Highmark Medicare Local Coverage Determinations (LCDs)

Highmark Medicare Services has published the initial draft set of LCDs as part of its plans to fulfill CMS requirements to consolidate ICEs by July 1, 2008. Highmark’s instructions for submitting comments for the proposed Local Coverage Determinations (LCDs) and the proposed LCDs are included in the attached link. The following LCDs are included:

  • Approved Drugs and Biologicals
  • Blepharoplasty/Blepharoptosis
  • Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)
  • Botulinum Toxin Type A and B
  • Cancer Chemotherapeutic Agents
  • Cardiovascular Stress Testing
  • Cataract Surgery
  • Chiropractic Services
  • Co-Management of Surgical Procedures
  • Complex Cataract Extraction
  • Computed Tomographic Angiography of the Chest
  • Consultations
  • Coverage of Services and Procedures in Nursing Facilities
  • Routine Foot Care
  • Debridement of Mycotic Nails
  • Diagnostic Laryngoscopy
  • Monitored Anesthesia Care (MAC)
  • Electrocardiography
  • End – Diagnostic Pneumatic Compression Therapy
  • Erythropoiesis Stimulating Agents (ESAs)
  • Evaluation and Management Services in a Nursing Facility
  • Fluorescein and Indocyanine Green Angiography
  • Fundus Photography
  • Intraoperative Neurophysiological Testing
  • Luteinizing Hormone-Releasing (LHRH) Analogs
  • Magnetic Pelvic Floor Stimulation (MPFS)
  • Magnetic Resonance Imaging (MRI) of the Breast
  • Moh’s Micrographic Surgery (MMS)
  • Non-Invasive Cerebrovascular Arterial Studies
  • Non-Invasive Peripheral Venous Studies
  • Ophthalmic A and B scans
  • Ophthalmic Biometry for Intraocular Leans (IOL) Power Calculation
  • Ophthalmoscopy Extended
  • Parathormone (Parathyroid Hormone)
  • Paravertebral Facet Joint Nerve Block and Sacroiliac Joint Injections
  • Physical Medicine and Rehabilitation Services, PT and OT
  • Psychiatric Therapeutic Procedures
  • Radiation Therapy Services
  • Radiologic Examination of the Chest (CXR)
  • Real-Time, Outpatient Cardiac Monitoring
  • Removal of Benign or Premalignant Skin Lesions
  • Removal of Impacted Cerumen
  • Scanning Computerized Ophthalmic Diagnostic Imaging
  • Sleep Disorder Testing
  • Speech-Language Pathology (SLP) Services
  • Surgical Treatment of Nails
  • Surveillance of Implantable Cardioverter-Defibrillator (ICD), Office, Internet or Non-Internet Based
  • Thermotherapies (Minimally Invasive Surgical Techniques [MISTs] for Benign Prostatic Hypertrophy (BPH))
  • Transesopageal Echocardiography (TEE)
  • Transthoracic Echocardiography (TTE)
  • Treatment of Dysphagia (Swallowing Disorders), General; Includes VitalStim® Therapy
  • Treatment of Varicose Veins of the Lower Extremities
  • Trigger Point Injections
  • Visual Fields
  • Wound Care
  • Acute Care: Inpatient, Observation, and Treatment Room Services
  • Human Skin Equivalents (HSE) – Use in the Treatment of Chronic Cutaneous Ulcer Wounds

http://www.highmarkmedicareservices.com/transition/j12/lcd.html