Medicare Coverage Updates September 2010

CMS recently announced an expansion of tobacco cessation counseling for Medicare beneficiaries.  Prior to the new coverage rules, only individuals with tobacco-related diseases were eligible for the counseling.  Under the new rules, all Medicare smokers are eligible to receive two individual tobacco cessation counseling attempts per year.  Each attempt may include up to four sessions for a total annual benefit of eight sessions.  Intermediate and intensive smoking cessation counseling services will be covered for outpatient and hospitalized beneficiaries who are smokers, as long as those services are furnished by qualified physicians and other Medicare-recognized practitioners.  Under the Affordable Care Act, effective Jan. 1, 2011, Medicare will cover preventive care services such as the tobacco cessation counseling services at no cost to beneficiaries.  View the Decision Memo for complete information.

Cahaba GBA announced the consolidation of duplicate Part A and Part B LCDs into single documents effective September 1, 2010.  Since the LCDs are identical, the consolidation does not alter the content or coverage, but only changes the policy number.  See the Cahaba Announcement for a list of the combined policies.

Cahaba GBA added three new articles to CMS Medicare Coverage Database for Pulmonary Rehabilitation, Cardiac Rehab and Intensive Cardiac Rehab, and Insertion of Posterior Spinous Process Distraction Device.  The articles detail the covered ICD-9-CM diagnosis codes that support medical necessity for these services.  Cahaba also updated several existing LCDs and a coverage article.  See the tables below for details and links.

All Cahaba LCDs and Articles can be found on the Cahaba website at the following link: http://www.cahabagba.com/part_a/policies_medical_review/lcd_active.htm