ASNC Asks Medicare Contractors to Clarify Coverage in Proposed Stress Testing LCD

In comments submitted to First Coast Service Options and Novitas Solutions, ASNC noted that the two Medicare Administrative Contractors (MACs) clearly had consulted cardiologists as they developed a proposed local coverage determination (LCD) for Cardiology: Non-Emergent Stress Testing. ASNC offered support for the draft policy overall but also asked for clarification in a few areas. 
  • ASNC urged the MACs to include specific language to preserve “the ability of a physician to choose the appropriate test” for each patient based on “medical decision making and a dialogue between the physician and patient.”
  • ASNC urged First Coast and Novitas to consider FDG PET a first-line test for the assessment of inflammation in cardiac sarcoidosis or when MRI is contraindicated or unavailable.
  • Citing the ACC's multimodality guidelines, ASNC asked the MACs to include the atrial fibrillation ICD-10 codes in the LCD. 
MACs create LCDs to govern coverage for Medicare in the regions over which they have jurisdiction. First Coast is the MAC for Florida, Puerto Rico, and the Virgin Islands; Novitas is the MAC for Arkansas, Delaware, District of Columbia, Louisiana, Maryland, Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania, and Texas.

ASNC monitors for the release of proposed LCDs and offers feedback to ensure patients' access to care. Watch Flashpoint and ASNC's Advocacy Hub for updates.  

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