Persius/hicric huggingface dataset:
Response to Comments: Magnetic Resonance Guided Focused Ultrasound Surgery
(MRgFUS) for Essential Tremor and Tremor Dominant Parkinson's Disease

The comment period for the Magnetic Resonance Guided Focused Ultrasound
Surgery (MRgFUS) for Essential Tremor and Tremor Dominant Parkinson's DL37729
Local Coverage Determination (LCD) began on 02/09/2023 and ended on
03/25/2023. The notice period for L37729 begins on 06/15/2023 and will become
effective on 07/30/2023.
Response to Comments: Magnetic Resonance Guided Focused Ultrasound Surgery
(MRgFUS) for Essential Tremor and Tremor Dominant Parkinson's Disease

The comment period for the Magnetic-Resonance-Guided Focused Ultrasound
Surgery (MRgFUS) for Essential Tremor and Tremor Dominant Parkinson's DL37738
Local Coverage Determination (LCD) began on 02/09/2023 and ended on
03/25/2023. The notice period for L37738 begins on 06/15/2023 and will become
effective on 07/30/2023.
Billing and Coding: MolDX: Molecular Biomarker Testing for Risk Stratification
of Cutaneous Squamous Cell Carcinoma

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell
Carcinoma.

To receive a denial, please submit the following claim information:

  * Select 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
Billing and Coding: Amniotic and Placental-Derived Product Injections and/or
Applications for Musculoskeletal Indications, Non-Wound

This Billing and Coding Article provides billing and coding guidance for Local
Coverage Determination (LCD) DL39624 Amniotic and Placental-Derived Product
Injections and/or Applications for Musculoskeletal Indications, Non-Wound.
Billing and Coding: Amniotic and Placental-Derived Product Injections and/or
Applications for Musculoskeletal Indications, Non-Wound

This Billing and Coding Article provides billing and coding guidance for Local
Coverage Determination (LCD) L39624 Amniotic and Placental-Derived Product
Injections and/or Applications for Musculoskeletal Indications, Non-Wound.
Response to Comments: MolDX: Prognostic and Predictive Molecular Classifiers
for Bladder Cancer

The comment period for the MolDX: Prognostic and Predictive Molecular
Classifiers for Bladder Cancer DL38586 Local Coverage Determination (LCD)
began on 06/23/2022 and ended on 08/06/2022. The notice period for L38586
begins on 07/06/2023 and will become effective on 08/20/2023.

The comments below were received from the provider community.
Response to Comments: MolDX: Molecular Assays for the Diagnosis of Cutaneous
Melanoma

The comment period for the MolDX: Molecular Assays for the Diagnosis of
Cutaneous Melanoma DL39373 Local Coverage Determination (LCD) began on
07/07/2022 and ended on 08/20/2022. The notice period for L39373 begins on
06/22/2023 and will become effective on 08/06/2023.

The comments below were received from the provider community.
Response to Comments: MolDX: Molecular Assays for the Diagnosis of Cutaneous
Melanoma

The comment period for the MolDX: Molecular Assays for the Diagnosis of
Cutaneous Melanoma DL39375 Local Coverage Determination (LCD) began on
07/07/2022 and ended on 08/20/2022. The notice period for L39375 begins on
06/22/2023 and will become effective on 08/06/2023.

The comments below were received from the provider community.
Response to Comments: Transcranial Magnetic Stimulation (TMS)

Noridian's Response to Provider Recommendations for Transcranial Magnetic
Stimulation (TMS) (for comment period ending 03/25/2023).
Response to Comments: Allogeneic Hematopoietic Cell Transplantation for
Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or
T-cell Origin

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 Allogeneic
Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin
and Non-Hodgkin Lymphoma with B-cell or T-cell Origin LCD. The official notice
period for the final LCD begins on June 15, 2023, and the final determination
will become effective on August 1, 2023.
Response to Comments: MolDX: Prognostic and Predictive Molecular Classifiers
for Bladder Cancer

The comment period for the MolDX: Prognostic and Predictive Molecular
Classifiers for Bladder Cancer DL38647 Local Coverage Determination (LCD)
began on 7/14/2022 and ended on 08/27/2022. The notice period for L38647
begins on 06/22/2023 and will become effective on 08/06/2023.
Response to Comments: MolDX: Prognostic and Predictive Molecular Classifiers
for Bladder Cancer

The comment period for the MolDX: Prognostic and Predictive Molecular
Classifiers for Bladder Cancer DL38649 Local Coverage Determination (LCD)
began on 7/14/2022 and ended on 08/27/2022. The notice period for L38649
begins on 06/22/2023 and will become effective on 08/06/2023.
Billing and Coding: Surgical Treatment of Nails

The information in this article contains billing, coding, or other guidelines
that complement the Local Coverage Determination (LCD) for Surgical Treatment
of Nails DL39258.

**Coding Guidelines**

When billing for non-covered services, use the appropriate modifier.

