Astiva Health : NCD

NATIONAL MEDICARE COVERAGE DETERMINATIONS

Title

Link URL

10.1

Use of Visual Tests Prior to and General Anesthesia during Cataract Surgery

10.2

Transcutaneous Electrical Nerve Stimulation (TENS) for Acute Post-Operative Pain

10.3

Inpatient Hospital Pain Rehabilitation Programs

10.4

Outpatient Hospital Pain Rehabilitation Programs

10.5

Autogenous Epidural Blood Graft

10.6

Anesthesia in Cardiac Pacemaker Surgery

100.1

Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid Obesity

100.10

Injection Sclerotherapy for Esophageal Variceal Bleeding

100.12

Gastrophotography

100.13

Laparoscopic Cholecystectomy

100.2

Endoscopy

100.3

24-Hour Ambulatory Esophageal pH Monitoring

100.4

Esophageal Manometry

100.5

Diagnostic Breath Analyses

100.6

Gastric Freezing

100.7

Colonic Irrigation

100.8

Intestinal Bypass Surgery - RETIRED

110.1

Hyperthermia for Treatment of Cancer

110.10

Intravenous Iron Therapy

110.11

Food Allergy Testing and Treatment

110.12

Challenge Ingestion Food Testing

110.13

Cytotoxic Food Tests

110.14

Apheresis (Therapeutic Pheresis)

110.15

Ultrafiltration, Hemoperfusion and Hemofiltration

110.16

Nonselective (Random) Transfusions and Living Related Donor Specific Transfusions (DST) in Kidney Transplantation

110.17

Anti-Cancer Chemotherapy for Colorectal Cancer

110.18

Aprepitant for Chemotherapy-Induced Emesis

110.2

Certain Drugs Distributed by the National Cancer Institute

110.20

Blood Brain Barrier Osmotic Disruption for Treatment of Brain Tumors

110.21

Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions

110.22

Autologous Cellular Immunotherapy Treatment

110.23

Stem Cell Transplantation (Formerly 110.8.1)

110.24

Chimeric Antigen Receptor (CAR) T-cell Therapy

110.3

Anti-Inhibitor Coagulant Complex (AICC)

110.4

Extracorporeal Photopheresis

110.5

Granulocyte Transfusions

110.6

Scalp Hypothermia During Chemotherapy to Prevent Hair Loss

110.7

Blood Transfusions

110.8

Blood Platelet Transfusions

110.9

Antigens Prepared for Sublingual Administration

130.1

Inpatient Hospital Stays for Treatment of Alcoholism

130.2

Outpatient Hospital Services for Treatment of Alcoholism

130.3

Chemical Aversion Therapy for Treatment of Alcoholism

130.4

Electrical Aversion Therapy for Treatment of Alcoholism

130.5

Treatment of Alcoholism and Drug Abuse in a Freestanding Clinic

130.6

Treatment of Drug Abuse (Chemical Dependency)

130.7

Withdrawal Treatments for Narcotic Addictions

130.8

Hemodialysis for Treatment of Schizophrenia

140.2

Breast Reconstruction Following Mastectomy

140.5

Laser Procedures

140.6

Wrong Surgical or Other Invasive Procedure Performed on a Patient

140.7

Surgical or Other Invasive Procedure Performed on the Wrong Body Part

140.8

Surgical or Other Invasive Procedure Performed on the Wrong Patient

140.9

Gender Dysphoria and Gender Reassignment Surgery

150.1

Manipulation

150.10

Lumbar Artificial Disc Replacement (LADR)

150.11

Thermal Intradiscal Procedures (TIPs)

150.12

Collagen Meniscus Implant

150.13

Percutaneous Image-Guided Lumbar Decompression for Lumbar Spinal Stenosis

150.2

Osteogenic Stimulators

150.3

Bone (Mineral) Density Studies

150.5

Diathermy Treatment

150.6

Vitamin B12 Injections to Strengthen Tendons, Ligaments, etc., of the Foot

150.7

Prolotherapy, Joint Sclerotherapy, and Ligamentous Injections with Sclerosing Agents

150.8

Fluidized Therapy Dry Heat for Certain Musculoskeletal Disorders

150.9

Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee

160.1

Induced Lesions of Nerve Tracts

160.10

Evoked Response Tests

160.12

Neuromuscular Electrical Stimulation (NMES)

160.13

Supplies Used in the Delivery of Transcutaneous Electrical Nerve Stimulation (TENS) and Neuromuscular Electrical Stimulation (NMES)

160.14

Invasive Intracranial Pressure Monitoring

160.15

Electrotherapy for Treatment of Facial Nerve Paralysis (Bell's Palsy)

160.16

Vertebral Axial Decompression (VAX-D)

