medicare national coverage determinations manual 2021 pdf

][/lE7gj[VOG,^5> July 2017 (ICD-10) THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. Measurement of plasma HIV RNA levels should be performed at the time of establishment of an HIV infection diagnosis. endobj January 2022 (PDF) (ICD-10) An NCD sets forth the extent to which Medicare will cover specific services, procedures, or technologies on a national basis. It will contain information about Medicare National Coverage Determinations (NCDs). 1476 0 obj <>/Encrypt 1454 0 R/Filter/FlateDecode/ID[<3C25BBF2E2721941BD4AC7726C91DC5B><1790F444726A6247B813740B82426AED>]/Index[1453 36]/Info 1452 0 R/Length 110/Prev 370056/Root 1455 0 R/Size 1489/Type/XRef/W[1 3 1]>>stream recipient email address(es) you enter. =^|}rD"BrZp-spb@0\`d AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. stream 'AB@U79]O%"q2t(TUE]i;\mcLb":>#m :@ PYcncpSqlT phBhCU[2@ CdAv[\JNdiHHNN7 su 07/2002 - Implemented NCD. ?A|)vp1ICo+?Cl|H,H|> qq) XpRdgA]HykXew]~\y/R $\X _GDX`+rg~XvG+9/<9&(]}.Y`Arp!Xw YCD_?o- @' 9(C)fiQrH`?OD4a(tU:DGA9& KdJ3:hu$< EN2Syw9OD~y~jm )n62WlH"Asi=0N Local Coverage Determinations (LCD)s - Describes local coverage policy and provides educational tools to assist providers in their jurisdiction (Medicare Integrity Manual, Chap 13 13.1.3). The AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. The CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. To sign up for updates or to access your subscriber preferences, please enter your contact information below. 100-03 Medicare National Coverage Determinations Manual Chapter 1, Part 2, Section 140.4 - Plastic Surgery to Correct "Moon Face" The cosmetic surgery exclusion precludes payment for any surgical procedure directed at improving View coverage and billing requirements for sterilization services to prevent reproduction. The Centers for Medicare & Medicaid Services will continue to allow coverage of all other uses of CSII in accordance with the Category B investigational device exemption clinical trials regulation (42 CFR 405.201) or as a routine cost under the clinical trials policy (Medicare National Coverage Determinations Manual 310.1). October 2019 (PDF) (ICD-10) % Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) NCD 190.31 January 2021 Changes ICD-10-CM Version - Red Fu Associates, Ltd. January 2021 1 190.31 - Prostate Specific Antigen Other Names/Abbreviations Total PSA Description January 2020 (PDF) (ICD-10) Quantification assays of HIV plasma RNA are used prognostically to assess relative risk for disease progression and predict time to death, as well as to assess efficacy of antiretroviral therapies over time. endstream endobj startxref 1 0 obj C1^Q Ni=`*i);j1 %Uf%,|jNh#-O6^\mIb %914wQfiKzP&B]su!2sbU-j s#cLpNHpz;k}@&f_koHTO.sJ7i\`tg[f h}dlSR:=T0 d Z]JXc&1p)>'=AB- [2L^@ck)6:-Gkb%E6 HX`,_.K L7nAa OVe@*5KMn(Cl P-] P6xUZ5d*RjP.aZP,K&Z$,Da:fqp3 i_Djv"I-~ `*Xl)NReVg"m ^0 endstream endobj startxref Introduction to NCDs and LCDs: Learn What They Are and How to Find Them. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Use as a diagnostic test method is not indicated. If this is a U.S. Government information system, CMS maintains ownership and responsibility for its computer systems. By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. 55250, 58600, 58605, 58611, 58615, 58670, 58671. endobj Muo )tSW0e6q t-?j x . July 2017 endobj The document is broken into multiple sections. %PDF-1.5 % Nucleic acid quantification techniques are representative of rapidly emerging and evolving new technologies. Back to National Coverage NCD Report Results, https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/r17ncd.pdf. April 2022 These materials contain Current Dental Terminology, (CDT), copyright 2020 American Dental Association (ADA). This email will be sent from you to the 1. The Centers for Medicare & Medicaid Services finalized revisions to Applications are available at the AMA Web site, https://www.ama-assn.org. The purpose of this Change Request (CR) is to inform contractors that CMS has removed six National Coverage Determinations (NCDs) from the Medicare Publication (Pub.) CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. Manual Update. Medicare National Coverage Determination (NCD) Manual Sets policy for determining medical necessity for specific services The coverage determinations in the manual will be revised based on the most recent medical and other scientific and technical evidence available to CMS. Warning: you are accessing an information system that may be a U.S. Government information system. LICENSE FOR USE OF "PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY", (CPT) The CMS.gov Web site currently does not fully support browsers with These are developed and published by CMS and apply to all states. 