When CPT code 11730, 11732 or 11750 is reported, it represents all services
performed on that nail for that date of service (DOS). When lateral and medial
sides of a nail are involved, do not report a separate code for each border.

Reporting CPT codes 11730 or 11732 (avulsion) with CPT code 11750 (excision)
and/or 11765 (wedge resection) for the same digit on the same DOS is not
correct coding.

Reporting CPT code 11750 (excision) with CPT code 11765 (wedge resection)
for the same digit on the same DOS is not correct coding.

Reporting CPT code 11765 for the removal of a small piece of the skin and/or
the nail without local anesthesia is not correct coding.

If CPT procedure codes 11730, 11750, or 11765 are performed on different
nails, report the procedure performed with 1 unit of service (UOS) and append
with the appropriate identifying digit modifiers.

For every subsequent avulsion, CPT code 11732 is reported as the add-on code
with 1 UOS and the appropriate identifying digit modifier appended.

CPT codes 11730 and 11732 for nail avulsion will be denied if billed for the
same finger less than 16 weeks or the same toe less than 32 weeks) following a
previous avulsion.

A medically necessary repeat nail avulsion on the same finger less than 16
weeks or the same toe less than 32 weeks following a previous avulsion will be
considered on a redetermination. The medical record documentation must be
specific as to the indication, such as ingrown nail of the opposite border or
new significant pathology on the same border recently treated.

For a medically necessary repeat excision of the nail and nail matrix for
permanent removal on the same finger or the same toe following a previous
excision of the nail and nail matrix for permanent removal, the medical record
documentation must also be specific as to the indication, such as ingrown nail
of the opposite border or new significant pathology on the same border
recently treated.
Response to Comments: MolDX: Molecular Assays for the Diagnosis of Cutaneous
Melanoma

The comment period for the MolDX: Molecular Assays for the Diagnosis of
Cutaneous Melanoma DL39479 Local Coverage Determination (LCD) began on
09/29/2022 and ended on 11/12/2022. The notice period for L39479 begins on
06/29/2023 and will become effective on 08/13/2023.

The comments below were received from the provider community.
Response to Comments: MolDX: Prognostic and Predictive Molecular Classifiers
for Bladder Cancer

The comment period for the MolDX: Prognostic and Predictive Molecular
Classifiers for Bladder Cancer DL38684 Local Coverage Determination (LCD)
began on 09/29/2022 and ended on 11/12/2022. The notice period for L38684
begins on 06/29/2023 and will become effective on 08/13/2023.
Response to Comments: Urine Drug Testing

The comment period for the Urine Drug Testing Local Coverage Determination
(LCD) began on 04/27/023 and ended on 06/12/2023. The notice period for L36668
begins on 08/24/2023 and will become effective on 10/08/2023.
Response to Comments: Urine Drug Testing

The comment period for the Urine Drug Testing Local Coverage Determination
(LCD) began on 04/27/2023 and ended on 06/12/2023. The notice period for
L36707 begins on 08/24/2023 and will become effective on 10/08/2023.
Billing and Coding: MolDX: Gene Expression Profile Tests for Decision-Making
in Castration Resistant and Metastatic Prostate Cancers

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Gene
Expression Profile Tests for Decision-Making in Castration Resistant and
Metastatic Prostate Cancer DL39636.

Please submit the following claim information:

  * Select CPT code 81479
  * Only 1 test may be billed per patient
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPTcode 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 CPTcode 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
    * Code first the malignant neoplasm and then use an additional code as applicable to identify the hormone sensitivity status
Billing and Coding: MolDX: Molecular Testing for Risk Stratification of
Thyroid Nodules

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Testing for Risk Stratification of Thyroid Nodules DL39646.

__

MolDX expects this test will be performed once per patient lifetime. Should
the unlikely situation of a second, unrelated thyroid nodule with
indeterminate pathology occur, coverage may be considered upon appeal with
support documentation.

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

  * Select 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
Billing and Coding: MolDX: Molecular Biomarkers for Risk Stratification of
Indeterminate Pulmonary Nodules Following Bronchoscopy

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules
Following Bronchoscopy DL39654.

Please submit the following claim information:

  * Select CPT code 81479
  * Only 1 test may be billed per patient
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPTcode 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 CPTcode 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
Billing and Coding: MolDX: Molecular Biomarkers for Risk Stratification of
Indeterminate Pulmonary Nodules Following Bronchoscopy

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules
Following Bronchoscopy DL39658.

Please submit the following claim information:

  * Select CPT code 81479
  * Only 1 test may be billed per patient
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPTcode 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 CPTcode 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: Molecular Biomarker Testing to Guide Targeted
Therapy Selection in Rheumatoid Arthritis

The comment period for the MolDX: Molecular Biomarker Testing to Guide
Targeted Therapy Selection in Rheumatoid Arthritis DL39424 Local Coverage
Determination (LCD) began on 09/01/2022 and ended on 10/15/2022. The notice
period for L39424 begins on 08/31/2023 and will become effective on
10/15/2023.

