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Dedicated to Lymphedema Patients and the Therapists Who Treat Them
LymphActivist's Site
Dedicated to Lymphedema Patients and the Therapists Who Treat Them
LymphActivist's Site
Dedicated to Lymphedema Patients and the Therapists Who Treat Them
MAC Open Meetings to Consider Local Coverage Determination on Bioimpedance Spectroscopy Devices for Detection and Management of Lymphedema (DL36141)
National Government Services, Inc. (NGS), Medicare Administrative Contractor for Part A/B and Home Health and Hospice Services, is planning Open Meetings on a number of Draft Local Coverage Determinations (LCDs), including a new LCD for the coverage of bioimpedance spectroscopy (BIS) devices for detection and management of lymphedema. The draft will establish Medicare reimbursement policy for the NGS states of Part A/B Jurisdiction K (CT, ME, MA, NH, NY, RI and VT) and Jurisdiction 6 (IL, MN and WI) [See page 8 of http://www.lymphactivist.org/medicare_101-insert.pdf]. Meetings will take place in New York City on June 17 for JK and in Minneapolis, MN on June 18 for J6. Details on the open meetings are available from National Government Services.
The proposed drafts will disallow coverage of BIS in the detection and management of lymphedema:
"Information to determine the usefulness of bioimpedance spectroscopy to assess the presence of lymphedema is currently inadequate to determine its clinical utility. Numbers of patients studied are small. Trials to examine its effect on clinical outcomes compared to other accepted techniques is lacking. Therefore, its use is considered investigational/not medically necessary in the Medicare population."
The comment period on these draft LCDs will be open from June 26, 2015 to August 9, 2015. Comments may be sent to:
National Government Services Medical Policy Unit
P.O. Box 7073
Indianapolis, IN 46207-7073
PartBLCDComments@anthem.com
The comment period on these draft LCDs will be open from June 26, 2015 to August 9, 2015. Instructions for commenting before or at the open meeting may be found in the Draft LCD DL36141 and details on the open meeting on the National Government Services web site http://www.ngsmedicare.com.
The full text of the proposed LCD is posted at http://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx by inserting the LCD Number "DL36141" into the SEARCH BY ID window
Previous announcements by ImpediMed implied that Medicare would cover the costs of BIS extracellular fluid analysis for lymphedema assessment, CPT 93702 [See page 43 of http://www.lymphactivist.org/medicare_101-insert.pdf], but the proposed LCD DL36141 would not allow claims by Medicare Providers in the ten states in NGS's jurisdictions.