Persius/hicric huggingface dataset:
Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for
Myeloid Malignancies and Suspected Myeloid Malignancies

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Next
Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and
Suspected Myeloid Malignancies L38176.

Relevant Article: Billing and Coding: MolDX: Testing of Multiple Genes A57880:

To report a Next Generation Sequencing Lab-Developed Tests for Myeloid
Malignancies and Suspected Myeloid Malignancies service, please submit the
following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types: 
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Box 19 for paper claim
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPT code in the comment/narrative field for the following Part A claim field/types: 
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code
Response to Comments: MolDX: Next-Generation Sequencing Lab-Developed Tests
for Myeloid Malignancies and Suspected Myeloid Malignancies (DL38176)

The comment period for the MolDX: Next-Generation Sequencing Lab-Developed
Tests for Myeloid Malignancies and Suspected Myeloid Malignancies Local
Coverage Determination (LCD) began on 4/25/19 and ended on 6/09/19. The
comments below were received from the provider community. The notice period
for L38176 begins on 12/26/19 and will become effective on 2/9/2020.
Billing and Coding: Magnetic-Resonance-Guided Focused Ultrasound Surgery
(MRgFUS) for Essential Tremor

This Billing and Coding Article provides billing and coding guidance for Local
Coverage Determination (LCD) L38506 Magnetic-Resonance- Guided Focused
Ultrasound Surgery (MRgFUS) for Essential Tremor. Please refer to the LCD for
reasonable and necessary requirements.

**Coding Guidelines  **

**Notice:** It is not appropriate to bill Medicare for services that are not
covered (as described by the entire LCD) as if they are covered. When billing
for non-covered services, use the appropriate modifier.

**Documentation Requirements  **

  1. All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
  2. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
  3. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.
Response to Comments: Magnetic Resonance Image Guided High Intensity Focused
Ultrasound (MRgFUS) for Essential Tremor

The comment period for the Magnetic Resonance Image Guided High Intensity
Focused Ultrasound (MRgFUS) for Essential Tremor DL37761 Local Coverage
Determination (LCD) began on 10/7/19 and ended on 11/21/19. No comments were
received from the provider community. The notice period for L37761 begins on
12/26/19 and will become effective on 2/10/20.
Response to Comments: Select Minimally Invasive (GERD) Procedures

As an important part of Medicare Local Coverage Determination (LCD)
development, National Government Services solicits comments from the provider
community and from members of the public who may be affected by or interested
in our LCDs. The purpose of the advice and comment process is to gain the
expertise and experience of those commenting.

We would like to thank those who suggested changes to the LCD for Select
Minimally Invasive (GERD) Procedures. The official notice period for the final
LCD begins on February 13, 2020 and the final determination will become
effective for services rendered on or after April 1, 2020.
Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for
Myeloid Malignancies and Suspected Myeloid Malignancies

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Next
Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and
Suspected Myeloid Malignancies L38123.

Relevant Article: Billing and Coding: MolDX: Testing of Multiple Genes A58120:

To report a Next Generation Sequencing Lab-Developed Tests for Myeloid
Malignancies and Suspected Myeloid Malignancies service, please submit the
following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types: 
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Item 19 for paper claim
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part A claim field/types: 
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code

**NOTE:** When entering the DEX Z-Code on the SV101-7 documentation field for
Part B claims please do not add additional characters and/or information on
the line.
Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for
Myeloid Malignancies and Suspected Myeloid Malignancies

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Next
Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and
Suspected Myeloid Malignancies L38125.