The comments below were received from the provider community.
Billing and Coding: MolDX: Molecular Biomarker Testing to Guide Targeted
Therapy Selection in Rheumatoid Arthritis

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis
L39424.

Only 1 test may be performed for a given patient.

****

**Please submit the following claim information:**

  * Select 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
Billing and Coding: Homocysteine Level, Serum

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for Homocysteine Level,
Serum DL34419.

**Limitations:**

Serum homocysteine levels will not be covered other than for suspected
B12/folate deficiency, or for risk stratification for the conditions noted in
the  _ **ICD-10-CM Codes that Support Medical Necessity**_ section of this
article. It is covered only once in a lifetime for the initial determination
for risk stratification. Subsequent determinations will be covered only if
appropriate treatment does not correct the anemia or symptoms.
Response to Comments: Urine Drug Testing

Urine Drug Test LCD comment period was open 4/27/2023 and closed 6/10/2023.
This Article is in response to submitted comments.
Response to Comments: Urine Drug Testing

The comment period for the Urine Drug Testing DL35724 Local Coverage
Determination (LCD) began on 4/27/23 and ended on 6/10/23. The notice period
for L35724 begins on 8/24/23 and will become effective on 10/8/23.

The comments below were received from the provider community.
Response to Comments: Urinary Biomarkers for Chronic Pain Management

This article reviews comments received during the Open Comment Period for the
Proposed Policy Urinary Biomarkers for Chronic Pain Management.
Billing and Coding: MolDX: Molecular Biomarkers for Risk Stratification of
Indeterminate Pulmonary Nodules Following Bronchoscopy

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules
Following Bronchoscopy DL39678.

Please submit the following claim information:

  * Select CPT code 81479
  * Only 1 test may be billed per patient
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPTcode 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-CodeTM identifier adjacent to the CPTcode 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
Billing and Coding: MolDX: Molecular Biomarkers for Risk Stratification of
Indeterminate Pulmonary Nodules Following Bronchoscopy

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Biomarkers for Risk Stratification of Indeterminate Pulmonary Nodules
Following Bronchoscopy DL39680.

Please submit the following claim information:

  * Select CPT code 81479
  * Only 1 test may be billed per patient
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPTcode 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-CodeTM identifier adjacent to the CPTcode 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
Billing and Coding: MolDX: Molecular Testing for Risk Stratification of
Thyroid Nodules

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Testing for Risk Stratification of Thyroid Nodules DL39682.

__

MolDX expects this test will be performed once per patient lifetime. Should
the unlikely situation of a second, unrelated thyroid nodule with
indeterminate pathology occur, coverage may be considered upon appeal with
support documentation.

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

  * Select 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
    * Item 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
Billing and Coding: MolDX: Molecular Testing for Risk Stratification of
Thyroid Nodules

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Molecular
Testing for Risk Stratification of Thyroid Nodules DL39684.

__

MolDX expects this test will be performed once per patient lifetime. Should
the unlikely situation of a second, unrelated thyroid nodule with
indeterminate pathology occur, coverage may be considered upon appeal with
support documentation.

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

  * Select 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
    *  Item 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
Billing and Coding: MolDX: Gene Expression Profile Tests for Decision-Making
in Castration Resistant and Metastatic Prostate Cancers

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Gene
Expression Profile Tests for Decision-Making in Castration Resistant and
Metastatic Prostate Cancer DL39686.

Please submit the following claim information:

  * Select CPT code 81479
  * Only 1 test may be billed per patient
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPTcode 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-CodeTM identifier adjacent to the CPTcode 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
    * Code first the malignant neoplasm and then use an additional code as applicable to identify the hormone sensitivity status
Billing and Coding: MolDX: Gene Expression Profile Tests for Decision-Making
in Castration Resistant and Metastatic Prostate Cancers

The information in this article contains billing, coding or other guidelines
that complement the Local Coverage Determination (LCD) for MolDX: Gene
Expression Profile Tests for Decision-Making in Castration Resistant and
Metastatic Prostate Cancer DL39688.

Please submit the following claim information:

  * Select CPT code 81479
  * Only 1 test may be billed per patient
  * Enter 1 unit of service (UOS)
  * Enter the appropriate DEX Z-CodeTM identifier adjacent to the CPTcode 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-CodeTM identifier adjacent to the CPTcode 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
    * Code first the malignant neoplasm and then use an additional code as applicable to identify the hormone sensitivity status
Response to Comments: Skin Substitute Grafts/Cellular and/or Tissue-Based
Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers

The following are the comment summaries and contractor responses for Novitas
Solutions Proposed Local Coverage Determination (LCD) DL35041 Skin Substitute
Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic
Foot Ulcers and Venous Leg Ulcers which was posted for comment on April 14,
2022 and August 11, 2022, and presented at the Open Meetings on April 29,
2022, and August 26, 2022. All comments were reviewed and incorporated into
the final LCD where applicable. Comments on the same topic are grouped
together.