PAXMAN announces that the Palmetto GBA Medicare Administrative Contractor (MAC) has issued a Local Coverage Determination (LCD) to provide coverage guidance for Scalp Cooling for the Prevention of Chemotherapy-Induced Alopecia. According to the final LCD guidance from
This is the first LCD that has been approved for scalp cooling and is a result of a request made to
A MAC is a private healthcare insurer that has been awarded a geographic jurisdiction to process claims for Medicare beneficiaries. The
CMS assigns MACs the task of developing LCDs to describe reasonable and necessary services within the Medicare program. CMS also assigns MACs the task of developing coverage articles that give direction on how to bill or code for a service or to provide education on a specific topic. In the Billing and Coding Guide: Scalp Cooling for the Prevention of Chemotherapy-Induced Alopecia,
This action solidifying localized coverage further advances support for healthcare providers to receive reimbursement from Medicare to administer FDA-cleared scalp cooling therapy, such as Paxman Scalp Cooling. Two separate CPT® Category III Codes for “mechanical scalp cooling,” 0662T and 0663T, were issued by the AMA with an effective date of
PAXMAN will use the approval of this LCD to form the strategy with other MACS around the country.
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