by AJ Riviezzo
Effective 12/27/2020, both First Coast Service Options and Novitas will have new Local Coverage Determinations (policies)in place. There are some substantial changes to both the policies and some minor changes to what we reported on the original drafts.
The largest change is to conservative therapy. If the patient is CEAP 2 or 3 and has a VCSS score of less than 6, then the conservative therapy ‘window’ is two to four weeks. There is no conservative therapy required if CEAP3-6 and/or if the VCSS score is 6 or greater.
A two smaller changes from the old Novitas LCD to this one includes a deletion of the BMI reporting and/or size measurement requirements along with vein size requirements that is 3mm for most veins and 3.5mm for perfs. There is also now a requirement in the new policy to document the patient’s VCSS number.
There is a continued focus on the disease impact on the patient’s activities of daily living and/or their quality of life.
Attached are copies of the policies and copies of the checklist we have created to make compliance a bit easier. The Novitas policy is attached here. The FCSO policy is identical. Novitas Policy Also attached are checklists for your consideration. Novitas Checklist FCSO Checklist If you have questions, please do not hesitate to reach out to us.
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