On November 27, 2012, the Centers for Medicare & Medicaid Services (CMS) released a new list of Potential National Coverage Determination (NCD) Topics. This list was released more than a year after CMS had solicited public input on items and services that may be inappropriately used or provide minimal benefit or items and services that might improve health outcomes that are not currently covered.
The list of Potential NCD Topics is noteworthy for a number of reasons. Although the title of the document is “Potential NCD Topics,” CMS explains that it could review the topics through claims analysis, literature reviews, or NCDs. In fact, CMS explicitly states that an NCD is not appropriate for certain items on the list. It therefore may be more appropriate to consider the items on the list as areas of interest or concern to CMS. While stakeholders should be prepared to see the items addressed through a variety of mechanisms, including potentially audits or other investigations, it also is worth noting that CMS did not develop NCDs for or otherwise review many of the items on the list of Potential NCD Topics that it released in 2008 and which is replaced by this new document.
The new list of Potential NCD Topics includes such items and services as power wheelchairs, abdominal computed tomography (CT), colorectal cancer screening, genetic testing, and proton beam therapy, among others. CMS identified three items of the list as internally generated including intraaortic balloon pumps and percutaneous ventricular assist devices, lap-band surgery for obesity, and kyphoplasty. Both kyphoplasty and proton beam therapy also were on the 2008 list of Potential NCD Topics.