Source: https://www.federalregister.gov/documents/2004/09/24/04-21202/medicare-and-medicaid-programs-quarterly-listing-of-program-issuances-april-2004-through-june-2004
Timestamp: 2018-09-20 12:42:56
Document Index: 326752982

Matched Legal Cases: ['art 414', 'arts 411', 'art 424', 'art 412', 'art 412', 'arts 403', 'art 440', 'art 484', 'art 412', 'arts 403', 'arts 405', 'art 411', 'art 409', 'arts 405', 'art 401', 'art 422', 'art 162', 'arts 160', 'art 422', 'arts 160']

Federal Register :: Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-April 2004 Through June 2004
Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-April 2004 Through June 2004
57312-57324 (13 pages)
CMS-9023-N
[April 2004 Through June 2004]
https://www.federalregister.gov/d/04-21202 https://www.federalregister.gov/d/04-21202
Start Preamble Start Printed Page 57312
This notice lists CMS manual instructions, substantive and interpretive regulations, and other Federal Register notices that were published from April 2004 through June 2004, relating to the Medicare and Medicaid programs. This notice provides information on national coverage determinations (NCDs) affecting specific medical and health care services under Medicare. Additionally, this notice identifies certain devices with investigational device exemption (IDE) numbers approved by the Food and Drug Administration (FDA) that potentially may be covered under Medicare. Finally, this notice also includes listings of all approval numbers from the Office of Management and Budget for collections of information in CMS regulations.
Addendum IV lists all substantive and interpretive Medicare and Medicaid Start Printed Page 57313regulations and general notices published in the Federal Register during the quarter covered by this notice. For each item, we list the—
For each CMS publication listed in Addendum III, CMS publication and transmittal numbers are shown. To help FDLs locate the materials, use the CMS publication and transmittal numbers. For example, to find the Medicare Benefit Policy publication titled “Arrangements for Physical, Occupational, and Speech Language Pathology Services,” use CMS-Pub. 100-02, Transmittal No. 09.
June 28, 2002 (67 FR 43762) Start Printed Page 57314
[April through June 2004]
Medicare General Information (CMS—Pub. 100-01)
04 Scheduled Release for April Updates to Software and Pricing/Codes Files.
05 Release of Software.
06 Shared System Maintainer and Medicare Contractor Responsibilities for System Release. Shared System Testing Requirements for Maintainers, Beta Testers, and Contractors. Maintainers and Beta Testers—Required Levels of Testing. Minimum Testing Standards for Maintainers and Beta Testers.
Testing Standards Applicable to All Beta Testers. Testing Requirements Applicable to the Common Working File Data Centers. Timeframe Requirements for All Testing Entities. Testing Documentation Requirements. Definitions. Test Care Specification Standard.
07 The Health Insurance Portability and Accountability Act Privacy Rule.
Medicare Benefit Policy (CMS—Pub. 100-02)
09 Arrangements for Physical, Occupational, and Speech Language Pathology Services.
10 Chapter 6. General Partial Hospitalization Services.
11 Nurse Practitioner as Attending Physician in Hospice. Requirements—General. Timing and Content of Certification. Election by Health Maintenance Organization Enrollees. Benefit Coverage.
Nursing Care. Physicians' Services. Short-Term Inpatient Care. Continuous Home Care. Contracting With Physicians.
12 New Requirements for Chiropractic Billing of Active/Corrective Treatment and Maintenance Therapy. Chiropractor's Services. Necessity for Treatment. Treatment Parameters.
13 Diabetes Self-Management Training Services. Coverage Requirements. Certified Providers. Coding and Frequency of Training. Payment for Diabetes Self-Management Training.
Incident-To Provision. Bill Processing Requiring. Special Claims Processing Instructions for Fiscal Intermediaries.
14 Changes in the Medicare Benefit Policy Manual—Chapter 10. The Destination. Institution to Institution. Separately Payable Ambulance Transport Under Part B Versus Patient. Transportation That Is Covered Under a Packaged Institutional Services. Transports to and From Medical Services for Beneficiaries Who Are Not Inpatients. Multiple Patient Ambulance Transport.
15 Chapter 9. Requirements—General. Timing and Content of Content of Certification. Election by Health Maintenance Organization Enrollees. Benefit Coverage.
Nursing Care. Physicians' Services.
16 Confidential.
17 Incident-To Services on Form CMS-1500. Incident to Physician's Professional Services. Incident to Physician's Service In Clinic.
