LCD and Policy Article Revisions Summary for August 25 2016 - JA DME

Outlined below are the principal changes to the DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted. The policies included are Pressure Reducing Support Surfaces – Group 1, Pressure Reducing Support Surfaces – Group 2 and Pressure Reducing Support Surfaces – Group 3.  Please review the entire LCD and related PA for complete information.

Pressure Reducing Support Surfaces – Group 1

LCD                                      

Revision Effective Date: 07/01/2016
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Revised: Standard Documentation language - ACA order requirements – Effective 04/28/16

DOCUMENTATION REQUIREMENTS:

Revised: Standard Documentation language to add ACA 6407 Prescriptions Requirements, New Order Requirements, and Correct Coding Instructions; revised Proof of Delivery instructions (Effective 04/28/16)

Policy Article

Revision Effective Date: 07/01/2016

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Revised Standard Language to add Statutory Prescription (Order) Requirements, revised Face to Face and ACA requirements (Effective 04/28/2016)

Pressure Reducing Support Surfaces – Group 2

LCD

Revision Effective Date: 07/01/2016

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Removed: WOPD instructions added erroneously

DOCUMENTATION REQUIREMENTS:

Revised: Standard Documentation language to add Dispensing orders, New order, and Correct coding requirements; revised Detailed written orders, WOPD, Proof of delivery (Effective 04/28/16)

Policy Article

Revision Effective Date: 07/01/2016

Removed: WOPD, this is in the document requirement section

Pressure Reducing Support Surfaces – Group 3

LCD

Revision Effective Date: 07/01/2016

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Revised: Standard Documentation language - ACA requirements (Effective 04/28/2016)

DOCUMENTATION REQUIREMENTS:

Revised: Standard Documentation language for ACA requirements; added New order requirements and Correct coding instructions; revised Proof of delivery instructions (Effective 04/28/2016)

Policy Article

Revision Effective Date: 07/01/2016:

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Revised Standard Language to add Statutory Prescription (Order) Requirements, revised Face to Face and ACA requirements (Effective 04/28/2016)

Note: The information contained in this article is only a summary of revisions to the LCDs and Policy Articles.  For complete information on any topic, you must review the LCDs and/or Policy Articles.