160.17

L-Dopa

160.18

Vagus Nerve Stimulation (VNS)

160.19

Phrenic Nerve Stimulator

160.2

Treatment of Motor Function Disorders with Electric Nerve Stimulation

160.20

Transfer Factor for Treatment of Multiple Sclerosis

160.21

Telephone Transmission of EEGs

160.23

Sensory Nerve Conduction Threshold Tests (sNCTs)

160.24

Deep Brain Stimulation for Essential Tremor and Parkinson’s Disease

160.25

Multiple Electroconvulsive Therapy (MECT)

160.26

Cavernous Nerves by Electrical Stimulation with Penile Plethsmography

160.27

Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low Back Pain (CLBP)

160.5

Stereotaxic Depth Electrode Implantation

160.7

Electrical Nerve Stimulators

160.7.1

Assessing Patient's Suitability for Electrical Nerve Stimulation Therapy

160.8

Electroencephalographic Monitoring During Surgical Procedures Involving the Cerebral Vasculature

170.1

Institutional and Home Care Patient Education Programs

170.2

Melodic Intonation Therapy

170.3

Speech-Language Pathology Services for the Treatment of Dysphagia

180.1

Medical Nutrition Therapy

190.1

Histocompatibility Testing

190.10

Laboratory Tests - CRD Patients

190.11

Home Prothrombin Time/International Normalized Ratio (PT/INR) Monitoring for Anticoagulation Management

190.12

Urine Culture, Bacterial

190.13

Human Immunodeficiency Virus (HIV) Testing (Prognosis Including Monitoring)

190.14

Human Immunodeficiency Virus (HIV) Testing (Diagnosis)

190.15

Blood Counts

190.16

Partial ThromboplastinTime (PTT)

190.17

Prothrombin Time (PT)

190.18

Serum Iron Studies

190.19

Collagen Crosslinks, any Method

190.2

Diagnostic Pap Smears

190.20

Blood Glucose Testing

190.21

Glycated Hemoglobin/Glycated Protein

190.22

Thyroid Testing

190.23

Lipid Testing

190.24

Digoxin Therapeutic Drug Assay

190.25

Alpha-fetoprotein

190.26

Carcinoembryonic Antigen

190.27

Human Chorionic Gonadotropin

190.28

Tumor Antigen by Immunoassay - CA 125

190.29

Tumor Antigen by Immunoassay - CA 15-3/CA 27.29

190.3

Cytogenetic Studies

190.30

Tumor Antigen by Immunoassay - CA 19-9

190.31

Prostate Specific Antigen

190.32

Gamma Glutamyl Transferase

190.33

Hepatitis Panel/Acute Hepatitis Panel

190.34

Fecal Occult Blood Test

190.5

Sweat Test

190.6

Hair Analysis

190.7

Human Tumor Stem Cell Drug Sensitivity Assays

190.8

Lymphocyte Mitogen Response Assays

190.9

Serologic Testing for Acquired Immunodeficiency Syndrome (AIDS)

20.1

Vertebral Artery Surgery

20.10.1

Cardiac Rehabilitation Programs for Chronic Heart Failure

20.11

Intraoperative Ventricular Mapping

20.12

Diagnostic Endocardial Electrical Stimulation (Pacing)

20.13

HIS Bundle Study

20.14

Plethysmography

20.15

Electrocardiographic Services

20.16

Cardiac Output Monitoring by Thoracic Electrical Bioimpedance (TEB)

20.17

Noninvasive Tests of Carotid Function

20.18

Carotid Body Resection/Carotid Body Denervation

20.19

Ambulatory Blood Pressure Monitoring

20.2

Extracranial-Intracranial (EC-IC) Arterial Bypass Surgery

20.20

External Counterpulsation (ECP) Therapy for Severe Angina

20.21

Chelation Therapy for Treatment of Atherosclerosis

20.22

Ethylenediamine-Tetra-Acetic (EDTA) Chelation Therapy for Treatment of Atherosclerosis

20.23

Fabric Wrapping of Abdominal Aneurysms

20.24

Displacement Cardiography

20.25

Cardiac Catheterization Performed in Other than a Hospital Setting - RETIRED

20.26

Partial Ventriculectomy

20.27

Cardiointegram (CIG) as an Alternative to Stress Test or Thallium Stress Test

20.28

Therapeutic Embolization

20.29

Hyperbaric Oxygen Therapy

20.3

Thoracic Duct Drainage (TDD) in Renal Transplants

20.30

Microvolt T-Wave Alternans (MTWA)