Medicare National Coverage Determinations (CMS—Pub. 100-03)
09 NCD—Ocular Photodynamic Therapy with Verteporfin for Age-Related Macular Degeneration.
10 Chapter 1—NCD Manual.
11 Reconsideration of NCD for Acupuncture.
11 Acupuncture for Fibromyalgia. Acupuncture for Osteoarthritis
13 Removal of Coding From NCD on Stem Cell Transplantation. Stem Cell Transplantation.
14 NCD—Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee.
15 Reconsideration of NCD for Sensory Nerve Conduction Threshold Test (Note that Change Request CR 3339 constitutes a technical correction to previously issued CR 2988 dated 03/19/04. CR 2988 should be discarded and replaced with 3339).
Sensory Nerve Conduction Threshold Test.
16 Internal Reconsideration of NCD for Cardiac Pacemakers. Cardiac Pacemakers.
Medicare Claims Processing (CMS—Pub. 100-04)
212 Confidential.
213 Payment To Be Sent to the Bank Similar Financial Institution in the Name of a Provider.
214 MSN Message. Remittance Advice Messages. Preventive Care.
215 Implementation of Skilled Nursing Facility Consolidated Billing Common. Working File Edit for Therapy Codes Considered Separately Physician Services. Edit for Therapy Services Separately Payable When Furnished by a Physician.
216 Chapter 32. Coverage and Billing for Home Prothrombin Time Monitoring for Anticoagulation Management. Coverage Requirements.
Intermediary Payment Requirements. Part A Payment Methods. Intermediary Billing Procedures. Bill Types. Revenue Codes. Intermediary Allowable Codes. Allowable Covered Diagnosis Codes.
Healthcare Common Procedure Coding System for Intermediaries. Carriers Billing Instructions. Healthcare Common Procedure Coding System for Carriers. Applicable Diagnosis Code for Carriers. Carrier Claims Requirements. Carrier Payment Requirements. Carrier and Intermediary General Claims Processing Instructions. Remittance Advice Notice. Medicare Summary Notice Message.
217 CR 3318, Full Replacement of CR3223, Implementation of the Analysis and Design Phases of the Physician Scarcity Bonus. CR 3318 rescinds CR 3223. Billing and Payment in a Physician Scarcity Area. Provider Education. Identifying Physician Scarcity Area Locations.
Claims Coding Requirements. Payment. Services Eligible for the Physician Scarcity Bonus. Remittance Messages. Post-Payment Review. Administrative and Judicial Review.
218 Implementation of the Analysis and Design Phases of the Revision to the Health Professional Shortage Area Bonus Payment. Provider Education. HPSA Designations. Claims Coding Requirements. Services Eligible for Health Professional Shortage Area Bonus Payment.
Remittance Messages. Post-Payment Review. Administrative and Judicial Review.
219 This CR fully replaces CR 3215, Implementation of the Analysis and Design Phases of the Revision to the Health Professional Shortage Area Bonus Payment.
220 Implementation of Section 414 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. General Coverage and Payment Policies. Billing Methods. Definitions. Carrier Calculation of Payment Amount.
General. Components of the Ambulance Fee Schedule. Zip Codes Determine Fee Schedule Amounts. Transition Overview.
221 Medicare Inpatient Rehabilitation Facilities Classification Requirements. Criteria That Must Be Met by Inpatient Rehabilitation Hospitals Counting a Comorbidity as One of the Listed Medical Conditions. Criteria That Must Be Met by Inpatient Rehabilitation Units.
Verification Process To Be Used To Determine if the Inpatient Rehabilitation Facility Met the Classification Criteria. Hospitals That Have Not Previously Participated in Medicare. Changes in the Status of an Inpatient Rehabilitation Facility Unit. New and Converted Inpatient Rehabilitation Facility Units.
Retroactive Adjustments for Provisionally Excluded Inpatient Rehabilitation Facilities or Beds. Verification of Compliance Using ICD-9-CM and Impairment Group Codes.
Medicare Secondary Payer (CMS—Pub. 100-05)
14 MSP Manual Update CR 2074. Fiscal and Intermediaries and Carriers Claim Processing Rules.
15 Change in Interest Calculation for Medicare Overpayment and Underpayments. Medicare Secondary Payer Recovery Claims (Re-Named and Revised).
16 Update Medicare Secondary Payer Group Health Recovery Demand Letters to Employers and Insurers for Data Match and Non-Data Match Debts. Insurer Letter.
Medicare Financial Management (CMS—Pub. 100-06)
38 Consolidation of Claims Crossover—Small Scale Initial Implementation. Consolidation of Medicare and Medicare Supplemental (Medigap) Health Insurance Policies.
