Reminder:  Draft LCDs were posted for comment on April 1, 2008. Please go to the J12 MAC Transition area of the website to send your comments before the close of the comment period on May 15, 2008.

J12 MAC Local Contractor Determinations (LCDs) and Current Part A / Part B LCDs

Key Points:

• Effective Date for Part A February, 2008 Draft LCDs for Pennsylvania, Maryland, and D.C.: 
  
  Will not finalize as effective; rather, MAC J12 LCDs will become effective on August 1, 2008. 
   
• Effective Date for Part B February, 2008 Draft LCDs for Pennsylvania: August 7, 2008
  
  Final LCDs and the Comment / Response Document will be published on or around June 17, 2008 for notice.

As you are aware, Highmark Medicare Services has begun work as a MAC contractor for Jurisdiction J12. The schedule for all current business to move to the new MAC contract is on the J12 MAC Transition area of our website.

Pennsylvania, Maryland, and DC Part A business is scheduled to transition into the MAC effective August 1, 2008.  Because of this, the draft LCDs listed below, which were published on February 7, 2008, with comment period ending March 31, 2008 will not be finalized as effective for Part A.  Instead, the comments received will be fully considered for the J12 MAC draft LCDs, which are currently open for comment through May 15, 2008.  On August 1, 2008, the J12 MAC LCDs will become effective for Pennsylvania, Maryland, and DC Part A business.  Please feel free to send in additional comments if you wish; some of the MAC J12 drafts were modified based on the comments received through March 31, 2008.

Pennsylvania Part B business is scheduled to transition into the MAC effective
December 12, 2008.  Because of this, the draft LCDs listed below, which were published on February 7, 2008, with comment period ending March 31, 2008, will be finalized, but will now become effective on August 7, 2008, rather than June 26, 2008.  Comments received will also be fully considered for the J12 MAC draft LCDs, which are currently open for comment through May 15, 2008.  On December 12, 2008, the J12 MAC LCDs will become effective for Pennsylvania Part B business.  Please feel free to send in additional comments if you wish; some of the MAC J12 drafts were modified based on the comments received through
March 31, 2008.

Draft LCDs 

I-6J – Approved Drugs and Biologicals
I-7V – Erythropoiesis Stimulating Agents (ESAs)
M-62F – Scanning Computerized Ophthalmic Diagnostic Imaging
R-13 – Radiation Therapy Services
Z-56G – Trigger Point Injections
Z-61B – Paravertebral Facet Joint Nerve Block and Sacroiliac Joint Injection