Update: Genetic Testing
States Applicable to Alert: Hawaii, Nevada, Guam, American Samoa, Northern Mariana Islands and California.
Background Information: The Genetic Testing Local Coverage Determination (LCD) has been retired. All services denied due to the coverage in this policy will be paid back to the effective date of the policy.
L27699 – Hawaii, Nevada, Guam, American Samoa and Northern Mariana Islands (effective September 4, 2008).
L28264 – California (effective September 2, 2008).
Applies to Procedure Codes:
83890 83892 83894 83904
83891 83893 83898 83912
Remark /Reason Codes:
50 - These are non-covered services because this is not deemed a medical necessity by the payer.
N115 - This decision was based on a Local Medical Review Policy (LMRP) or Local Coverage Determination (LCD). An LMRP/LCD provides a guide to assist in determining whether a particular item or service is covered.
A copy of this policy is available at www.cms.hhs.gov/mcd. If you do not have Web access, you may contact the contractor to request a copy of the LMRP/LCD.
MAC Action: A mass adjustment was performed in Northern and Southern Carlifornia on March 12, 2009, for services listed in the Genetic Testing LCD that were denied due to this LCD. On March 20, 2009, the mass adjustment was performed in Hawaii, Nevada, Guam, American Samoa, Northern Mariana Islands.
Provider Action: No action needed.
Date Reported: February 5, 2009
Date Resolved: Northern and Southern Carlifornia - March 12, 2009
Hawaii, Nevada, Guam, American Samoa, Northern Mariana Islands - March 20, 2009
last updated on 03/30/2009