39 Installation of Version 34.0 of the Provider Statistical and Reimbursement (PS&R) Reporting System.
40 Modification of Contractor Reporting of Operational and Workload Data Form 5. Body of Report.
41 Change in Interest Calculation for Medicare Overpayments and Underpayments and Medicare Secondary Payer Recoveries. Sample Demand Letter for Claims Accounts Receivables. Interest Accruals. Procedures for Applying Interest During Overpayment Recoupment. Notification to Provider Regarding Interest Assessment. Waiver and Adjustment of Interest Charges.
42 Unsolicited/Voluntary Refunds. General Information. Office of Inspector General Initiatives. Unsolicited/Voluntary Refund Accounts. Receiving and Processing Unsolicited/Voluntary Refund Checks When Identifying Information Is Provided.
Handling Checks or Associated Correspondence With Conditional Endorsements. Receiving and Processing Unsolicited/Voluntary Refund Checks When Identifying Information Is Provided. CMS Reporting Requirements. Overpayment Refund Form. Unsolicited/Voluntary Refund Checks—Summary Report. Education.
43 Expanded Identification and Workload Reporting for CMS Medicare System. Provider Overpayment Requirements System User Manual. Request Provider Overpayment Debt From the Provider Overpayment Requesting System.
General Information. Structure of the Workload Identifier. Initial Implementation. Basic Requirements and Uses of the Identifier. Maintenance of Contractor Workload Identifiers.
44 Notices of New Interest Rate for Medicare Overpayments and Underpayments CR 2830.
45 Addition of Instructions for Form CMS-2591 to Chapter 6. Monthly Intermediary Part A and Part B Appeals Report (Form CMS-2591). Purpose and Scope. Due Date. Completion of Items on Form CMS-2591. Heading.
A—Intermediary Appeal Request. B—Part B Hearing Results. C—Part A and Part B ALJ Hearings. D—Limitation of Liability. E—Part A and Part B Reopenings. Checking Reports.
46 Installation of Version 33.0 of the Provider Statistical and Reimbursement Reporting System-Modification of CR 3131.
47 Expanded Identification and Workload Reporting for CMS Medicare Systems. Provider Overpayment Requirements System User Manual. Request Provider Debts from the Provider Overpayment Requirements. History File. Request Ad Hoc Reports from ARMS. General Information.
Structure of the Workload Identifier. Initial Implementation. Basic Requirements and Uses of the Identifier. Maintenance of Contractor Workload Identifier.
48 This transmittal is rescinded and Replaced With Transmittal 50, dated July 30, 2004.
Medicare State Operations Manual) (Pub. 100-07)
1 Release of Basic Manual.
Medicare Program Integrity (CMS—Pub.100-08)
770 New Requirements for Self-Administered Drug Exclusion List Articles in the Medicare Coverage Database Articles.
71 Program Integrity Manual Revisions 72 Automated Prepayment Review.
73 Program Integrity Management Reporting System Section 7.2 of the Program Integrity Manual.
74 Skilled Nursing Facility Certification and Recertification. Medical Review of Certification and Recertification of Residents in Skilled Nursing Facilities.
75 Informing Beneficiaries About Which Local Medical Review Policy and /or Local Coverage Determination and /or National Coverage Determination Is Associated with Their Claim Denial.
76 Clarification of Complex Medical Review. Types of Prepayment and Postpayment Review.
77 Instructions for Carriers, DMERCs, FIs, and Full PSCs When Interacting With the Comprehensive Error Rate Testing (CERT) Contractor (i.e., Handling Appeals of CERT-Initiated Denials, Contracting Non-Responders, Tracking Over/Underpayments).
Affiliated Contractor Full PSC Communication With the CERT Contractor. Providing Sample Information to the CERT Contractor. Providing Review Information to the CERT Contractor. Disputing Disagreeing with a CERT Decision. Handling Overpayments and Underpayments Resulting from the CERT Findings. Handling Appeals Resulting from CERT Initiated Denials. Tracking Overpayments and Appeals.
Tracking Overpayments. Tracking Appeals. AC/Full PSC Requirements Involving CERT Information Dissemination. Contracting Non-Responders. Late Documentation. Voluntary Refunds.
LMRP/NCD. Medicare Program Integrity Manual Exhibits Table of Contents. CERT Formats for Carrier and DMERC Standard System. CERT PSC Contractor Feedback Data Entry Screen Version 1.01. Data Items Included on CERT Reports. Acceptable No Resolution Reasons.
Types of Referral of Non-Responding Providers. OIG Referral of Non-Responding Providers. Offices of Audit Services—Regions. Fee-For-Services-Appeal Processes.
