444.01 and 444.09. Corrected typo in revision history effective date for R9 - changed to 08/01/201. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

R5 (effective 10/01/2011): Based on a provider request, ICD-9-CM codes 996.41, 996.42, 996.43, 996.44, 996.45, 996.46, 996.47, 996.49, 996.66 and 996.67 were added to the "ICD-9-CM Codes that Support Medical Necessity" section for MRI Lower Extremity (CPT codes 73718, 73719, 73720, 73721, 73722, 73723, 76376 and 76377).

LCD revised for annual ICD-9-CM code updates for 2012.

ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4 and 173.6 were deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for MRI Head, Neck, Face, Orbit, Jaw (CPT codes 70336, 70540, 70542, 70543, 70551, 70552, 70553, 76376 and 76377). ICD-9-CM codes 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.60, 173.61, 173.62 and 173.69 were added as replacement codes. ICD-9-CM codes 331.6, 358.30, 358.31, 358.39 and 379.27 were added.

ICD-9-CM code 173.5 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for MRI Chest and Thorax (CPT codes 71550, 71551, 71552, 76376 and 76377). ICD-9-CM codes 173.50, 173.51, 173.52 and 173.59 were added as replacement codes. ICD-9-CM code 425.1 was deleted and ICD-9-CM codes 425.11 and 425.18 were added as replacement codes. ICD-9-CM code 512.8 was deleted and ICD-9-CM codes 512.81, 512.82, 512.83, 512.84 and 512.89 were added as replacement codes. ICD-9-CM code 516.3 was deleted and ICD-9-CM codes 516.30, 516.31, 516.32, 516.33, 516.34, 516.35, 516.36 and 516.37 were added as replacement codes. ICD-9-CM code 518.5 was deleted and ICD-9-CM codes 518.51, 518.52 and 518.53 were added as replacement codes. ICD-9-CM code 747.3 was deleted and ICD-9-CM codes 747.31, 747.32 and 747.39 were added. ICD-9-CM code 793.1 was deleted and ICD-9-CM codes 793.11 and 793.19 were added as replacement codes. ICD-9-CM code 998.0 was deleted and ICD-9-CM codes 998.00, 998.01, 998.02 and 998.09 were added as replacement codes. ICD-9-CM codes 415.13, 508.2, 512.2 and 997.32 were added.

ICD-9-CM code 997.4 was deleted from MRI Abdomen and Pelvis (CPT codes 72195, 72196, 72197, 74181, 74182, 74183, 76376 and 76377). ICD-9-CM codes 997.41 and 997.49 were added as replacement codes. ICD-9-CM code 596.8 was deleted and ICD-9-CM codes 596.81, 596.82, 596.83 and 596.89 were added as replacement codes. ICD-9-CM code 998.0 was deleted and ICD-9-CM codes 998.00, 998.01, 998.02 and 998.09 were added as replacement codes. ICD-9-CM codes 444.01, 444.09, 573.5, 629.31, 629.32, 808.44 and 808.54 were added.

ICD-9-CM code 173.6 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for MRI Upper Extremity (CPT codes 73218, 73219, 73220, 73221, 73222, 73223, 76376 and 76377). ICD-9-CM codes 173.60, 173.61, 173.62 and 173.69 were added as replacement codes. ICD-9-CM code 726.13 was added.

ICD-9-CM code 173.7 was deleted from the "ICD-9-CM Codes that Support Medical Necessity" section for MRI Lower Extremity (CPT codes 73718, 73719, 73720, 73721, 73722, 73723, 76376 and 76377). ICD-9-CM codes 173.70, 173.71, 173.72 and 173.79 were added as replacement codes. ICD-9-CM code 718.60 was deleted.

The following reference was added to the "CMS National Coverage Policy" section:

CMS Transmittal No. 134, Publication 100-03, Medicare National Coverage Determinations Manual, Change Request #7441, August 26, 2011, advises that CMS will allow for coverage of MRI for beneficiaries with implanted permanent pacemakers (PMs) when the PMs are used according to the FDA-approved labeling for use in an MRI environment.