20.31

Intensive Cardiac Rehabilitation (ICR) Programs

20.31.1

The Pritikin Program

20.31.2

Ornish Program for Reversing Heart Disease

20.31.3

Benson-Henry Institute Cardiac Wellness Program

20.32

Transcatheter Aortic Valve Replacement (TAVR)

20.33

Transcatheter Edge-to-Edge Repair (TEER) for Mitral Valve Regurgitation

20.34

Percutaneous Left Atrial Appendage Closure (LAAC)

20.35

Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)

20.4

Implantable Cardioverter Defibrillators (ICDs)

20.6

Transmyocardial Revascularization (TMR)

20.7

Percutaneous Transluminal Angioplasty (PTA)

20.8

Cardiac Pacemakers

20.8.1

Cardiac Pacemaker Evaluation Services

20.8.1.1

Transtelephonic Monitoring of Cardiac Pacemakers

20.8.2

Self-Contained Pacemaker Monitors

20.8.3

Cardiac Pacemakers: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers

20.8.4

Leadless Pacemakers

20.9.1

Ventricular Assist Devices

200.1

Nesiritide for Treatment of Heart Failure Patients

200.2

Nebulized Beta Adrenergic Agonist Therapy for Lung Diseases

200.3

Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease (AD)

210.1

Prostate Cancer Screening Tests

210.10

Screening for Sexually Transmitted Infections (STIs) and High-Intensity Behavioral Counseling (HIBC) to Prevent STIs

210.11

Intensive Behavioral Therapy for Cardiovascular Disease

210.12

Intensive Behavioral Therapy for Obesity

210.13

Screening for Hepatitis C Virus (HCV) in Adults

210.14

Lung Cancer Screening with Low Dose Computed Tomography (LDCT)

210.2

Screening Pap Smears and Pelvic Examinations for Early Detection of Cervical or Vaginal Cancer

210.2.1

Screening for Cervical Cancer with Human Papillomavirus (HPV)

210.3

Colorectal Cancer Screening Tests

210.4.1

Counseling to Prevent Tobacco Use

210.6

Screening for Hepatitis B Virus (HBV) Infection

210.7

Screening for the Human Immunodeficiency Virus (HIV) Infection

210.8

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse

210.9

Screening for Depression in Adults

220.1

Computed Tomography

220.10

Portable Hand-Held X-Ray Instrument

220.11

Thermography

220.12

Single Photon Emission Computed Tomography (SPECT)

220.13

Percutaneous Image-Guided Breast Biopsy

220.2

Magnetic Resonance Imaging

220.4

Mammograms

220.5

Ultrasound Diagnostic Procedures

220.6.1

PET for Perfusion of the Heart

220.6.13

FDG PET for Dementia and Neurodegenerative Diseases

220.6.17

Positron Emission Tomography (FDG) for Oncologic Conditions

220.6.19

Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer

220.6.20

Beta Amyloid Positron Tomography in Dementia and Neurodegenerative Disease

220.6.8

FDG PET for Myocardial Viability

220.6.9

FDG PET for Refractory Seizures

220.9

Digital Subtraction Angiography

230.1

Treatment of Kidney Stones

230.10

Incontinence Control Devices

230.12

Dimethyl Sulfoxide (DMSO)

230.13

Peridex CAPD Filter Set

230.14

Ultrafiltration Monitor

230.15

Electrical Continence Aid

230.16

Bladder Stimulators (Pacemakers)

230.17

Urinary Drainage Bags

230.18

Sacral Nerve Stimulation For Urinary Incontinence

230.19

Levocarnitine for use in the Treatment of Carnitine Deficiency in ESRD Patients

230.2

Uroflowmetric Evaluations

230.3

Sterilization

230.4

Diagnosis and Treatment of Impotence

230.5

Gravlee Jet Washer

230.6

Vabra Aspirator

230.7

Water Purification and Softening Systems Used in Conjunction with Home Dialysis

230.8

Non-Implantable Pelvic Floor Electrical Stimulator

230.9

Cryosurgery of Prostate

240.1

Lung Volume Reduction Surgery (Reduction Pneumoplasty)

240.2

Home Use of Oxygen

240.2.1

Home Use of Oxygen in Approved Clinical Trials

240.3

Heat Treatment, Including the Use of Diathermy and Ultra-Sound for Pulmonary Conditions

240.4

Continuous Positive Airway Pressure (CPAP) Therapy For Obstructive Sleep Apnea (OSA)

240.4.1

Sleep Testing for Obstructive Sleep Apnea (OSA)

240.5

Intrapulmonary Percussive Ventilator (IPV)

240.7

Postural Drainage Procedures and Pulmonary Exercises

240.8

Pulmonary Rehabilitation Services

250.1

Treatment of Psoriasis

250.2

Hemorheograph

250.3

Intravenous Immune Globulin for the Treatment of Autoimmune Mucocutaneous Blistering Diseases