78 Medical Review Progressive Corrective Action for Part A.
Medicare Contractor Beneficiary and Provider Communications (CMS—Pub. 100-09)
05 Manual Instruction for Updated Beneficiary Services Sections 5104 and 2958, and Beneficiary Services Section 20 of the Internet-Only Manual. Beneficiary Services. Guidelines for Telephone Services. Call Handling Requirements.
Customer Service Assessment and Management System Reporting Requirements. Disclosure of Information (Adherence to the Privacy Act and the Health Insurance Portability and Accountability Act Privacy Rule). Second Level Screening of Beneficiary and Provider Inquiries (Activity Code 13201) (CR-2719).
Second Level Screening of Provider Inquiries (Miscellaneous Code 13201/01). Medicare Customer Service Next Generation Desktop. Publication Requests. Medicare Participating Physicians and Suppliers Directory. Transfer of Part A Telephone/Written Inquiries Workload.
Local Medical Review Policy Local Coverage Determination Requests. Guidelines for Handling Beneficiary Written Inquiries (Activity Code 13002). Customer Service Plan (Activity Code 13004).
06 Provider/Supplier Communications—Revisions and Additions to Existing Contractor Requirements. Provider Services. Guidelines for Telephone Service. Toll Free Network Services. Publication of Toll Free Numbers.
Call Handling Requirements. Customer Service Assessment and Management System Reporting Requirements. CSR Qualifications. Staff Development and Training. Quality Call Monitoring. Disclosure of Information (Adherence to the Privacy Act). Fraud and Abuse.
Next Generation Desktop. Call Center User Group. Performance Improvements. Guidelines for Handling Written Inquiries. Contractor Guidelines for High Quality Written Responses to Inquiries. Walk-In-Inquiries. Guidelines for High Quality Walk-In-Service. Surveys.
Medicare Managed Care (CMS—Pub. 100-16)
48 Grievances, Organization Determinations, and Appeals.
49 Chapter 4—Benefits and Beneficiary Protections.
50 Chapter 20—Plan Communications Guide.
51 Revisions to Chapter 2—Medicare+Choice Enrollment and Disenrollment.
52 Chapter 17a and 17b.
53 Chapter 11—Revisions.
54 Chapter 19—Revisions.
55 Chapter 10, Organization Compliance With State Law and Preemption by Federal Law.
One Time Notification (CMS—Pub. 100-20)
67 Transmittal 67, Dated April 2, 2004, Was Rescinded and Replaced With Transmittal 81 dated May 14, 2004.
68 Transmittal 49 Implementation Data Extension.
69 Carrier Only Shared System Maintainer Hours for Resolution of Problems Detected as a Result of Implementation of CR 2525 and CR 2527.
70 How Fiscal Intermediaries Are To Record Coinsurance Amounts From the Provider. Statistical and Reimbursement Report for Providers Who Elected To Accept Reduced Coinsurance for Outpatient Prospective Payment System Services.
71 Update to the Healthcare Provider Taxonomy Codes Version 4.0.
72 Pub. 100-20, Transmittal 72, dated April 16, 2004, Is Rescinded and Replaced With Pub. 100-20, Transmittal 82 Dated May 14, 2004.
73 Revised American National Standards Institute X12N 837 Professional Health Care Claims Companion Document.
74 Emergency Correction Regarding Correction to Healthcare Common Procedure. Coding System Codes for Low Osmolar Contrast Material.
75 One Time Instructions for Audit Intermediary Cost Reporting Processes To Accommodate Claims Processing Error That Prevented Some Supply Charges From Being Reported on Home Health Prospective Payment System Claim.
76 Shared System Maintainer Hours for Resolution of Problems Detected During Health Insurance Portability and Accountability Act Transaction Release Testing.
77 Instructions Related to Redistribution of Unused Resident Positions, Section 422 of the Modernization Act of 2003 (MMA), P.L. 108-173, for Purposes of Graduate Medical Education Payment.
78 Renovate Override Code Processing in Common Working File.
79 18-Month Moratorium on Physician Self-Referrals to Specialty Hospitals; Processing of Form CMS-855A Applications To Become a Medicare Certified Hospital.
80 Medicare System Acceptance of New Provider Numbers for Home Health Agencies.
81 Requirement for Carriers, Durable Medical Equipment Regional Carriers, Fiscal Intermediaries, and Full Program Safeguard Contractors To Encourage Providers To Submit Medical Records to the Comprehensive Error Rate Testing Contractor for Use in the November 2004 Improper Medicare Fee-For-Service Payment Report.
82 This OTN Replaces Pub. 100-20, Transmittal 72, dated April 16, 2004. Changes in Determining Rural Status of Hospitals for Transitional Outpatient Payments for 2004.