Based on the aforementioned Change Request, the following bullet under Item e in the "Indications and Limitations of Coverage and/or Medical Necessity" section was added:

 Effective July 07, 2011, CMS will allow coverage of MRI for Medicare beneficiaries with implanted PMS when the PMs are used according to the FDA-approved labeling for use in an MRI environment.

No comment and notice periods required and none given

Article published October 2011: Based on CMS Transmittal No. 134, Publication 100-03, Medicare National Coverage Determinations Manual, Change Request #7441, August 26, 2011, the following coding guideline was added:

Article published October 2011: The ICD-9-CM Codes That Support Medical Necessity section was updated to add 249.00-249.91 (Secondary Diabetes mellitus) as a payable diagnosis for patients with diabetes per provider request. No notice and comment given and none required.

R8 (effective 10/01/2011): LCD revised for annual ICD-9 update. ICD-9 codes 358.30, 358.31 and 358.39 added to list of ICD-9 Codes That Support Medical Necessity. No comment or notice periods required and none given.

R7 (effective 10/01/2011): LCD revised for annual ICD-9 update for 2012. ICD-9 codes 358.30, 358.31 and 358.39 added to list of ICD-9 Codes That Support Medical Necessity. No comment or notice periods required and none given.

R9 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was revised to add code 348.82 for CPT codes 93886, 93888. 93890, 93892 and 93893. For the Extremity Venous Evaluation (93965, 93970, 93971) coding list new ICD-9 codes 415.13 and V12.55 were added. For the Visceral Vascular Studies (93975, 93976, 93978, 93979) coding list new ICD-9 code 415.13 was added. ICD-9- code 444.0 was deleted and replaced with codes 444.01 and 444.09.

Additional updates were made. For the Cerebrovascular Evaluation (93875, 93883, 93882) coding list, ICD-9 codes 282.41, 282.42, 282.61, 282.62 were moved to the Cerebrovascular Evaluation (93886, 93888, 93890, 93892, 93893) coding list. ICD-9 code 348.89 was deleted and the statement "Use ICD-9-CM code 348.89 to report assessment of brain death." was removed. ICD-9 code 282.60 was added. ICD-9 codes 435.8 and 435.9 were added due to a provider reconsideration request. References reviewed for reconsideration request were added to the Sources of Information and Basis for Decision section. Minor changes were made to reflect current template language. No comment period required and none given.

R4 (Effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. ICD-9-CM code 173.1 was deleted from the ICD-9 Codes that Support Medical Necessity section. ICD-9-CM codes 173.10, 173.11, 173.12 and 173.19 were added as replacement codes. No comment and notice periods required and none given.

Article published October 2011: Based on an external request regarding changes to the composition of the products covered under the purview of this article, the following changes have been made:

• All references to OASIS® Burn Matrix in the "Abstract", "Indications", "Limitations", "Coding Guidelines" and "Utilization Guidelines" sections have been removed and replaced with OASIS® Ultra Tri-Layer Matrix
• OASIS® should be in all capital letters which was corrected throughout the article
• HCPCS codes C9365 and J3590 have been added to the "CPT/HCPCS Codes" section with the following explanatory notes:

• HCPCS code Q4103 was removed from the "CPT/HCPCS Codes" section on the basis that the product is no longer manufactured
• All references to HCPCS codes Q4103 were removed from the "Coding Guidelines" section
• The following coding guideline was added for HCPCS code J3590:

• The following sources were added to the "Sources of Information and Basis for Decision" section:

• Oasis® Burn Matrix was removed from the following source in the "Sources of Information and Basis for Decision" section:
•  

R4 (effective 10/01/2011): LCD revised for annual ICD-9 update for 2012. ICD-9 code 379.27 added to lists of ICD-9 Codes That Support Medical Necessity for CPT codes 76510, 76512, 76513, and 76511. No comment and notice periods required and none given.

R7 (effective 10/01/2011): LCD revised for annual ICD-9 update for 2012. ICD-9 codes 365.05, 365.06, 365.70-365.74, and 379.27 added to list of ICD-9 Codes That Support Medical Necessity for CPT codes 92225, 92226, 92228 and 92250. No comment or notice periods required and none given.

Article published October 2011: Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language.

