Payment Criteria

30.1.1 - Payment Criteria (Rev. 627, Issued: 07-29-05, Effective: 01-01-05, Implementation: 10-31-05) A/B MACs (B) make separate payments for LOCM (HCPCS codes Q9945-Q9951) in the case of all medically necessary intrathecal radiologic procedures furnished to nonhospital patients. Effective January 1, 2005 in the case of intraarterial and intravenous radiologic procedures, the five restrictive criteria (a history of previous adverse reaction to contrast material, with the exception of a sensation of heat, flushing, or a single episode of nausea or vomiting; a history of asthma or allergy; significant cardiac dysfunction including recent or imminent cardiac decompensation, severe arrhythmia, unstable angina pectoris, recent myocardial infarction, and pulmonary hypertension; generalized severe debilitation; or sickle cell disease) for the payment of LOCM are eliminated.