Relevant Article: Billing and Coding: MolDX: Testing of Multiple Genes A58121:

To report a Next Generation Sequencing Lab-Developed Tests for Myeloid
Malignancies and Suspected Myeloid Malignancies service, please submit the
following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types: 
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Item 19 for paper claim
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part A claim field/types: 
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code

**NOTE:** When entering the DEX Z-Code on the SV101-7 documentation field for
Part B claims please do not add additional characters and/or information on
the line.
Response to Comments: Micro-Invasive Glaucoma Surgery (MIGS)

The comment period for the Micro-Invasive Glaucoma Surgery (MIGS) DL37531
Local Coverage Determination (LCD) began on 10/7/19 and ended on 11/21/19. The
comments below were received from the provider community. The notice period
for L37531 begins on 12/26/19 and will become effective on 2/10/20.
Response to Comments: MolDX: Next Generation Sequencing Lab-Developed Tests
for Myeloid Malignancies and Suspected Myeloid Malignancies

The comment period for the MolDX: Next Generation Sequencing Lab-Developed
Tests for Myeloid Malignancies and Suspected Myeloid Malignancies DL38123
Local Coverage Determination (LCD) began on 5/30/19 and ended on 7/15/19. The
comments below were received from the provider community. The notice period
for MolDX: Next Generation Sequencing Lab-Developed Tests for Myeloid
Malignancies and Suspected Myeloid Malignancies DL38123 begins on 04/2/20 and
will become effective on 5/17/20.

Subsequent to Noridian's posting of these comments, PGBA MolDx retired A57503
noted in response 1 and 2 and later clarified as A57757. "Primary cancer
definition: Please refer to Article A57757 for clarification of when a
metastatic or recurrent tumor could be considered a primary." This article has
not been replaced as of this posting." Noridian has not adopted nor
implemented this article.
Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Next
Generation Sequencing for Solid Tumors L38119.

Relevant Article: Billing and Coding: MolDx: Testing of Multiple Genes A58120:

To report a Next Generation Sequencing for Solid Tumors service, please submit
with the following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types: 
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Item 19 for paper claim
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Par A claim field/types: 
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code

**NOTE:** When entering the DEX Z-Code on the SV101-7 documentation field for
Part B claims please do not add additional characters and/or information on
the line.
Response to Comments: MolDX: Next-Generation Sequencing for Solid Tumors

The comment period for the MolDX: Next Generation Sequencing for Solid Tumors
DL38119 Local Coverage Determination (LCD) began on 5/30/19 and ended on
7/15/19. The comments below were received from the provider community. The
notice period for MolDX: Next Generation Sequencing for Solid Tumors L38119
begins on 4/2/20 and will become effective on 5/17/20.

Subsequent to Noridian's posting of these comments, PGBA MolDx retired A57900
noted in response 3. "Primary cancer definition: Please refer to Article
A57900 for clarification of when a metastatic or recurrent tumor could be
considered a primary." This article has not been replaced as of this posting."
Noridian has not adopted nor implemented this article.
Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Next
Generation Sequencing for Solid Tumors L38121.

Relevant Article: Billing and Coding: MolDx: Testing of Multiple Genes A58121:

To report a Next Generation Sequencing for Solid Tumors service, please submit
with the following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types:
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Item 19 for paper claim
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Par A claim field/types:
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code

**NOTE:** When entering the DEX Z-Code on the SV101-7 documentation field for
Part B claims please do not add additional characters and/or information on
the line.
Response to Comments: MolDX: Next-Generation Sequencing for Solid Tumors

The comment period for the MolDX: Next Generation Sequencing for Solid Tumors
DL38121 Local Coverage Determination (LCD) began on 5/30/19 and ended on
7/15/19. The comments below were received from the provider community. The
notice period for MolDX: Next Generation Sequencing for Solid Tumors L38121
begins on 4/2/20 and will become effective on 5/17/20.
Response to Comments: Micro-Invasive Glaucoma Surgery (MIGS)

As an important part of Medicare Local Coverage Determination (LCD)
development, Noridian solicits comments from the provider community and from
members of the public who may be affected by or interested in our LCDs. The
purpose of the advice and comment process is to gain the expertise and
experience of those commenting.

