External Infusion Pumps & Glucose Monitors - Final LCDs and Response to Comments (RTC) Articles Published

Joint DME MAC Publication

Posted on June 3, 2021

On June 3, 2021, the DME MACs published the following final Local Coverage Determinations (LCDs) and LCD-related Policy Articles (PAs):

  • External Infusion Pumps LCD (L33794) and LCD-related PA (A52507)
  • Glucose Monitors LCD (L33822) and LCD-related PA (A52464)

These LCDs incorporate finalized revisions, as a result of LCD reconsideration requests and written comments received during the comment periods for the Proposed LCDs. The External Infusion Pumps policy extends coverage for Hizentra, to treatment of chronic inflammatory demyelinating polyneuropathy (CIDP). The Glucose Monitors policy criteria for continuous glucose monitors (CGMs) is revised in regard to frequency of testing and insulin treatment administration.

The posting of the final LCDs marks the beginning of the 45-day notice period. The final LCDs go into effect for claims with dates of service on or after July 18, 2021.

Along with the final LCDs and LCD-related PAs, the DME MACs published Response to Comments (RTC) articles, which address written comments received during the comment periods. The RTC articles are as follows:

  • Response to Comments: External Infusion Pumps - DL33794 (A58802)
  • Response to Comments: Glucose Monitors - DL33822 (A58798)

Interested stakeholders may find the RTC document by searching for the article number in the Medicare Coverage Database. The RTC document is also located in the Associated Documents section of the respective LCDs.

Please refer to each DME MAC website for additional information about policy development and access to the final LCDs.

 

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