354 0 obj <>stream April 2020 (PDF) (ICD-10) CPT codes, descriptions and other data only are copyright 2002-2020 American Medical Association (AMA). 200 Independence Avenue, S.W. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. January 2016 GSdP3DbPOCKL0fK October 2020 (PDF) (ICD-10) 5697 0 obj <>stream Final. NCDs generally outline the conditions for which a service is considered to be covered (or not covered) and usually issued as a program instruction. A federal government website managed and paid for by the U.S. Centers . hbbd```b`` ) Providers may also access the various CMS CRs and associated documents issued as part of the ICD-10 conversion activities related to NCDs from the CMS ICD-10 webpage. NCDs are published by The Centers for Medicare & Medicaid Services (CMS), and become effective as of the date listed in the transmittal that announces the manual revision. %PDF-1.6 % CMS Disclaimer <>>> (National Coverage Determination, Local Coverage Determinations and Local Coverage Articles). LCDs cannot contradict NCDs, but exist to clarify an NCD or address common coverage issues. Print the LCD or Article: Select the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD). hbbd``b`s]@)Hpn ' $ bc@QH10009` 5 In the absence of an NCD, coverage determinations will be made by the Medicare Administrative Contractors under 1862(a)(1)(A) of the of every MCD page. lock Coverage Determinations, Part 2 Sections 90 - 160.26 (PDF) Chapter 1 - Coverage Determinations, Part 1 Sections 10 - 80.12 (PDF) Chapter 1 - Coverage Determinations, Part 3 Sections 170 - 190.34 (PDF) . If Federal government websites often end in .gov or .mil. 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IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THESE AGREEMENTS CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. a^qvW)00Ex[=bQ?]Nq%L;Bz! excluded from coverage under Title XVIII of the Social Security Act (SSA) 1862(a)(10) of the Act.) The NCD will be published in the Medicare National Coverage Determinations Manual. Please click here to see all U.S. Government Rights Provisions. "H[`5d\@$k5_&xu9HL0 V"U?z blg201208`; ?u Billing and Coding: Positron Emission Tomography Scans Coverage. NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for a specific medical service procedure or device. In clinical situations where the risk of HIV infection is significant and initiation of therapy is anticipated, a baseline HIV quantification may be performed. Effective and Implementation dates NA. Assays vary both in methods used to detect viral RNA as well as in ability to detect viral levels at lower limits. DISCLAIMER . If you choose not to accept the agreement, you will return to the Noridian Medicare home page. ;;=.vS[H ep@1flP j!i,@v4~b7M?;ipv\LFQCeb{/AsQ.*0 q8. Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) NCD 190.18 January 2021 Changes ICD-10-CM Version - Red Fu Associates, Ltd. January 2021 3 Limitations 1. This license will terminate upon notice to you if you violate the terms of this license. CDT is a trademark of the ADA. You, your employees and agents are authorized to use CPT only as contained in the following authorized materials: Local Coverage Determinations (LCDs), training material, publications, and Medicare guidelines, internally within your organization within the United States for the sole use by yourself, employees and agents. 43644, 43645, 43770, 43845, 43846, 43847, 43775, Billing and Coding: Implantable Automatic Defibrillators. 331 0 obj <>/Encrypt 311 0 R/Filter/FlateDecode/ID[<58D03DAB1834B8F5690247B103881366>]/Index[310 45]/Info 309 0 R/Length 108/Prev 130122/Root 312 0 R/Size 355/Type/XRef/W[1 3 1]>>stream All rights reserved. View coverage, coding and billing information for Positron Emission Tomography Scans Coverage defined by the SSA, NCD and CMS manuals, including contractor determined coding criteria. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare and Medicaid Services (CMS). 