Cahaba GBA Coverage Updates May 2010

Effective for May 1, 2010, Cahaba GBA, Medicare Administrative Contractor (MAC) for Alabama, published two educational coverage articles and updated the LCD for Rituxan.

Educational Article: 0193T (Transurethral radiofrequency micro-modeling of the female bladder neck and proximal urethra for stress urinary incontinence (A49858) provides coverage guidance and the appropriate ICD-9 diagnosis codes when billing for this service.

NCD - Ocular Photodynamic Therapy (OPT (A49819) outlines the appropriate ICD-9 diagnosis codes when billing for these services, in accordance with instructions outlined in the Medicare National Coverage Determinations (NCD) Manual (Pub 100-03), Chapter 1, Part 1, Section 80.2.

LCD on Drugs and Biologicals: Rituximab (Rituxan®) (L30002) is being updated.

• Autoimmune hemolytic anemias were added to the ‘Indications’ section as an off-label use. ICD-9 diagnosis code 283.0 is being added to the list of ‘ICD-9 Codes that Support Medical Necessity’ for this use.
• This LCD has been revised to delineate between the FDA indications and the off-label uses.

All Cahaba GBA LCDs and Articles can be accessed from the Local Coverage Determinations (LCDs) and Articles page of their web site, where you can click on your state for the information you need.

Coverage updates and other Cahaba information is available at www.cahabagba.com.