Several Medicare Administrative Contractors (MACs) will soon have new Local Coverage Determinations (LCDs) in place for various FISH testing codes that will require providers to list a diagnostic code supporting medical necessity in order to receive payment.
The following codes are impacted: 88271, 88273, 88274, 88275 and 88291.
Palmetto — 4/8/2019
CGS — 5/6/2019
WPS — 5/13/2019
Noridian — 6/3/2019
Below is a listing of diagnostic codes that support medical necessity. Failing to include an appropriate dx code will result in a denial of payment.