R10 (effective 10/01/2011) – LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy is expanded with the addition of codes 294.20 and 294.21 in the "Psychiatric Diagnosis" list and the description for codes 317, 318.0, 318.1 and 318.2 has been revised. ICD-9-CM code 310.8 has been deleted and replaced with 310.81 and 310.89 in the "Other Medical Diagnoses Not Included in DSM-IV™" list and 331.6 has been added. The description for ICD-9-CM codes 318.1 and 318.2 has been revised in the first paragraph in the "Limitations" section of the LCD. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

Article published October 2011: Based on compendia review, ICD-9-CM codes 199.0, 235.2, 235.5, 235.9, V10.00, V10.01, V10.02, V10.03, V10.04, V10.21 and V10.22 have been added to the "ICD-9 Codes that are Covered" section of the article for paclitaxel (HCPCS code J9265) effective for dates of service on or after 10/01/2011.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99 for paclitaxel (HCPCS code J9265).

Article published October 2011: Based on compendia review, the "Indications" section and the "ICD-9 Codes that are Covered" section of the article has been revised as follows:

• An indication for hypercalcemia associated with primary hyperparathyroidism or hypercalcemia associated with end-stage renal failure including patients with secondary hyperparathyroidism has been added to the "Indications" section of the article:
• Hyperparathyroidism has been removed from the third bullet in the "Limitations" section of the article;
• The first coding guideline has been revised to include "primary hyperparathyroidism or hypercalcemia associated with end-stage renal failure including patients with secondary hyperparathyroidism";
• "Primary hyperparathyroidism or hypercalcemia associated with end-stage renal failure including patients with secondary hyperparathyroidism" has been added to the ICD-9 code paragraph for "Moderate or severe hypercalcemia associated with malignancy, including Tamoxifen induced tumor flare";
• ICD-9-CM codes 252.01 and 588.81 have been added to the secondary table for hypercalcemia;
• ICD-9-CM code 193 has been added to the secondary table for osteolytic bone metastasis; and
• ICD9-CM codes 203.10, 203.80 and 238.6 have been added to the table for osteolytic lesions of multiple myeloma effective for dates of service on or after 10/01/2011.

Article revised for annual ICD-9-CM code updates for 2012. In the secondary table for hypercalcemia, ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language.

R4 (effective 10/01/2011): LCD revised for annual ICD-9 update for 2012. ICD-9 code 414.4 added to ICD-9 Codes That Support Medical Necessity. No comment or notice periods required and none given.

R1 (effective 10/01/2011): LCD revised to update Sources of Information and Basis for Decisions by adding a list of references submitted for reconsideration request (not previously reviewed) and other literature reviewed August 2011. No comment and notice periods required and none given.

R5 (effective 10/01/2011): Annual LCD review per CMS, Program Integrity Manual, Chapter 13, Section 13.4[C]. The entire policy was reviewed: The "CMS National Coverage Policy" section and references throughout the text have been updated to reflect the CMS Online Manual System. A number of minor changes are made to reflect the current CMS and National Government Services current policy formats. LCD revised for annual ICD-9-CM code updates for 2012. The description for ICD-9-CM codes 317, 318.0, 318.1, 318.2 and 319 has been revised in the "ICD-9-CM Codes That Do NOT Support Medical Necessity" section of the policy. No comment and notice periods required and none given.

Article published October 2011: Annual review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. Content reviewed and minor formatting changes made.

R7 (effective 10/01/2011): LCD revised for annual ICD-9 code updates for 2012. The following ICD-9 codes were added:

• 415.13
• 425.11, 425.18 replaced deleted code 425.1
• 444.01, 444.09 replaced deleted code 444.0
• 488.81, 488.82, 488.89, 508.2, 512.2
• 512.81-518.84, 512.89 replaced deleted code 512.8
• 516.30-516.37 replaced deleted code 516.3
• 516.4, 516.5, 516.61, 516.62, 516.63, 516.64, 516.69
• 518.51, 518.52, 518.53 replaced deleted code 518.5
• 747.31, 747.32, 747.39 replaced deleted code 747.3
• 793.11, 793.19 replaced deleted code 793.2
• 795.51, 795.52 replaced deleted code 795.5
• 996.88, 997.32
• 998.00-998.02, 998.09 replaced deleted code 998.0
• 999.32, 999.33, 999.34
• 999.41, 999.42, 999.49 replaced deleted code 999.4

No comment or notice periods required and none given.

