Awareness : Newsletter Articles

Major Joint Replacement (Hip and Knee) Revision to the Part A and Part B LCD

LCD ID number: L33618

The local coverage determination (LCD) for major joint replacement (hip and knee) was revised to add ICD-10-CM diagnosis code Z47.32 to the “ICD-10-CM Diagnosis Codes for Total Hip Arthroplasty” section of the LCD and ICD-10-CM diagnosis code Z47.33 to the “ICD-10-CM Diagnosis Codes for Total Knee Arthroplasty” section of the LCD. Also, the “Sources of Information and Basis for Decision” section of the LCD was updated. In addition, based on an annual review of the LCD, it was determined that some of the italicized language in the “Documentation Requirements” section of the LCD does not represent direct quotation from the Centers for Medicare & Medicaid Services (CMS) sources listed in the LCD; therefore, this LCD was revised to assure consistency with the CMS sources.

This LCD revision is effective for services rendered on or after February 15, 2018. LCDs are available through the CMS Medicare coverage database at https://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx.