Cahaba GBA LCD Updates December 2009
Cahaba GBA recently published revisions to the following Local Coverage Determinations (LCDs):
- Upper Gastrointestinal Endoscopy
- Gemcitabine Hydrochloride (Gemzar)
- MRI of the Brain and MRI of the Spine
LCD Updates effective December 1, 2009
Effective December 1, 2009, Cahaba GBA is updating two LCDs with additional diagnoses that support Medical Necessity.
The following diagnosis code is added to the list of ‘ICD-9 Codes that Support Medical Necessity’ for Surgery: Upper Gastrointestinal Endoscopy (L30021)
- 577.9 (Unspecified disease of pancreas)
The following diagnosis code is added to the list of ‘ICD-9 Codes that Support Medical Necessity’ for Drugs and Biologicals: Gemcitabine Hydrochloride (Gemzar ®) (L29995):
- 179 (Malignant neoplasm of uterus, part unspecified)
LCD Update for MRIs
As a result of CMS CR 6672, Cahaba GBA published an update of their Local Coverage Determinations (LCDs) for MRI of the Brain and MRI of the Spine to allow coverage for blood flow measurement if all other requirements of the LCD are met. Effective September 28, 2009, the ‘Limitations’ sections of these LCDs were revised to remove the reference to the use of MRI for blood flow measurement as investigational.
All LCDs for Alabama can be viewed at this link on the Cahaba GBA website:
Local Coverage Determinations (LCDs) and Articles