Article Detail - JE Part A
LCD Associated Billing and Coding Article - Billing and Coding: Treatment of Ulcers and Symptomatic Hyperkeratoses - R1
The following Local Coverage Determination (LCD) associated Billing and Coding Article (LCA) has been revised under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).
|Medicare Coverage Database Number||LCD Title and Revision Number|
|L34243||Treatment of Ulcers and Symptomatic Hyperkeratoses|
|Medicare Coverage Database Number||Billing and Coding Article Title and Revision Number|
|A57459||Billing and Coding: Treatment of Ulcers and Symptomatic Hyperkeratoses|
Effective Date: June 29, 2020
Summary of Changes: No updates were made to the LCD. The following language updates were made to the associated Billing and Coding Article.
- In the Article Text, added the statement “Other treatment modalities not discussed here will be included in the soon-to-be released for comment, Noridian Wound Care policy” in the second paragraph under Coding Guidelines.
- Added the statement “If the coverage conditions for the treatment of Symptomatic Hyperkeratoses are not met, the claims will be adjudicated based off Noridian’s Billing and Coding: Routine Foot Care LCA” in the Group 2 Paragraph.
- Updated the Group 2 and 3 Paragraph sections to indicate when billing claims for 11055-11057 providers must use at least one diagnosis code listed in Group 2 and at least one diagnosis code listed in Group 3.
- Removed the redundant diagnosis codes from the Group 2 and Group 3 Medical Necessity ICD-10 Codes Asterisk Explanation sections.
Last Updated Tue, 13 Oct 2020 19:45:22 +0000