LCD and Policy Article Revisions Summary for August 24, 2017

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

Wheelchair Seating
LCD
Revision Effective Date: 01/01/2017

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

Added: Z codes for acquired absence of limb to Group 3 and Group 4 Diagnosis Codes

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Clarified: Verbiage in Policy Specific Documentation Requirements

08/24/2017: 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.

Policy Article
Revision Effective Date: 01/01/2017

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Added: 42 CFR 410.38(g) language, previously in Policy Specific Documentation Requirements section

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.

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