Tumor Treatment Field Therapy (TTFT)

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: “face-to-face” to “in-person”, where applicable
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled “Bill Type”
 Removed: Field titled “Revenue Codes”
Removed: Field titled “ICD-10 Codes that Support Medical Necessity”
Removed: Field titled “ICD-10 Codes that DO NOT Support Medical Necessity”
Removed: Field titled “Additional ICD-10 Information”
DOCUMENTATION REQUIREMENTS:
Revised: “physician’s” to “ treating practitioner’s”
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO


02/27/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

Revision Effective Date: 09/01/2019
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Added: Criteria for Initial Coverage for Newly Diagnosed Glioblastoma Multiforme
Added: Criteria for Continued Coverage for Newly Diagnosed GBM Beyond the First Three Months of Therapy
Added: Coverage statement for Recurrent GBM
Added: Coverage statement for Other Uses
Added: Beneficiaries Entering Medicare FFS requirements
SUMMARY OF EVIDENCE:
Added: Summary of evidence reviewed
ANALYSIS OF EVIDENCE (RATIONALE FOR DETERMINATION):
Added: Background, CAC and key question information, and Conclusion
HCPCS CODES:
Added: HCPCS Modifiers GA, GZ, KF, and KX
SOURCES OF INFORMATION:
Added: References to sources of information
BIBLIOGRAPHY:
Added: Bibliography information
RELATED LOCAL COVERAGE DOCUMENTS:
Added: Response to Comments: Tumor Treatment Field Therapy (TTFT) – DL34823

Revision Effective Date: 01/01/2017
COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Added: New reference language and directions to Standard Documentation Requirements
Added: General Requirements
DOCUMENTATION REQUIREMENTS:
Added: General Documentation Requirements
Added: New reference language and directions to Standard Documentation Requirements
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Direction to Standard Documentation Requirements
Removed: PIM reference from Appendices
SOURCES OF INFORMATION AND BASIS FOR DECISION:
Removed: Sources of Information
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements article

Revision Effective Date: 07/01/2016
Links for Sources of Information and Basis for Decision updated.

Revision Effective Date: 07/01/2016
Links for Sources of Information and Basis for Decision updated.

Effective July 1, 2016 oversight for DME MAC LCDs is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the LCDs.

Draft promoted to final.