250.4

Treatment of Actinic Keratosis

250.5

Dermal Injections for the Treatment of Facial Lipodystrophy Syndrome (LDS)

260.1

Adult Liver Transplantation

260.10

Heartsbreath Test for Heart Transplant Rejection

260.2

Pediatric Liver Transplantation

260.3

Pancreas Transplants

260.3.1

Islet Cell Transplantation in the Context of a Clinical Trial

260.5

Intestinal and Multi-Visceral Transplantation

260.6

Dental Examination Prior to Kidney Transplantation

260.7

Lymphocyte Immune Globulin, Anti-Thymocyte Globulin (Equine)

260.9

Heart Transplants

270.1

Electrical Stimulation (ES) and Electromagnetic Therapy for the Treatment of Wounds

270.2

Noncontact Normothermic Wound Therapy (NNWT)

270.3

Blood-Derived Products for Chronic Non-Healing Wounds

270.4

Treatment of Decubitus Ulcers

270.5

Porcine Skin and Gradient Pressure Dressings

270.6

Infrared Therapy Devices

280.1

Durable Medical Equipment Reference List

280.10

Prosthetic Shoe

280.11

Corset Used as Hernia Support

280.12

Sykes Hernia Control

280.14

Infusion Pumps

280.15

INDEPENDENCE iBOT 4000 Mobility System

280.16

Seat Elevation Equipment (Power Operated) on Power Wheelchairs

280.2

White Cane for Use by a Blind Person

280.3

Mobility Assistive Equipment (MAE)

280.4

Seat Lift

280.6

Pneumatic Compression Devices

280.7

Hospital Beds

280.8

Air-Fluidized Bed

290.1

Home Health Visits to a Blind Diabetic

290.2

Home Health Nurses' Visits to Patients Requiring Heparin Injection

30.1

Biofeedback Therapy

30.1.1

Biofeedback Therapy for the Treatment of Urinary Incontinence

30.2

Thermogenic Therapy

30.3

Acupuncture

30.3.1

Acupuncture for Fibromyalgia

30.3.2

Acupuncture for Osteoarthritis

30.3.3

Acupuncture for Chronic Lower Back Pain (cLBP)

30.5

Transcendental Meditation

30.6

Intravenous Histamine Therapy

30.7

Laetrile and Related Substances

30.8

Cellular Therapy

30.9

Transillumination Light Scanning or Diaphanography

300.1

Obsolete or Unreliable Diagnostic Tests

310.1

Routine Costs in Clinical Trials

40.1

Diabetes Outpatient Self-Management Training

40.2

Home Blood Glucose Monitors

40.3

Closed-Loop Blood Glucose Control Device (CBGCD)

40.4

Insulin Syringe

40.5

Treatment of Obesity

40.7

Outpatient Intravenous Insulin Treatment

50.1

Speech Generating Devices

50.2

Electronic Speech Aids

50.3

Cochlear Implantation

50.4

Tracheostomy Speaking Valve

50.5

Oxygen Treatment of Inner Ear/Carbon Therapy

50.7

Cochleostomy with Neurovascular Transplant for Meniere's Disease

50.8

Ultrasonic Surgery

70.1

Consultations with a Beneficiary's Family and Associates

70.2

Consultation Services Rendered by a Podiatrist in a Skilled Nursing Facility

70.2.1

Services Provided for the Diagnosis and Treatment of Diabetic Sensory Neuropathy with Loss of Protective Sensation (aka Diabetic Peripheral Neuropathy)

70.3

Physician's Office within an Institution Coverage of Services and Supplies Incident to a Physician's Services

70.4

Pronouncement of Death

70.5

Hospital and Skilled Nursing Facility Admission Diagnostic Procedures

80.1

Hydrophilic Contact Lens For Corneal Bandage

80.10

Phaco-Emulsification Procedure - Cataract Extraction

80.11

Vitrectomy

80.12

Intraocular Lenses (IOLs)

80.2

Photodynamic Therapy

80.2.1

Ocular Photodynamic Therapy (OPT)

80.3

Photosensitive Drugs

80.3.1

Verteporfin

80.4

Hydrophilic Contact Lenses

80.5

Scleral Shell

80.6

Intraocular Photography

80.7

Refractive Keratoplasty

80.8

Endothelial Cell Photography

80.9

Computer Enhanced Perimetry

90.1

Pharmacogenomic Testing for Warfarin Response

90.2

Next Generation Sequencing (NGS)

National Coverage Determination

NATIONAL MEDICARE COVERAGE DETERMINATIONS

NATIONAL MEDICARE COVERAGE DETERMINATIONS