83 Additional Health Insurance Health Insurance Portability and Accountability Act Coordination of Benefits Information for Trading Partners.
84 Reporting Medicare Secondary Payer Information on the Health Insurance Portability and Accountability Act of 1996 X12N 837 Created via Free Billing Software.
85 CD-ROM Initiative for Distribution of the Annual Disclosure, Dear Doctor Letter and Participation Enrollment Material.
86 Interface File From Recovery Management and Accounting System.
87 Instructions Related to Redistribution of Unused Resident Positions, Section 422 of the Medicare Modernization Act of 2003, P.L. 108-173, for Purpose of Graduate Medical Education Payments.
88 Clarification and Revision of Change Request 3084, Implementation of Section 508 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, (Public Law 108-173).
89 Shared System Maintainer Hours for Resolution of Problems Detected As a Result of Implementation of CR 2525 and CR 2527.
90 MMA Drug Pricing Update-Payment Limits for J7308 (Levulan Kerastick) and J9395 (Faslodex).
FR Vol. 69 page no.
April 6, 2004 17935 42 CFR part 414 CMS-1380-IFC Medicare Program; Manufacturer Submission of Manufacturer's Average Sales Price (ASP) Data for Medicare Part B Drugs and Biologicals.
April 6, 2004 17933 42 CFR parts 411 and 424 CMS-1810-CN Medicare Program; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships (Phase II); Correction.
April 23, 2004 22083 CMS-1363-N Medicare Program; Meeting of the Practicing Physicians Advisory Council.
April 23, 2004 22081 CMS-4071-N2 Medicare Program; Listening Sessions on Performance Measures for Public Reporting on the Quality of Hospital Care During April, May, and June 2004.
April 23, 2004 22080 CMS-4066-N Medicare Program; Meeting of the Advisory Panel on Medicare Education—May 11, 2004, Friday, April 23, 2004.
April 23, 2004 22079 CMS-1273-N Medicare Program; Public Meetings in Calendar Year 2004 for New Durable Medical Equipment Coding and Payment Determinations.
April 23, 2004 22065 CMS-5004-N Medicare Program; Voluntary Chronic Care Improvement Under Traditional Fee-for-Service Medicare.
April 23, 2004 21963 42 CFR part 424 CMS-1185-F Medicare Program; Elimination of Statement of Intent Procedures for Filing Medicare Claims.
May 7, 2004 25752 42 CFR part 412 CMS-1262-F Medicare Program; Changes to the Criteria for Being Classified as an Inpatient Rehabilitation Facility.
May 7, 2004 25674 42 CFR part 412 CMS-126-F Medicare Program; Prospective Payment System for Long-Term Care Hospitals: Annual Payment Rate Updates and Policy Changes, Part II.
May 18, 2004 28196 42 CFR parts 403, 412, 413, 418, 460, 480, 482, 483, 485, and 489 CMS-1428-P Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates, Part II.
May 18, 2004 28133 CMS-2189-N Medicaid Program; Real Choice Systems Change Grants.
May 28, 2004 30660 CMS-3130-N Medicare Program; Meeting of the Medicare Coverage Advisory Committee—July 14, 2004.
May 28, 2004 30659 CMS-4069-N Medicare Program; Open Public Meeting To Discuss Definitions of Regions for Regional Medicare Preferred Provider Organizations and Prescription Drug Plans Under the Medicare Modernization Act—July 21, 2004.
May 28, 2004 30658 CMS-1266-N Medicare Program; Public Meeting in Calendar Year 2004 for New Clinical Laboratory Tests Payment Determinations.
May 28, 2004 30656 CMS-2195-N Medicaid Program; Demonstration To Improve the Direct Service Community Workforce.
May 28, 2004 30654 CMS-1269-N Medicare Program; Establishment of the Emergency Medical Treatment and Labor Act (EMTALA) Technical Advisory Group (TAG) and Request for Nominations for Members.
May 28, 2004 30580 42 CFR part 440 CMS-2132-F Medicaid Program; Provider Qualifications for Audiologists.
June 2, 2004 31248 42 CFR part 484 CMS-1265-P Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2005, Part IV.
June 2, 2004 31125 CMS-1279-N Medicare Program; Request for Nominations for the Program Advisory Oversight Committee for the Competitive Acquisition of Durable Medical Equipment and Other Items.
June 2, 2004 31123 CMS-5033-N Medicare Program; Establishment of the Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End Stage Renal Disease Services and Request for Nominations for Members.
June 18, 2004 34169 CMS-2200-N3 Medicare Program; Meeting of the State Pharmaceutical Assistance Transition Commission—July 7, 2004.