We would like to thank those who suggested changes to the Micro-Invasive
Glaucoma Surgery (MIGS) LCD. The official notice period for the final LCD
begins on February 6, 2020, and the final determination will become effective
on March 23, 2020.
Response to Comments: MolDX: Next Generation Sequencing Lab-Developed Tests
for Myeloid Malignancies and Suspected Myeloid Malignancies

The comment period for the MolDX: Next Generation Sequencing Lab-Developed
Tests for Myeloid Malignancies and Suspected Myeloid Malignancies DL38125
Local Coverage Determination (LCD) began on 5/30/19 and ended on 7/15/19. The
comments below were received from the provider community. The notice period
for MolDX: Next Generation Sequencing Lab-Developed Tests for Myeloid
Malignancies and Suspected Myeloid Malignancies DL38125 begins on 4/2/20 and
will become effective on 5/17/20.

Subsequent to Noridian's posting of these comments, PGBA MolDx retired A57503
noted in response 1 and 2 and later clarified as A57757. "Primary cancer
definition: Please refer to Article A57757 for clarification of when a
metastatic or recurrent tumor could be considered a primary." This article has
not been replaced as of this posting." Noridian has not adopted nor
implemented this article.
Billing and Coding: MolDX: Pigmented Lesion Assay

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Pigmented
Lesion Assay L38111.

To report a service, please submit the following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types: 
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Box 19 for paper claim
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPT code in the comment/narrative field for the following Part A claim field/types: 
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code
Response to Comments: MolDX: Pigmented Lesion Assay

The comment period for the MolDX: Pigmented Lesion Assay DL38111 Local
Coverage Determination (LCD) began on 05/07/19 and ended on 06/21/19 _._ The
notice period for MolDX: Pigmented Lesion Assay L38051 LCD begins on
01/30/2020 and will become effective on 03/16/2020 _._ The comments below were
received from the provider community.
Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Plasma-Based
Genomic Profiling in Solid Tumors L38065.

To report a Plasma-Based Genomic Profiling in Solid Tumors service, please
submit the following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types: 
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Box 19 for paper claim
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPT code in the comment/narrative field for the following Part A claim field/types:
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code
Response to Comments: MolDX: Plasma-Based Genomic Profiling in Solid Tumors

The comment period for the MolDX: Plasma-Based Genomic Profiling in Solid
Tumors DL38065 Local Coverage Determination (LCD) began on 5/7/19 and ended on
6/21/19. The comments below were received from the provider community. The
notice period for L38065 begins on 06/11/2020 and will become effective on
07/27/2020.
Response to Comments: Stereotactic Radiation Therapy: Stereotactic
Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)

As an important part of Medicare Local Coverage Determination (LCD)
development, National Government Services solicits comments from the provider
community and from members of the public who may be affected by or interested
in our LCDs. The purpose of the advice and comment process is to gain the
expertise and experience of those commenting.

We would like to thank those who suggested changes to the Stereotactic
Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body
Radiation Therapy (SBRT) LCD. The official notice period for the final LCD
begins on February 13, 2020, and the final determination will become effective
on April 1, 2020.
Response to Comments: Fluid Jet System in the Treatment of Benign Prostatic
Hyperplasia (BPH)

As an important part of Medicare Local Coverage Determination (LCD)
development, National Government Services solicits comments from the provider
community and from members of the public who may be affected by or interested
in our LCDs.

The purpose of the advice and comment process is to gain the expertise and
experience of those commenting. We would like to thank those who suggested
changes to the Fluid Jet System in the Treatment of Benign Prostatic
Hyperplasia (BPH) LCD. The official notice period for the final LCD begins on
February 13, 2020, and the final determination will become effective on April
1, 2020.
Billing and Coding: Fluid Jet System in the Treatment of Benign Prostatic
Hyperplasia (BPH)

This Billing and Coding Article provides billing and coding guidance for Local
Coverage Determination (LCD) L38378-Fluid Jet System in the Treatment of
Benign Prostatic Hyperplasia (BPH). Please refer to the LCD for reasonable and
necessary requirements.

