CMS Publishes Transmittal Removing LOCM Restrictive Coverage Criteria

Thanks to the efforts of the ACR Carrier Advisory Committee (CAC) Network, the Centers for Medicare and Medicaid Services (CMS) recently released a Transmittal instructing Medicare carriers to remove the restrictive coverage criteria for the payment of low osmolar contrast media (LOCM). CMS removed the five criteria in the 2005 Medicare Physician Fee Schedule Final Rule, however, some Medicare carriers were waiting for the publication of a Transmittal prior to removing the restrictive criteria from their Local Coverage Determinations (LCDs). Transmittal #627 states that the effective date of this change is January 1, 2005, however the implementation date is October 31, 2005. The Transmittal also establishes the payment method for LOCM as the average sales price (ASP) plus six percent, effective April 1, 2005. To view the CMS Transmittal click here. CMS also plans to publish a follow-up MedLearn Matters article on their website soon.

If you have any questions concerning coverage of LOCM or the ACR CAC Network, please contact Kathryn Keysor at (800) 227-5463, ext. 4950.