National and Local Coverage Determinations (NCD & LCD) are the clinical review policies by which Medicare and its various administrative contractors determine the medical justification for a provided service.  In advance of October 1, these policies were updated to reflect ICD-10 diagnoses that support medical necessity and subsequent payment to providers.  As the industry continues to successfully navigate the transition, it is beginning to notice that certain ICD-10 codes considered clinically equivalenet to the original ICD-9 codes in the old policies have been conspicuously omitted.  As such, providers could be denied for services for which they used to be paid.  As with any policy from the CMS, changes are generally provided in draft and subject to a public comment and reveiew period.  The mere addition of ICD-10 codes to the policy consitutes such a change not to mention the omission of codes.  Medicare has acknowledged those that have been found including   LCD L33627 (peripheral arterial examinations (CPT® codes 93922-93931) which omitted I73.9, the non-specific code for peripheral vascular disease and L35125 (Wound Care) which omitted the ICD-10-CM unspecified stage of pressure ulcer codes.  As such they will be adding these codes into the new policy, making it retroactive to October 1, 2015.  To read more about this developing issue, please click here