Policy Article Revisions Summary for September 24, 2020

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Ankle-Foot/Knee-Ankle-Foot Orthoses, High Frequency Chest Wall Oscillation Devices, Mechanical In-exsufflation Devices and Wheelchair Seating. Please review the entire LCDs and related PAs for complete information.

Ankle-Foot/Knee-Ankle-Foot Orthoses

PA

Revision Effective Date: 10/01/2020

MISCELLANEOUS:
Clarified: Custom fabricated items that do not have specific HCPCS codes require additional information in claim narrative
Added: Statement referring to the LCD-related Standard Documentation Requirements article for more information

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: Non-specific ICD-10 codes M24.573 and M24.576 from Group 1 codes
Removed: Non-specific ICD-10 code M14.679 from Group 2 codes

09/24/2020: At this time 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.

High Frequency Chest Wall Oscillation Devices

PA

Revision Effective Date: 10/01/2020

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 code G71.2 from Group 1 codes, due to annual ICD-10 Code updates
Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, and G71.29 to Group 1 codes, due to annual ICD-10 Code updates

09/24/2020: At this time 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.

Mechanical In-exsufflation Devices

PA

Revision Effective Date: 10/01/2020

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 code G71.2 from Group 1, due to annual ICD-10 Code updates
Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, G71.29 to Group 1 codes, due to annual ICD-10 Code updates

09/24/2020: At this time 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.

Wheelchair Seating

PA

Revision Effective Date: 10/01/2020

CODING GUIDELINES:
Added: RT and LT modifier billing instructions, for use when applicable

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 codes G11.1 and G71.2 from Group 2 and Group 4 codes, due to annual ICD-10 Code updates
Added: ICD-10 codes G11.10, G11.11, and G11.19 to Group 2 and Group 4 codes, due to annual

ICD-10 Code updates
Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, and G71.29 to Group 2 and Group 4 codes, due to annual ICD-10 Code updates

09/24/2020: At this time 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 PAs. For complete information on any topic, you must review the LCDs and/or PAs.
With the update 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

 

            Last Updated Wed, 23 Sep 2020 13:42:39 +0000