Content created by Departmental Appeals Board (DAB)
|
NCD Name |
NCD Number |
Board Docket Number |
Intervention Deadline |
Resolution |
|---|---|---|---|---|
|
Ocular Photodynamic Therapy |
80.2.1 |
A-02-75 |
10/7/2004 |
Dismissed |
|
Pancreas Transplants |
35-82 |
A-04-89 |
1/1/2006 |
Dismissed* |
|
Infusion Pumps |
60-14 |
A-04-118 |
10/7/2004 |
Dismissed |
|
Durable Medical Equipment Reference List — (Air Cleaners) |
280.1 |
A-04-145 |
11/1/2005 |
Decision issued finding that record supports validity of the NCD. (DAB No. 1999) |
|
Carcinoembryonic Antigen |
190.26 |
A-07-106 |
11/30/2007 |
Dismissed** |
|
Lipid Testing |
190.23 |
A-09-3 |
|
Dismissed |
|
Vagus Nerve Stimulation |
160.18 |
A-09-67 |
8/24/2009 |
Dismissed |
|
Magnetic Resonance Angiography |
220.3 |
A-09-124 |
10/22/2009 |
Dismissed |
|
Presbyopia-Correcting and Astigmatism-Correcting Intraocular Lenses |
CMS Manual System, Pub. 100-04, Ch. 32, §120 |
A-10-97 |
12/21/2010 |
Decision issued finding that record supports validity of the NCD. (DAB No. 2418 - PDF) |
|
Bariatric Surgery for Treatment of Morbid Obesity |
100.1 |
A-11-92 |
8/22/2011 |
Dismissed |
|
Adult Liver Transplantation |
260.1 |
A-11-98 |
8/25/2011 |
Dismissed |
|
Transsexual Surgery |
140.3 |
A-13-47 |
1/6/14 |
Decision issued finding that NCD is not valid under the "reasonableness standard" (DAB No. 2576)*** |
|
Vagus Nerve Stimulation |
160.18 |
A-14-3 |
8/1/2014 |
Decision issued finding that record supports validity of the NCD. (DAB No. 2613). |
* The Board ruled that the record was not complete and adequate to support the validity of the NCD. The Centers for Medicare and Medicaid (CMS) agreed to reconsider the NCD. The NCD complaint was dismissed after CMS revised the NCD to address the concerns raised.
** The Board ruled that the beneficiary was not entitled to challenge the NCD for carcinoembryonic antigen (CEA) testing because CMS had determined that the NCD did not bar coverage for indications not specifically listed in the NCD as either covered or excluded from coverage. Rather, CMS determined that coverage of CEA testing for such indications required individual showings that testing was reasonable and necessary based on individual medical circumstances. A redacted copy of the Board’s dismissal ruling can be viewed through the following link: CEA NCD DISMISSAL RULING (PDF).
***The Board previously ruled that the NCD record is not complete and adequate to support the validity of the NCD. (NCD Ruling No. 2)
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