Oral Appliances for Obstructive Sleep Apnea, Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea and Respiratory Assist Devices - Final LCDs and Response to Comments (RTC) Articles Published

Posted on June 24, 2021

Joint DME MAC Publication

On June 24, 2021, the DME MACs published the following final Local Coverage Determinations (LCDs) and LCD-related Policy Articles (PAs):

  • Oral Appliances for Obstructive Sleep Apnea LCD (L33611) and LCD-related PA (A52512)
  • Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea (L33718) and LCD-related PA (A52467)
  • Respiratory Assist Devices (L33800) and LCD-related PA (A52517)

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 three policies remove the sleep testing requirements from the LCDs and defer to the CMS National Coverage Determination 240.4.1 and the A/B MAC LCDs and Billing and Coding articles.

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 August 8, 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: Oral Appliances for Obstructive Sleep Apnea - DL33611 (A58823)
  • Response to Comments: Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea - DL33718 (A58824)
  • Response to Comments: Respiratory Assist Devices - DL33800 (A58822)

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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