LCD and Policy Article Revisions Summary for September 1 2016 - JD DME

Outlined below are the principal changes to the DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted. The policies included are Canes and Crutches, Cervical Traction Devices, External Breast Prostheses, Power Mobility Devices.  Please review the entire LCD and related PA for complete information.

Canes and Crutches

LCD                                      

Revision Effective Date: 07/01/2016
DOCUMENTATION REQUIREMENTS:
Revised: Standard documentation language for orders, added New order requirements, and Correct coding instructions; revised Proof of delivery instructions – Effective 04/28/16

Cervical Traction Devices

LCD

Revision Effective Date: 07/01/2016

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation language - ACA order requirements – Effective 04/28/16
DOCUMENTATION REQUIREMENTS:
Revised: Standard documentation language for orders, added New order requirements, and Correct coding instructions; revised Proof of delivery and ACA Face to face instructions – Effective 04/28/16
Removed: Refill requirements section

Policy Article

Revision Effective Date: 07/01/2016:

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised Standard Language to add Statutory Prescription (Order) Requirements, revised Face to Face and ACA requirements (Effective 04/28/2016)

External Breast Prostheses

LCD

Revision Effective Date: 07/01/2016

DOCUMENTATION REQUIREMENTS:
Revised: Standard documentation language for orders, added New order requirements, and Correct coding instructions; revised Refill documentation and Proof of delivery instructions (Effective 04/28/16)

Policy Article

Revision Effective Date: 07/01/2016

Updated: Title to remove effective date

Power Mobility Devices

LCD

Revision Effective Date: 07/01/2016

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Removed: Group 4 power wheelchair HCPCS Codes from the Miscellaneous section

DOCUMENTATION REQUIREMENTS:
Revised: Standard documentation language for orders, added New order requirements, and Correct coding instructions; revised Proof of delivery instructions – Effective 04/28/16

Policy Article

Revision Effective Date: 07/01/2016

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Revised Standard Language to add Statutory Prescription (Order) Requirements, revised Face to Face and ACA requirements - Effective 04/28/2016

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.