Medicare Coverage Policies —ICD-9

HNL’s Frequently Used Policies

Medicare Coverage Policies —ICD-9

The policies listed here are the Medicare Local Coverage Determinations (LCDs) and the National Coverage Determinations (NCDs) and are intended to be a quick reference, not a substitute for the complete LCDs, NCDs or the ICD-9 manual.

The complete policies may be accessed through Novitas Solutions, Inc. and Centers for Medicare & Medicaid Services. Please refer to the ICD-9 manual for a complete listing of ICD-9 codes. The ultimate responsibility for correct coding lies with the ordering physician. All ICD-9 codes must be medically appropriate for the patient's condition and consistent with the information found in the patient's medical record for the date of service.

Most Medicare Advantage Plans follow these coverage policies. Please consult the specific Medicare Advantage carrier for confirmation.

  1. ADVANCE BENEFICIARY NOTICE (ABN) Form
  2. Introduction
  3. NonCovered ICD9CM Codes for all NCDs
  4. CodingGuidelines for all NCDs
  5. Reasons for Denial
  6. Additional Coding Guidelines
  7. Alpha-fetoprotein
  8. Blood Counts
  9. Blood Glucose Testing
  10. C-Reactive Protein Testing-LCD
  11. Carcinoembryonic Antigen
  12. Collagen Crosslinks
  13. Digoxin Therapeutic Drug Assay
  14. Fecal Occult Blood Test
  15. Flow Cytometry – LCD
  16. Gamma Glutamyl Transferase
  17. Glycated Hemoglobin_Glycated Protein
  18. Hepatitis Panel_Acute Hepatitis Panel
  19. Human Chorionic Gonadotropin
  20. Human Immunodeficiency Virus Testing
  21. Human Immunodeficiency Virus Testing_Diagnosis
  22. Lipids Testing
  23. Molecular Diagnostics - LCD
  24. Prostate Specific Antigen
  25. PTT
  26. PT
  27. Qualitative Drug Testing-LCD
  28. RAST Type Tests-LCD
  29. Serum Iron Studies
  30. Thyroid Testing
  31. Tumor Antigen by Immunoassay CA125
  32. Tumor Antigen by Immunoassay CA15-3
  33. Tumor Antigen by Immunoassay CA19-9
  34. Urine Culture_Bacterial
  35. Vitamin D Assay Testing-LCD
  36. HNL’S GUIDE TO FREQUENTLY USED MEDICARE COVERAGE POLICIES – COMPLETE LIST note: Downloading the full book is a 1MG file and may extend downloading time depending on your internet connection.

Policies have been updated July 2015

Note: In order to view the PDF file you must have Adobe Acrobat Reader. If you do not, click here to download Adobe Acrobat Reader.

For additional information, please contact Customer Care at 1-877-402-4221 or Click here.

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