R5 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. Descriptors were updated for several codes.. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

R8 (effective 10/01/2011): LCD revised for annual ICD-9 update for 2012. ICD-9 codes 358.30, 358.31 and 358.39 added to list of the ICD-9 Codes that Support Medical Necessity, provided they meet the active care requirement. No comment and notice periods required and none given.

Article published October 2011: Article revised for annual ICD-9 update for 2012, to add ICD-9 codes 358.30, 358.31 and 358.39 to the list of covered ICD-9 codes must meet the active care requirement.

Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (L28488)

R4 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of codes 365.05, 365.06, 365.70, 365.71, 365.72, 365.73, and 365.74 for CPT code 92133. Descriptor changed for 365.01. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

R4 (effective 10/01/2011): LCD revised for annual ICD-9 code updates for 2012. The following ICD-9 codes were added:

• 294.20, 294.21
• 998.00, 998.01, 998.02, 998.09 replaced deleted code 998.0.

No comment or notice periods required and none given.

Article published October 2011: Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language.

R5 (effective 10/01/2011): Annual LCD review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. Content reviewed, and no changes required other than for minor formatting. No comment and notice periods required and none given.

Article published October 2011: Annual review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. Content reviewed and no changes needed.

Speech-Language Pathology (L27404) –

R7 (effective 10/01/2011): The following reference was added to the "CMS National Coverage Policy" section:

CMS Transmittal No. 2276, Publication 100-04, Medicare Claims Processing Manual, Change Request #7528, August 19, 2011, advises that the physician supervision level for CPT code 31579 has been removed from the Medicare Physician Fee Schedule Database (MPFSDB).

Based on the aforementioned Change Request, the following indication in the "Indications and Limitations of Coverage and/or Medical Necessity" section was revised to remove "under direct physician supervision" from the second sentence:

This procedure may be used for assessing voice production and vocal function. It may be performed by qualified speech-language pathologists.

Minor template changes were made to reflect current template language. No comment and notice periods required and none given.

R3 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of codes 282.40, 282.43, 282.44, 282.45, 282.46, and 282.47 for HCPCS code 38240. ICD-9-CM code 282.49 was deleted. ICD-9-CM code 284.1 was deleted and replaced with 284.11. 284.12, 284.19. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. Annual LCD review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. Content reviewed, and no changes required other than for minor formatting. No comment and notice periods required and none given.

R4 (effective 10/01/2011): Due to the annual ICD-9-CM code update for 2012, ICD-9-CM codes 294.20 and 294.21 were added to the "ICD-9-CM Codes that Support Medical Necessity" section for CPT codes 86592, 86593, 86780, 87164, 87166 and 87285.

Minor template changes were made to reflect current template language. No comment and notice periods required and none given.

Article published October 2011: Based on compendia review, the "Indications" section and the "ICD-9 Codes that are Covered" section of the article has been revised as follows:

• Osteosarcoma has been added to the indication for bone cancer in the "Indications" section of the article;
• Rhabdomyosarcoma has been added to the "Indications" section of the article:
• Fallopian tube cancer and primary peritoneal cancer have been removed from the "Indications Expanded by this Article" section and added to an indication for ovarian cancer in the "Indication" section of the article; and
• ICD-9-CM codes 171.0, 171.2, 171.3, 171.4, 171.5, 171.6, 171.7, 171.8, 171.9 and V10.11 have been added to the "ICD-9 Codes that are Covered" section of the article effective for dates of service on or after 10/01/2011.

Article revised for annual ICD-9-CM code updates for 2012. ICD-9-CM codes 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8 and 173.9 have been deleted and replaced with 173.00, 173.01, 173.02, 173.09, 173.10, 173.11, 173.12, 173.19, 173.20, 173.21, 173.22, 173.29, 173.30, 173.31, 173.32, 173.39, 173.40, 173.41, 173.42, 173.49, 173.50, 173.51, 173.52, 173.59, 173.60, 173.61, 173.62, 173.69, 173.70, 173.71, 173.72, 173.79, 173.80, 173.81, 173.82, 173.89, 173.90, 173.91, 173.92, and 173.99. Minor changes were made to reflect current template language.

