CMS Tells Contractors to have ICD-10 LCDs available by April 2014

According to a recent announcement by The Centers for Medicare and Medicaid (CMS), the Medicare Administrative Contractors (MACs) are required to post Local Coverage Decisions (LCDs) associated with the changeover to ICD-10 on the Medicare Coverage Database (MCD) no later than April 10, 2014.  All other LCDs and Articles (e.g., changes not affected by ICD-10) shall be published on the MCD no later than September 4, 2014.

In addition, CMS announced that “All LCDs and Articles will receive a new LCD/Article ID number (e.g., LCD ID 1234 will become LCD ID 4567)”  and this could have an impact on Medicare Administrative Contractors (MACs) local systems; such as changing their Medicare Summary Notice (MSN) to capture the new LCD/Article ID number.

Break Away from the Static

CMS has determined that although new LCD numbers will be assigned to the ICD-10 LCD policies, the policies shall not be considered new policies. Because this is just a change in the numbering (and not the underlying policy), CMS considers this type of update to be a coding revision.  Therefore, Contractors have been advised that as long as the change does not alter the “intent of coverage/non-coverage within an LCD” and only translates ICD-9 codes to the appropriate ICD-10 code, the policy does not need to be vetted through the Carrier Advisory Committee.   If, however, the MAC is revising more than just the codes, they must follow the normal LCD development process

ADVOCATE will continue to keep you informed on this and all issues impacting your practice.

Best regards,

Kirk Reinitz, CPA