June 22, 2004 34585 42 CFR part 412 OFR-generated correction Prospective Payment Systems for Inpatient Hospital Services—OFR Correction.
June 25, 2004 35920 42 CFR parts 403, 412, 413, 418, 460, 480, 482, 483, 485, and 489 CMS-1428-CN Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates; Correction, Part V.
June 25, 2004 35716 42 CFR parts 405, 413, and 417 CMS-1727-P Medicare Program; Provider Reimbursement Determinations and Appeals, Part II.
June 25, 2004 35650 CMS-3134-N Medicare Program; Town Hall Meeting on Potential Facility Qualifications for Expanded Coverage of Percutaneous Transluminal Angioplasty for Carotid Stenting Procedures
June 25, 2004 35634 CMS-9022-N Medicare and Medicaid Programs; Quarterly Listing of Program Issuances—January 2004 Through March 2004.
June 25, 2004 35634 CMS-2189-CN Medicaid Program; Real Choice Systems Change Grants; Correction Notice.
June 25, 2004 35529 42 CFR part 411 CMS-1809-F5 Medicare and Medicaid Programs; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships: Extension of Partial Delay of Effective Date.
June 25, 2004 35529 42 CFR part 409 CMS-1469-F2 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Correcting Amendment.
June 25, 20043 35527 42 CFR parts 405 and 414 CMS-1372-CN2 Medicare Program; Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004: Correction.
June 29, 2004 38898 CMS-5025-N Medicare Program; Medicare Replacement Drug Demonstration.
A national coverage determination (NCD) is a determination by the Secretary with respect to whether or not a particular item or service is covered nationally under Title XVIII of the Social Security Act, but does not include a determination of what code, if any, is assigned to a particular item or service covered under this title, or determination with respect to the amount of payment made for a particular item or service so covered. We include below all of the NCDs that were issued during the quarter covered by this notice. The entries below include information concerning completed decisions as well as sections on program and decision memoranda, which also announce pending decisions or, in some cases, explain why it was not appropriate to issue an NCD. We identify completed decisions by the section of the NCDM in which the decision appears, the title, the date the publication was issued, and the effective date of the decision. Information on completed decisions as well as pending decisions has also been posted on the CMS Web site at http://cms.hhs.gov/​coverage.Start Printed Page 57321
Pub. 100-03 NCDM
80.2 Ocular Photodynamic Therapy With Verteporfin for Age-Related Macular Degeneration 4/01/04 4/01/04
30.3 Acupuncture for Fibromyalgia 4/16/04 4/16/04
30.3 Acupuncture for Osteoarthritis 4/16/04 4/16/04
110.8.1 Stem Cell Transplantation 5/28/04 7/06/04
150.9 Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee 6/10/04 7/11/04
160.23 Sensory Nerve Conduction Threshold Tests 6/18/04 4/01/04
20.8 Cardiac Pacemakers 6/25/04 4/30/04
The following list includes all Category B IDEs approved by FDA during the 2nd quarter, April 2004 through June 2004.
G010048 B
G030067 B
G030123 B
G030163 B
G030242 B
G030251 B
G040003 B
G040004 B
G040011 B
G040036 B
G040038 B
G040050 B
G040053 B
G040054 B
G040055 B
G040056 B
G040058 B
G040059 B
G040060 B
G040061 B
G040062 B
G040066 B
G040067 B
G040068 B
G040069 B
G040075 B
G040076 B
G040077 B
G040078 B
G040079 B
G040080 B
G040083 B
G040085 B
G040087 B
G040089 B
G040093 B
G040106 B
[Approved CFR sections in title 42, title 45, and title 20 (Note: Sections in Title 45 are preceded by “45 CFR,” and sections in Title 20 are preceded by “20 CFR”)]
Approved CFR sections
0938-0008 414.40, 424.32, 424.44.
0938-0022 413.20, 413.24, 413.106.
0938-0023 424.103.
0938-0025 406.28, 407.27.
0938-0027 486.100-486.110.
0938-0033 405.807.
0938-0035 407.40.
0938-0037 413.20, 413.24.
0938-0041 408.6, 408.22.
0938-0042 410.40, 424.124.
0938-0045 405.711.
0938-0046 405.2133.
0938-0050 413.20, 413.24.
0938-0062 431.151, 435.1009, 440.250, 440.220, 442.1, 442.10-442.16, 442.30, 442.40, 442.42, 442.100-442.119, 483.400-483.480, 488.332, 488.400, 498.3-498.5.
0938-0065 485.701-485.729.
0938-0074 491.1-491.11.
0938-0080 406.7, 406.13.
