National Government Services, Inc. Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter

MMR-2007- 08B, August 2007

National Government Services, Inc. Medical Policy Update (MPU) - Indiana (00630) and Kentucky (00660) - Revised Local Coverage Determination (LCD): Psychological Services Coverage under the “Incident to” Provision for Physicians and Non-physicians (R3) – Effective Date: August 1, 2007

Source of Revision – Internal
Annual Review: In March 2007, the seven Contractor Medical Directors (CMD) and MPU associates thoroughly reviewed each existing legacy local coverage determination (LCD) and applied agreed-upon criteria to determine the final roster of National Government Services policies. During the March 21 – 23 meeting, the CMDs decided which policies to retain/ consolidate as all- National Government Services LCDs and which policies to retire. Data were pulled (including edit effectiveness data) and criteria were applied to each policy in making the retention determinations. The preparation and review of the policies in March constitutes the annual review for every legacy LCD and fulfills requirements in Chapter 13, Section 13.4(C) of the Medicare Program Integrity Manual. References to AdminaStar Federal were updated to National Government Services. LCD was subsequently reviewed by the National Government Services Part B carrier on July 11, 2007.

Minor formatting changes made to conform to National Government Services documentation standards. References were added to the Centers for Medicare & Medicaid Services (CMS) National Coverage Policy section for the GA/GY/GZ modifier. The supplemental instructions article (SIA) associated with this LCD was similarly updated. No notice period required and none given.

National Government Services Medical Policy Update - Indiana (00630) and Kentucky (00660) - Revised Supplemental Instructions Article (SIA): Psychological Services Coverage under the “Incident to” Provision for Physicians and Non-physicians - Effective Date: July 20, 2007

Source of Revision: Coding guidelines have been updated with instructions on the use of the GA/GZ/GY modifiers by physicians, practitioners, or suppliers when billing claims to Medicare. References were added to the CMS National Coverage Policy section for the GA/GY/GZ modifier. Minor formatting changes made to conform to National Government Services documentation standards.