RETIRED - Retirement of Enteral Nutrition Local Coverage Determination (LCD) and Related Policy Article - Effective November 12, 2020

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.

Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Joint DME MAC Article
Posted October 8, 2020

Chapter 13, Section 13.3 of the CMS Program Integrity Manual (CMS Pub. 100-08) grants Medicare Administrative Contractors (MACs) the discretion to revise or retire their Local Coverage Determinations (LCDs) at any time on their own initiative. The DME MACs will be retiring the Enteral Nutrition LCD (L33783) and related Policy Article (A52493), effective for claims with dates of service on or after November 12, 2020, due to the evolution of enteral nutrition clinical paradigms.

Enteral nutrition is covered under the Prosthetic Device benefit (Social Security Act §1861(s)(8)), and coverage is further outlined in the National Coverage Determinations (NCD) Manual (CMS Pub. 100-03), Chapter 1, Section 180.2. With the retirement of the LCD and Policy Article, providers and suppliers should refer to the CMS NCD 180.2 - Enteral and Parenteral Nutritional Therapy, which addresses coverage criteria for enteral and parenteral nutrition. In addition, providers and suppliers should review the recently published joint DME MAC correct coding article entitled "Enteral Nutrition - Correct Coding and Billing" for more information regarding coverage and billing of enteral nutrition.

For claims with dates of service prior to November 12, 2020, please visit the Medicare Coverage Database (MCD) to access the retired LCD and Policy Article.

Note: LCDs and Policy Articles that have been retired for less than one year are housed on the MCD. LCDs and Policy Articles that have been retired for one year or more are accessible on the MCD Archive.

Publication History

Date of Change Description
10/08/20 Originally Published
12/16/21 Retired due to information no longer current

 

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