0938-0086 420.200-420.206, 455.100-455.106.
0938-0101 430.30.
0938-0102 413.20, 413.24.
0938-0107 413.20, 413.24.
0938-0146 431.800-431.865.
0938-0147 431.800-431.865.
0938-0151 493.1405, 493.1411, 493.1417, 493.1423, 493.1443, 493.1449, 493.1455, 493.1461, 493.1469, 493.1483, 493.1489.
0938-0155 405.2470.
0938-0170 493.1269-493.1285.
0938-0193 430.10-430.20, 440.167.
0938-0202 413.17, 413.20.
0938-0214 411.25, 489.2, 489.20.
0938-0236 413.20, 413.24.
0938-0242 488.26, 442.30.
0938-0245 407.10, 407.11.
0938-0246 431.800-431.865.
0938-0251 406.7.
0938-0266 416.41, 416.83, 416.47, 416.48.
0938-0267 485.56, 485.58, 485.60, 485.64, 485.66, 410.65.
0938-0269 412.116, 412.632, 413.64, 413.350, 484.245.
0938-0270 405.376.
0938-0272 440.180, 441.300-441.305.
0938-0273 485.701-485.729.
0938-0279 424.5.
0938-0287 447.31.
0938-0296 413.170, 413.184.
0938-0300 431.800.
0938-0301 413.20, 413.24.
0938-0302 418.22, 418.24, 418.28, 418.56, 418.58, 418.70, 418.74, 418.83, 418.96, 418.100.
0938-0313 418.1-418.405.
0938-0328 482.12, 482.13, 482.21, 482.22, 482.27, 482.30, 482.41, 482.43, 482.45, 482.53, 482.56, 482.57, 482.60, 482.61, 482.62, 482.66, 485.618, 485.631.
0938-0334 491.9, 491.10.
0938-0338 486.104, 486.106, 486.110.
0938-0354 441.60.
0938-0355 488.26, 442.30.
0938-0357 409.40-409.50, 410.36, 410.170, 411.4-411.15, 421.100, 424.22, 484.18, 489.21.
0938-0358 412.20-412.30.
0938-0359 412.40-412.52.
0938-0360 488.60.
0938-0365 484.10, 484.11, 484.12, 484.14, 484.16, 484.18, 484.20, 484.36, 484.48, 484.52.
0938-0372 414.330.
0938-0378 482.60-482.62.
0938-0379 488.26, 442.30.
0938-0382 488.26, 442.30.
0938-0386 405.2100-405.2171.
0938-0391 488.18, 488.26, 488.28.
0938-0426 476.104, 476.105, 476.116, 476.134.
0938-0429 447.53.
0938-0443 473.18, 473.34, 473.36, 473.42.
0938-0444 1004.40, 1004.50, 1004.60, 1004.70.
0938-0445 412.44, 412.46, 431.630, 456.654, 466.71, 466.73, 466.74, 466.78.
0938-0447 405.2133.
0938-0448 405.2133, 45 CFR 5, 5b; 20 CFR part 401 and part 422, subpart E.
0938-0449 440.180, 441.300-441.310.
0938-0454 424.20.
0938-0456 412.105.
0938-0463 413.20, 413.24, 413.106.
0938-0467 431.17, 431.306, 435.910, 435.920, 435.940-435.960.
0938-0469 417.107, 417.478.
0938-0470 417.143, 422.6, 417.800-417.840.
0938-0477 412.92.
0938-0484 424.123.
0938-0501 406.15.
0938-0502 433.138.
0938-0512 486.304, 486.306, 486.307.
0938-0526 475.102, 475.103, 475.104, 475.105, 475.106.
0938-0534 410.38, 424.5.
0938-0544 493.1-493.2001.
0938-0564 411.32.
0938-0565 411.20-411.206.
0938-0566 411.404, 411.406, 411.408.
0938-0573 412.256, 412.230.
0938-0578 447.534.
0938-0581 493.1-493.2001.
0938-0599 493.1-493.2001.
0938-0600 405.371, 405.378, 413.20.
0938-0610 417.436, 417.801, 422.128, 430.12, 431.20, 431.107, 434.28, 483.10, 484.10, 489.102.
0938-0612 493.801, 493.803, 493.1232, 493.1233, 493.1234, 493.1235, 493.1236, 493.1239, 493.1241, 493.1242, 493.1249, 493.1251, 493.1252, 493.1253, 493.1254, 493.1255, 493.1256, 493.1261, 493.1262, 493.1263, 493.1269, 493.1273, 493.1274, 493.1278, 493.1283, 493.1289, 493.1291, 493.1299.
0938-0618 433.68, 433.74, 447.272.
