WPS Medicare LCD for 97033 Iontophoresis

[Guest guest]

All

I recently had a client's services denied as not medically necessary. As a

result, I went to this Medicare r's website and pulled the LCD for the

client. Since this LCD appeared to be different from the last one I reviewed, I

dug in to see if I noticed any changes. The biggest thing I noticed with the

LCD is that WPS no longer pays DX codes by the CPT code. The list all of the

payable DX codes and other than 97033 Iontophoresis, all CPT's are payable for

these DX's (in other words, you no longer have to find your CPT code and then

look to see if the DX code(s) you're using qualify as medically necessary.

The other thing to note was that Iontophoresis (97033) is now a covered service

if you use one of their listed DX codes. I cannot remember what year

Iontophoresis stopped paying with the explanation that it was experimental, but

I know it has been in the neighborhood of 7-10 years. So I would recommend that

if anyone uses Ionto on their Medicare patients, they may want to review their

Medicare MAC's/r/Intermediary's LCD to see if they reflect this change.

WPS covers Minnesota, Michigan, Wisconsin, Illinois, Iowa and Kansas (and other

states I think).

Jim <///><