R6 (effective 10/01/2011): Annual LCD review per CMS Program Integrity Manual, Chapter 13, Section 13.4[C]. The entire policy was reviewed. Minor changes made to reflect current template language. No additional comment or notice periods required and none given.

R6 (effective 10/01/2011): LCD revised for annual ICD-9 updates for 2012. The following ICD-9 codes were added:

• For CPT codes 93312, 93313, 93314: ICD-9 codes 415.13; 425.11, 425.18 replaced deleted code 425.1; 998.00-998.02, 998.09 replaced deleted code 998.0
• For CPT codes 93315, 93316, 93317: ICD-9 codes 747.31, 747.32, 747.39 replaced deleted code 747.3.

No comment or notice periods required and none given.

R7 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The following ICD-9 codes were added for CPT codes 93306, 93307, 93308, 93320, 93321, 93325, C8923, C8924, and C8929:

• 425.11, 425.18 replaced deleted code 425.1
• 518.51, 518.52, 518.53 replaced deleted code 518.5
• 747.31, 747.32, 747.39 replaced deleted code 747.3
• 998.00-998.02, 998.09 replaced deleted code 998.0
• 999.32, 999.33, 999.34
• 999.41, 999.42, 999.49 replaced deleted code 999.4

The following ICD-9 codes were added for CPT codes 93350, 93351, 93352, and C8930:

• 425.11, 425.18 replaced deleted code 425.1

No comment or notice periods required and none given.

R4 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of code 573.5 for HCPCS codes 86692, 86704, 86705, 586707, 86708, 86709, 86803, 86804, 87340, 87341, 87350, and 87380. In addition for the same HCPCS codes ICD-9-CM code 516.3 was deleted and replaced with 516.30, 516.31, 516.32, 516.33, 516.34, 516.35, 516.36, and 516.37. ICD-9-CM code 999.5 was deleted and replaced with 999.51, 999.52, and 999.59. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

R8 (effective 10/01/2011): LCD revised for annual ICD-9-CM code updates for 2012. The "ICD-9-CM Codes That Support Medical Necessity" section of the policy was expanded with the addition of codes 365.05, 365.06, 365.70, 365.71, 365.72, 365.73 and 365.74 for HCPCS codes 92081, 92082, and 92083. Several minor changes are made to reflect the current CMS and National Government Services current policy formats. No comment and notice periods required and none given.

Article published October 2011: ICD-9-CM code 294.11 has been added to the "ICD-9 Codes that are Covered" section of the article effective for dates of service on or after 10/01/2011. Minor changes were made to reflect current template language.

Article published October 2011: Based upon compendia review, monoclonal gammopathy of uncertain significance, with osteopenia or osteoporosis has been added for Zometa® and Reclast® in the "Indications" section of the article and osteoporosis in men has been added to the indications for Reclast®. The indications for Zometa® and Reclast® have been revised for clarity. In the "Coding Guidelines" section the guideline for management of hypercalcemia of malignancy for Zometa® has been revised to indicate that the use of the drug and related malignancy must be documented in the patient’s medical record. The requirement to report a secondary diagnosis has been removed. In the "ICD-9 Codes that are Covered" section of the article the following updates have been made:

• ICD-9-CM code 273.1 has been added as a primary diagnosis and ICD-9-CM codes 733.00 and 733.90 have been added as secondary diagnoses for both Reclast® (J3488) and Zometa® (J3487) effective for dates of service on or after 10/01/2011
• The secondary ICD-9 code list for Zometa® for hypercalcemia of malignancy have been removed and ICD-9-CM code 275.42 has been added to the stand-alone list of diagnoses; and
• ICD-9-CM code 733.90 has been removed from the stand-alone list for Zometa® (J3487) effective for dates of service on or after 10/01/2011.

Minor changes were made to reflect current template language.