0938-0653 493.1771, 493.1773, 493.1777.
0938-0657 405.2110, 405.2112.
0938-0658 405.2110, 405.2112.
0938-0659 456.700, 456.705, 456.709, 456.711, 456.712.
0938-0667 482.12, 488.18, 489.20, 489.24.
0938-0679 410.38.
0938-0685 410.32, 410.71, 413.17, 424.57, 424.73, 424.80, 440.30, 484.12.
0938-0686 493.551-493.557.
0938-0688 486.304, 486.306, 486.307, 486.310, 486.316, 486.318, 486.325.
0938-0690 488.4-488.9, 488.201.
0938-0691 412.106.
0938-0692 466.78, 489.20, 489.27.
0938-0701 422.152.
0938-0702 45 CFR 146.111, 146.115, 146.117, 146.150, 146.152, 146.160, 146.180.
0938-0703 45 CFR 148.120, 148.124, 148.126, 148.128.
0938-0713 441.16, 489.66, 489.67.
0938-0714 411.370-411.389.
0938-0717 424.57.
0938-0721 410.33.
0938-0722 422.370-422.378.
0938-0723 421.300-421.318.
0938-0730 405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61, 415.110, 424.24.
0938-0732 417.126, 417.470.
0938-0734 45 CFR 5b.
0938-0739 413.337, 413.343, 424.32, 483.20.
0938-0742 422.300-422.312.
0938-0749 424.57.
0938-0753 422.000-422.700.
0938-0754 441.152.
0938-0758 413.20, 413.24.
0938-0760 484 subpart E, 484.55.
0938-0761 484.11, 484.20.
0938-0763 422.1-422.10, 422.50-422.80, 422.100-422.132, 422.300-422.312, 422.400-422.404, 422.560-422.622.
0938-0770 410.2.
0938-0778 422.111, 422.64.
0938-0779 417.470, 417.126, 422.210, 422.64.
0938-0781 411.404-411.406, 484.10.
0938-0783 422.66, 422.562, 422.564, 422.568, 422.570, 422.572, 422.582, 422.584, 422.586, 422.590, 422.594, 422.602, 422.612, 422.618, 422.619, 422.620, 422.622.
0938-0786 438.352, 438.360, 438.362, 438.364.
0938-0787 406.28, 407.27.
0938-0790 460.12, 460.22, 460.26, 460.30, 460.32, 460.52, 460.60, 460.70, 460.71, 460.72, 460.74, 460.80, 460.82, 460.98, 460.100, 460.102, 460.104, 460.106, 460.110, 460.112, 460.116, 460.118, 460.120, 460.122, 460.124, 460.132, 460.152, 460.154, 460.156, 460.160, 460.164, 460.168, 460.172, 460.190, 460.196, 460.200, 460.202, 460.204, 460.208, 460.210.
0938-0792 491.8, 491.11.
0938-0798 413.24, 413.65, 419.42.
0938-0802 419.43.
0938-0818 410.141, 410.142, 410.143, 410.144, 410.145, 410.146, 414.63.
0938-0829 422.568.
0938-0832 489.
0938-0833 483.350-483.376.
0938-0841 431.636, 457.50, 457.60, 457.70, 457.340, 457.350, 457.431, 457.440, 457.525, 457.560, 457.570, 457.740, 457.750, 457.810, 457.940, 457.945, 457.965, 457.985, 457.1005, 457.1015, 457.1180.
0938-0842 412.23, 412.604, 412.606, 412.608, 412.610, 412.614, 412.618, 412.626, 413.64.
0938-0846 411.1, 411.350-411.357, 424.22.
0938-0857 419.
0938-0860 419.
0938-0866 45 CFR part 162.
0938-0872 483.20, 413.337.
0938-0873 422.152.
0938-0874 45 CFR parts 160 and 162.
0938-0878 Part 422 subparts F and G.
0938-0883 45 CFR parts 160 and 164.
0938-0884 405.940.
0938-0887 45 CFR 148.316, 148.318, 148.320.
0938-0897 412.22, 412.533.
0938-0907 412.230, 412.304, 413.65.
0938-0910 422.624, 422.626, 422.620.
0938-0911 426.400, 426.500.
0938-0916 483.16.
0938-0920 438.6, 438.8, 438.10, 438.12, 438.50, 438.56, 438.102, 438.114, 438.202, 438.206, 438.207, 438.240, 438.242, 438.402, 438.404, 438.406, 438.408, 438.410, 438.414, 438.416, 438.710, 438.722, 438.724, 438.810.
[FR Doc. 04-21202 Filed 9-23-04; 8:45 am]