Medicare Part B local coverage determination (LCD) comment summary

LCD Number

62263

Contractor Name

First Coast Service Options, Inc.

Contractor Number

09102 - Florida
09202 - Puerto Rico
09302 - U.S. Virgin Islands

Contractor Type

MAC Part B

LCD Title

Endoscopic and Percutaneous Lysis of Epidural Adhesions

AMA CPT Copyright Statement

CPT codes, descriptions, and other data only are copyright 2008 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

Start Date of Comment Period:

06/01/2009

End Date of Comment Period:

07/15/2009

Comments received:

Comment #1: The endoscopic and percutaneous lysis of adhesions LCD should also provide coverage language for the cervical spine.  It is a procedure that is useful in the cervical or thoracic regions for radicular type problems and this draft LCD, as written, strongly emphasizes the lumbar spine only.

Contractor response:  Medical literature reviewed supports the use of lysis of adhesions for the cervical and thoracic regions.  The LCD  will be updated to include ICD-9-CM codes that support medical necessity for treatment of the cervical and thoracic regions.

Comment #2:  Utilization of this procedure should be limited to once per six months in the same anatomical area.

Contractor response:  The addition of utilization guidelines to the LCD at this time will further restrict the LCD.  In order to add such restrictions to the LCD a new draft, comment and notice period would be required.  Therefore, utilization guidelines can not be added to the current draft of this LCD.  However, services exceeding more than one every six months to the same anatomical region may be subject to medical review, and this will be stated in the policy.