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NCDs are made through an evidence-based process, with opportunities for public participation. endstream endobj startxref %%EOF Some of the Provider information contained on the Noridian Medicare web site is copyrighted by the American Medical Association, the American Dental Association, and/or the American Hospital Association. A federal government website managed by the January 2021 (PDF) (ICD-10) Last Reviewed: 1/9/2023 An official website of the United States government. Medical Service Agreement (MA MSA) - The "Agreement" between HMO and IPA to facilitate the provision of prepaid health care for members of the HMO. The CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties. "JavaScript" disabled. 5689 0 obj <>/Filter/FlateDecode/ID[<404F802F6D2B094FB36B21BC9F638550>]/Index[5671 27]/Info 5670 0 R/Length 93/Prev 893369/Root 5672 0 R/Size 5698/Type/XRef/W[1 3 1]>>stream 2294_10/5/2021. However, all employ some type of nucleic acid amplification technique to enhance sensitivity, and results are expressed as the HIV copy number. There are multiple ways to create a PDF of a document that you are currently viewing. You acknowledge that the AMA holds all copyright, trademark, and other rights in CPT. Making copies or utilizing the content of the UB-04 Manual or UB-04 Data File, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual / Data File or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. View NCD 250.3 coverage guidelines for intravenous immune globulin. To submit a comment or question to CMS, please use the Feedback/Ask a Question link available at the bottom It will contain information about Medicare National Coverage Determinations (NCDs). An official website of the United States government. hbbd```b``ok=dN .&"A`R ,2f`&d| b/)CD 3 h5 July 2021 (TN 17) (CR 2130), January 2023 (PDF) (ICD-10) }C/h:Lb5D)aLG(PelTBiNgq _D:w@8;McOZ Sign up to get the latest information about your choice of CMS topics in your inbox. QP-l8{4Wv2n}8KTQQc=x)s _['m>(LQQn(J0qc' Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). .a;~m#>(cI`JN8H6v P9kLl+hV3`+|B 9tV)su(`JccVR!X1Thks Q]K L;;) April 2018 (PDF) (ICD-10) End users do not act for or on behalf of the CMS. <>>> 2. Resource: The CMS Medicare National Coverage Determinations Manual (Pub. Use as a diagnostic test method is not indicated. 78429, 78430, 78431, 78432, 78433, 78434, 78459, 78491, 78492, 78608, 78609, 78811, 78812, 78813, 78814, 78815, 78816, A4641, A9515, A9526, A9552, A9555, A9580, A9586, A9587, A9588, A9591, A9592, A9593, A9594, A9597, A9598, G0235, Q9982, Q9983, Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence. April 2020 If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816. All Rights Reserved. u1OU~O kVy[ER;DqC|3a5#de` >~?FHWz7 WF0CZFO?f"n:1w&bzF. %PDF-1.6 % Downloads. Receive Medicare's "Latest Updates" each week. U.S. Department of Health & Human Services <> View Coverage and Billing requirements for Billing and Coding: Implantable Automatic Defibrillators coverage. October 2014. lock This page displays your requested National Coverage Determination (NCD). hb```,K@( (TN AB-02-110) (CR 2130), 07/2004 - Published NCD in the NCD Manual without change to narrative contained in PM AB-02-110. Medicare Benefit Policy Manual, Chapter 15, 50.4.5 - Off-Label Use of Drugs and Biologicals in an Anti -Cancer . var url = document.URL; Implementation date 1/01/03. Heres how you know. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. End Users do not act for or on behalf of the CMS. Effective January 1, 2022, the Centers for Medicare & Medicaid Services determined that no national coverage determination (NCD) is appropriate at this time for Enteral and Parenteral Nutritional Therapy. View bariatric surgery procedures defined by NCD as reasonable and necessary under specified conditions for the treatment of complications of morbid obesity. website belongs to an official government organization in the United States. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. % Last Updated Tue, 14 Feb 2023 14:51:54 +0000. You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles, You are leaving the CMS MCD and are being redirected to, Human Immunodeficiency Virus (HIV) Testing (Prognosis Including Monitoring), NCD - Human Immunodeficiency Virus (HIV) Testing (Prognosis Including Monitoring) (190.13). 64561, 64581, 64585, 64590, 64595, A4290, C1767, C1778, C1820, C1883, C1897, L8680, Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers - Coding and Billing. 