Policy Article Revisions Summary for June 20, 2024 - JD DME

Joint DME MAC Publication
Posted June 20, 2024

Outlined below are the principal changes to the DME MAC Policy Article (PA) that has been revised and posted. The policy included is Nebulizers. Please review the entire Local Coverage Determination (LCD) and related PA for complete information.

Nebulizers

PA

Revision Effective Date: 01/01/2024
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: Information pertaining to aztreonam lysine and amikacin liposome, to clarify that the inhalation solutions, nebulizer, and related accessories are noncovered under the Medicare Part B DME benefit
Added: "(The aztreonam lysine inhalation solution and related accessories may be eligible for coverage under a different Medicare benefit (e.g., Medicare Part D))."
Added: "(The amikacin liposome inhalation solution and related accessories may be eligible for coverage under a different Medicare benefit (e.g., Medicare Part D))."

06/20/2024: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

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

With the update(s) listed above, Noridian would like to remind users how to find the policy that was previously effective. When billing, the supplier should follow guidance that was effective on the date of service. The below steps can be followed to find all previous policies:

1. Open the currently effective policy on the Medical Coverage Database (MCD)
   1. Links to the MCD can be found on the Active LCDs page on the Noridian website
      1. There is a link at the top of the Active LCD page that goes to a full list of the LCDs or PAs, depending on which link is selected OR
      2. There are direct links to all LCDs under the ‘LCD ID number and Effective Date’ column
2. Scroll down to the bottom of the policy
3. Find the section labeled Public Version(s)
4. Look for the link to the policy that was effective on the dates of service in question.
5. Click on hyperlink to go to the policy.