{"id":6455,"date":"2021-03-30T19:33:12","date_gmt":"2021-03-30T19:33:12","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=6455"},"modified":"2021-03-30T19:33:12","modified_gmt":"2021-03-30T19:33:12","slug":"local-and-national-coverage-determination-rules","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/local-and-national-coverage-determination-rules\/","title":{"rendered":"Local and National Coverage Determination Rules"},"content":{"rendered":"<p>Health New England continues to apply local and national coverage determination editing rules based on CMS policies. It is important when submitting claims to Health New England that you are familiar with the rules. For more information, go to <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/indexes\/national-and-local-indexes.aspx or https:\/\/www.ngsmedicare.com\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cms.gov\/medicare-coverage-database\/indexes\/national-and-local-indexes.aspx or https:\/\/www.ngsmedicare.com<\/a>. In the \u201c<strong>Continue as Guest<\/strong>\u201d Box, select Part B Provider and your state.<\/p>\n<p><em><strong>The following rules were implemented in January:<\/strong> <\/em><br \/>\n<a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/details\/lcd-details.aspx?LCDId=36037&amp;ver=46&amp;DocType=2&amp;s=24&amp;bc=AICAAAAAAAAA&amp;\" target=\"_blank\" rel=\"noopener\">Urine Drug Testing (L36037)<\/a><\/p>\n<p><em><strong>The following rules were implemented in March:<\/strong><\/em><br \/>\n<a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/details\/ncd-details.aspx?NCDId=268&amp;ncdver=2&amp;bc=AIAAIAAAAAAA&amp;\" target=\"_blank\" rel=\"noopener\">Prostate Cancer Screening Tests (210.1)<\/a><br \/>\n<a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/details\/ncd-details.aspx?NCDId=100&amp;ncdver=1&amp;bc=AIAAIAAAAAAA&amp;\" target=\"_blank\" rel=\"noopener\">Glycated Hemoglobin\/Glycated Protein (190.21)<\/a><br \/>\n<a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/details\/article-details.aspx?articleId=54602&amp;ver=11&amp;SearchType=Advanced&amp;CoverageSelection=Local&amp;ArticleType=BC%7cSAD%7cRTC%7cReg&amp;PolicyType=Both&amp;s=24&amp;AdvSearchName=1&amp;KeyWord=Skin+lesions&amp;KeyWordLookUp=Doc&amp;KeyWordSearchType=Exact&amp;kq=true&amp;bc=EAAAAAgAEAAA&amp;\" target=\"_blank\" rel=\"noopener\">LCD Removal of Benign Skin Lesions (A54602)<\/a><\/p>\n<p><strong><em>The following rules coming in April:<\/em> <\/strong><br \/>\n<a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/details\/ncd-details.aspx?NCDId=90&amp;ncdver=1&amp;bc=AIAAIAAAAAAA&amp;\" target=\"_blank\" rel=\"noopener\">Serum Iron Studies (190.18)<\/a><br \/>\n<a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/details\/ncd-details.aspx?NCDId=61&amp;DocID=190.15\" target=\"_blank\" rel=\"noopener\">Blood Counts (190.15)<\/a><\/p>\n<p>For any additional question, you may call your Provider Relations Representative (800) 842-4464, extension 5000, or send an email to <a href=\"mailto:providerrelations@hne.com\" target=\"_blank\" rel=\"noopener\">providerrelations@hne.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Health New England continues to apply local and national coverage determination editing rules based on CMS policies. It is important when submitting claims to Health New England that you are familiar with the rules. For more information, go to https:\/\/www.cms.gov\/medicare-coverage-database\/indexes\/national-and-local-indexes.aspx or https:\/\/www.ngsmedicare.com. In the \u201cContinue as Guest\u201d Box, select Part B Provider and your state. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4950,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-6455","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2019\/11\/GettyImages-1015267018.jpg?fit=813%2C430","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-1G7","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6455","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=6455"}],"version-history":[{"count":1,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6455\/revisions"}],"predecessor-version":[{"id":6456,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6455\/revisions\/6456"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/4950"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=6455"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=6455"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=6455"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}