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View coverage, coding and billing information for Outpatient Cardiac Rehabilitation defined by the SSA, NCD and CMS manuals, including contractor determined coding criteria. 4 April 2017 (ICD-10) required field. View coverage of Sacral Nerve Stimulation for Urinary and Fecal Incontinence as defined by the CMS National Coverage Determination (NCD) 230.18. DEPARTMENT: Regulatory Compliance Support POLICY DESCRIPTION: Medicare National and Local Coverage Determinations for Physician Professional Services and Non-Hospital Entities PAGE: 1 of 6 REPLACES POLICY: 10/1/11, 10/1/15, 2/1/17 EFFECTIVE DATE: December 1, 2021 REFERENCE NUMBER: REGS.OSG.007 APPROVED BY: Ethics and Compliance Policy Committee . California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands. Before you can enter the Noridian Medicare site, please read and accept an agreement to abide by the copyright rules regarding the information you find within this site. Any communication or data transiting or stored on this system may be disclosed or used for any lawful Government purpose. If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. endobj October 2018 (PDF) (ICD-10) Instructions for enabling "JavaScript" can be found here. Section 240.2.2 of the National Coverage Determination (NCD) Manual (Pub. These situations include: Persistence of borderline or equivocal serologic reactivity in an at-risk individual. Other manuals in this system in which coverage-related instructions may be found are: Pub 100-02 (Benefit Policy); Pub 100-04 (Claims Processing); Pub 100-05 (Medicare Secondary Payer); and January 2022 CMS has removed six National Coverage Determinations (NCDs) from the Medicare Publication (Pub.) 33202, 33203, 33215, 33216, 33217, 33218, 33220, 33223, 33224, 33225, 33230, 33231, 33240, 33241, 33243, 33244, 33249, 33262, 33263, 33264, 33270, 33271, 33272, 33273, C7537, C7538, C7539, C7540, G0448, Billing and Coding: Intravenous Immune Globulin (IVIg) - NCD 250.3. In order for any item to be covered by the DME MAC, it must fall into one of the benefit categories defined below. endobj The scope of this license is determined by the AMA, the copyright holder. July 2021 (PDF) (ICD-10) Prior to implementation of an NCD, CMS must first issue a Manual Transmittal, CMS ruling, or Federal Register Notice giving specific directions to claims-processing contractors. :{+ $= !~kse38>kxt$ F>I,bgGVJcQ$>cJ-Q4uPq?t/U90$b(KCM`T:^okzoku!k,k[+V. 2119e*4Boh\sJ#);1Y^c+G"+d"f#pE8hE}N8&)G3vR"uSmcD^NT (!vgrgb@W;;VP&5wP"HL[k.>$:H;@. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Effective date 11/25/02. NCDs generally outline the conditions for which a service is considered to be covered (or not covered) and usually issued as a program instruction. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. . View coverage, coding and billing information for Single Chamber and Dual Chamber Permanent Pacemakers defined by the Social Security Administration (SSA), National Coverage Determination (NCD) and CMS manuals, including contractor determined coding criteria. stream Limitations. 1 CBPe 3 ]J$-a$r`Cq K_`v1A G$h q$N2>(F x 'g A#o jj;mk5hz^=(?ljfqP@+@{,(B. January 2018 (ICD-10) October 2016 (ICD-10) October 2022 (PDF) (ICD-10) s0I}d$>Ig+rPb nTY[t5xP~W{0'^g2LbgR2rQj G8- pf. incorporated into a contract. UsXAh/p=ACF1B!e y@2]C4$x,91*9 4_?SSyCGt>DI3?$A~ADy7n4ex;%{qYFB6T+8SnTh+bi')x,W*_? 100-03, NCD Manual as a result of an NCD removal process through rulemaking in the Calendar Year 2021 Medicare Physician Fee Schedule (85 FR 84472, December 28, 2020). You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. Medicare Administrative Contractors (MAC)s of the changes associated with these NCDs effective September 27, 2021. 100-03) LCDs are published by each Medicare Administrative Contractor (MAC). AMA Disclaimer of Warranties and Liabilities License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. January 2017 Toll Free Call Center: 1-877-696-6775. `!DVA9K+$\=>?BW9)I::_ $^D?i)Q>h:k?%6t)rM@~C*N7p"ph*{ZMuu l W&[%Ty{+/khxu1AJo]$ydwPF78jzJi6 TW g\\\bu`um*9xpt(s3'UA3P4EjX[AhmQ glQg9 2124 0 obj <>stream Reproduced with permission. October 2021 April 2017 After examining the available medical evidence, the Centers for Medicare & Medicaid determines that no national coverage determination (NCD) is appropriate at this time. The frequency of viral load testing should be consistent with the most current Centers for Disease Control and Prevention guidelines for use of anti-retroviral agents in adults and adolescents or pediatrics. ;.Cc(JWuWp,Wov}t]L 8q;\VAY!