**Coding Guidance**

**Notice:** It is not appropriate to bill Medicare for services that are not
covered (as described by the entire LCD) as if they are covered. When billing
for non-covered services, use the appropriate modifier.

**Documentation Requirements**

    1. All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
    2. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
    3. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.
Response to Comments: Hypoglossal Nerve Stimulation for the Treatment of
Obstructive Sleep Apnea

The evidence related to hypoglossal nerve stimulation (HNS) for treatment of
obstructive sleep apnea was presented at the Contractor Advisory Committee
(CAC) meeting on June 13, 2019. The advice of the CAC members and Subject
Matter Experts was considered in the development of the proposed policy. The
following are the comment summaries and contractor responses for the Proposed
Local Coverage Determination (LCD) DL38385 (Hypoglossal Nerve Stimulation for
the Treatment of Obstructive Sleep Apnea) which was posted for comment on
August 29, 2019, and presented at the September 13, 2019 Open Meeting. All
comments were reviewed and incorporated into the final LCD where applicable.
Response to Comments: Immune Thrombocytopenia (ITP) Therapy

CGS Administrators, LLC received comments on proposed policy DL38268-Immune
Thrombocytopenia (ITP) Therapy from 10-30-2019 through 12-14-2019. Comments
were received from the provider community. The notice period begins 02-15-2020
to 03-31-2020. The LCD becomes final on 04-01-2020.
Response to Comments: Hypoglossal Nerve Stimulation for the Treatment of
Obstructive Sleep Apnea

The evidence related to hypoglossal nerve stimulation (HNS) for treatment of
obstructive sleep apnea was presented at the Contractor Advisory Committee
(CAC) meeting on June 13, 2019. The advice of the CAC members and Subject
Matter Experts was considered in the development of the proposed policy. The
following are the comment summaries and contractor responses for the Proposed
Local Coverage Determination (LCD) L38307 (Hypoglossal Nerve Stimulation for
the Treatment of Obstructive Sleep Apnea) which was posted for comment on
10/30/2019 and presented at the October 29, 2019 Open Meeting. All comments
were reviewed and incorporated into the final LCD where applicable.
Response to Comments: MolDX: Plasma-Based Genomic Profiling in Solid Tumors
(L38168)

The comment period for the DL38168 MolDX: Guardant 360 Plasma-Based
Comprehensive Genomic Profiling in Solid Tumors Local Coverage Determination
(LCD) began on 4/25/2019 and ended on 6/09/2019. The comments below were
received from the provider communities in the MolDX Program. The notice period
for L38168 begins on 1/30/2020 and it will become effective on 3/15/2020.
Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Plasma-Based
Genomic Profiling in Solid Tumors L36168.

To report a Plasma-Based Genomic Profiling in Solid Tumors service, please
submit the following claim information:

  * Select the appropriate CPT code
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part B claim field/types: 
    * Loop 2400 or SV101-7 for the 5010A1 837P
    * Box 19 for paper claim
  * Enter the appropriate DEX Z-Code identifier adjacent to the CPT code in the comment/narrative field for the following Part A claim field/types: 
    * Line SV202-7 for 837I electronic claim
    * Block 80 for the UB04 claim form
  * Select the appropriate ICD-10-CM code
Response to Comments: Hypoglossal Nerve Stimulation for the Treatment of
Obstructive Sleep Apnea

The evidence related to hypoglossal nerve stimulation (HNS) for treatment of
obstructive sleep apnea was presented at the Contractor Advisory Committee
(CAC) meeting in June 2019. The advice of the CAC members and Subject Matter
Experts was considered in the development of the proposed policy. The
following are the comment summaries and contractor responses for the Proposed
Local Coverage Determination (LCD) DL38310 (Hypoglossal Nerve Stimulation for
the Treatment of Obstructive Sleep Apnea) which was posted for comment and
presented at the September 9, 2019, Open Public Meeting. All comments were
reviewed and incorporated into the final LCD where applicable.