Yesterday CMS posted a Final Decision Memorandum for the Expedited Removal of National Coverage Determinations (NCDs). By way of background, in an August 7, 2013 Federal Register notice (78 FR 48164), CMS established an expedited process for removing NCDs under certain circumstances, such as when they are no longer contain clinically pertinent or when the items or services are used infrequently by beneficiaries. Removal of an NCD does not necessarily result in noncoverage; instead, it allows the local Medicare Administrative Contractors (MACs) to determine coverage.
CMS reviewed NCDs that have not been reviewed in 10 years in order to evaluate the continued need for those policies to remain active on a national scale, and on November 27, 2013 CMS published for public comment the first list of NCDs proposed for removal. After review of public comments, CMS is now removing the following NCDs from the NCD Manual, effective December 18, 2014:
50.6 - Tinnitus masking
160.4 - Stereotactic Cingulotomy as a Means of Psychosurgery
160.6 - Carotid Sinus Nerve Stimulator
160.9 - Electroencephalographic (EEG) Monitoring During Open-Heart
Surgery
190.4 - Electron Microscope
220.7 - Xenon Scan
220.8 - Nuclear Radiology Procedure
CMS is retaining the following NCDs:
20.17 - Noninvasive Tests of Carotid Function
140.5 - Laser Procedures
160.17 - L-DOPA
A summary of CMS's response to public comments is included in the decision memorandum.
This article is presented for informational purposes only and is not intended to constitute legal advice.