/5,QAn!;l^>tN\X;&V2YQv6(&Ao)6Haw July 2019 F 9: 1f X" w5@EC!20 i&%_haJ@&nGH8Xk03Y2ff\]eo^p]|+tzH00Ss3:(M. xrFU)R8TJ owwK11L}pe}+j}]^W]mO[y{ax"=f^{M/_x/N~s;1w0" Om_[/_|\yo7/_|@@?XxZ'SL;1C`FXr else{document.getElementById("usprov").href="/web/"+"jeb"+"/help/us-government-rights";}, Advance Beneficiary Notice of Noncoverage (ABN), Cardiac and Pulmonary Rehabilitation Programs, Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), Acute Inpatient Prospective Payment System (IPPS) Hospital, Comprehensive Outpatient Rehabilitation Facility (CORF), Fee-for-Time Compensation Arrangements and Reciprocal Billing, Outpatient Prospective Payment System (OPPS), Provider Appeal Requests - PRRB or Contractor Hearings, Provider Statistical and Reimbursement (PS&R) System, Documentation Requests: How, Who and When to Send, Medical Documentation Signature Requirements, Supplemental Medical Review Contractor (SMRC), Unified Program Integrity Contractor (UPIC), Provider Outreach and Education Advisory Group (POE AG), PECOS and the Identity and Access Management System, Provider Enrollment Reconsiderations, CAPs, and Rebuttals, CMS Medicare Coverage Determination Process, click here to see all U.S. Government Rights Provisions, American Hospital Association Online Store, Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for Osteoarthritic Knees, View coverage guidelines for Arthroscopic Lavage and Debridement for Osteoarthritic Knees, Billing and Coding: Bariatric Surgery Coverage. Coding guidance now published in Medicare Lab NCD Manual. NCDs can be found in the Medicare National Coverage Determinations Manual (Pub. X8Y2/1X85nz]{XD#(7KFlLqY Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Billing and Coding: Outpatient Cardiac Rehabilitation. Issued by: Centers for Medicare & Medicaid Services (CMS). <> CMS DISCLAIMER. . National Coverage Determination (NCD) NCDs are national policy granting, limiting or excluding Medicare coverage for a specific medical item or service. By doing so, you can ensure your Medicare patients' lab tests are performed without delay and prevent disruptions to your office. For an accurate baseline, 2 specimens in a 2-week period are appropriate. Please do not use this feature to contact CMS. 0 /V[DNlEeekCef41Vo8K!rB_*?ET'/PV~qvl'|D7\ 8h(1zFb?SkQ!OBC+9T+gr~ 2 0 obj The responsibility for the content of this file/product is with Noridian Healthcare Solutions or the CMS and no endorsement by the AMA is intended or implied. July 2018 (PDF) (ICD-10) HIV quantification is often performed together with CD4+ T cell counts which provide information on extent of HIV induced immune system damage already incurred. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. You can use the Contents side panel to help navigate the various sections. Also see the Medicare Claims Processing Manual, Chapter 120, Clinical Laboratory Services Based on Negotiated Rulemaking. 7308 0 obj <> endobj the Coverage Issues Manual (CIM). October 2017 (ICD-10) Medical Review Department, medical policies, Advance Determination of Medicare Coverage (ADMC) process, and Prior Authorization. In rare instances, if there is contradicting information in the NCD and LCD, the NCD overrides the LCD. Medicare National Coverage Determinations Manual. Because differences in absolute HIV copy number are known to occur using different assays, plasma HIV RNA levels should be measured by the same analytical method. x]s3x`[nw4m4)"[} Af# Cr}/]l~,Uy~*A#/ca {jW3 _1/Pn~5WTWF@fXxGHxLP(yIL KBN_E_F"Y83UUOTyo}{_XT]w9Ig~[@BoDg;Q y"sY Qk=DTS=_}+h]TxX=h>b#PTq)#P Rx Users must adhere to CMS Information Security Policies, Standards, and Procedures. %%EOF Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with hT]lUCsiweb2;KC&d6 nX"&5B"C@! 0 hUoerfFY\;(K:: d8TdeR2`KBUC:$5!F0=KQ~0&uGy^ L(>y5!#MG>G9C8bC-&J92J}OE:-]ujPC,ep$3) <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 2098 0 obj <> endobj Regular periodic measurement of plasma HIV RNA levels may be medically necessary to determine risk for disease progression in an HIV-infected individual and to determine when to initiate or modify antiretroviral treatment regimens.

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