LCD Revisions Summary for September 7 2017 - JA DME

Outlined below are the principal changes to the DME MAC Knee Orthoses Local Coverage Determination (LCD) that has been revised and posted. Please review the entire LCD and related PA for complete information.

Knee Orthoses
LCD
Revision Effective Date: 10/16/2017
COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Updated: References to ICD 10 code lists to reflect accurate title of the list

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

Added: ICD 10 codes S76.111 (A,D,S), S76.112 (A,D,S), S76.121 (A,D,S) and S76.122 (A,D,S) to Group 2 and Group 4 codes

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Updated: language under to add "justify"

DATE (09/07/2017): At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

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.