LCD and Policy Article Revisions Summary for April 29, 2021

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 Intravenous Immune Globulin and Urological Supplies. Please review the entire LCDs and related PAs for complete information.

Intravenous Immune Globulin

LCD

Revision Effective Date: 04/01/2021
HCPCS CODES:
Added: J1554

04/29/2021: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS HCPCS coding determinations.

Urological Supplies

LCD

Revision Effective Date: 04/01/2021
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Removed: Trademark symbol from first use of inFlow
HCPCS CODES:
Removed: K1010, K1011 and K1012 (effective for DOS on or after 04/01/2021)

04/29/2021: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS HCPCS coding determinations.

PA

Revision Effective Date: 04/01/2021
GENERAL:
Removed: Trademark symbol from first use of inFlow
CODING GUIDELINES:
Revised: inFlow HCPCS billing directions for K1010, K1011 and/or K1012 for DOS 10/01/2020 through 03/31/2021
Added: Billing direction for inFlow under HCPCS A4335 for DOS on or after 04/01/2021
Revised: inFlow replacement language, to include product information instead of K1010, K1011, and K1012

04/29/2021: 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(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

 

            Last Updated Thu, 29 Apr 2021 16:36:56 +0000