Medical Director Articles - 2020

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Title Brief Description Last Updated
External Infusion Pumps Final LCD (L33794) and Response to Comments (RTC) Article Published The DME MACs published the External Infusion Pumps Final LCD (L33794) and LCD-related Policy Article (PA) (A52507) 07/23/20
Scoliosis Brace - Correct Coding The DME MACs wants to reminder DMEPOS suppliers about the correct coding for scoliosis braces. 07/22/20
Insulin Infusion Pumps with Integrated Continuous Glucose Sensing Capabilities and Related Accessories/Supplies - Codes E0787 and A4226 - Correct Coding HCPCS Code E0787 and A4226 will become invalid on or after September 15, 2020. 07/20/20
Correct Coding and Coverage of Ventilators - Revised July 2020 View information about the application of Medicare proper coding and payment rules for ventilators. 07/16/20
CMS Issues Interim Final Rules with Comment (CMS-1744-IFC & CMS-5531-IFC) - COVID-19 Public Health Emergency - Revised On April 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment (CMS-1744-IFC), establishing that certain requirements for face-to-face/in-person encounters will not apply during the COVID-19 public health emergency. 06/29/20
Prosthetic Feet and Additions to Lower Limb Extremity Prostheses - Correct Coding and Coding Verification Review Requirement CMS published the continuation of prior authorization for 45 HCPCS codes on the Required Prior Authorization List of DMEPOS Items that require prior authorization as a condition of payment including three prosthetic foot system codes. 06/25/20
Xembify® - Correct Coding Xembify® is included in the External Infusion Pumps Local Coverage Determination (LCD L33794). 06/18/20
Oxygen and Oxygen Equipment Final LCD (L33797) and Response to Comments (RTC) Article Published Today the DME MACs published the Oxygen and Oxygen Equipment Final LCD (L33797) and Response to Comments (RTC) Article 06/18/20
Incorrect Use of HCPCS Code A9279 - Correct Coding The DME MACs have recently been made aware of the inappropriate use of HCPCS code A9279 (MONITORING FEATURE/DEVICE, STAND-ALONE OR INTEGRATED, ANY TYPE, INCLUDES ALL ACCESSORIES, COMPONENTS AND ELECTRONICS, NOT OTHERWISE CLASSIFIED). 06/11/20
Urological Supplies Final LCD (L33803) and Response to Comments (RTC) Article Published The DME MACs published the Urological Supplies Final LCD (L33803), LCD-related Policy Article (PA) (A52521) and Response to Comments Article. 06/11/20
CMS Issues Interim Final Rules with Comment (CMS-1744-IFC & CMS-5531-IFC) - COVID-19 Public Health Emergency - Revised On April 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment (CMS-1744-IFC), establishing that certain requirements for face-to-face/in-person encounters will not apply during the COVID-19 public health emergency. 05/21/20
Correct Use of the KX Modifier During the COVID-19 PHE On or after March 1, 2020 and for the duration of the COVID-19 Public Health Emergency (PHE), for the following LCDs in which the Face-to-Face evaluation or other services with an implied Face-to-Face evaluation such as a home assessment are waived during the PHE. 05/14/20
Billing of Part B Drugs and Enteral Nutrition to DME MACs During COVID-19 Pandemic - Dispensing Amounts - Revised The Centers for Medicare & Medicaid Services (CMS), under their National Emergency authority, is allowing Medicare beneficiaries to obtain amounts of Part B drugs in excess of the current monthly (30 day) limitation during COVID-19 Pandemic. 05/11/20
RETIRED - CMS Issues Interim Final Rules with Comment (CMS-1744- IFC & CMS-5531-IFC) - COVID-19 Public Health Emergency On April 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment (CMS-1744-IFC), establishing that certain requirements for face-to-face/in-person encounters will not apply during the COVID-19 public health emergency. 05/07/20
Open Meeting Announcement - External Infusion Pumps (DL33794) This article announces the Open Meeting for the External Infusion Pumps LCD 04/30/20
External Infusion Pumps Open Meeting Agenda This article announces the Agenda for the External Infusion Pumps LCD 04/30/20
Required Prior Authorization Suspended for the Duration of the COVID-19 Pandemic Effective on or after March 01, 2020, the Centers for Medicare & Medicaid Services (CMS) and the DME MACs are suspending the requirements to prior authorize certain power mobility devices (PMDs) and pressure reducing support surfaces (PRSS). 04/03/20
External Infusion Pumps Final LCD (L33794) and Response to Comments (RTC) Article Published The DME MACs published the External Infusion Pumps Final LCD (L33794) and LCD-related Policy Article (PA) (A52507) 04/16/20
Nebulizers Final LCD (L33370) and Response to Comments (RTC) Article Published The DME MACs published the Nebulizers Final LCD (L33370) and LCD-related Policy Article (PA) (A52466) 04/02/20
RETIRED - Billing of Part B Drugs to DME MACs During COVID-19 Pandemic - Dispensing Amounts The Centers for Medicare & Medicaid Services (CMS), under their National Emergency authority, is allowing Medicare beneficiaries to obtain amounts of Part B drugs in excess of the current monthly (30 day) limitation during COVID-19 Pandemic. 03/19/20
L3960 - Coding Verification Review Requirement This article reminds DMEPOS suppliers the description of HCPCS code L3960 and establishes a written coding verification review for dates of service on or after August 1, 2020 by the PDAC. 03/12/20
Frequently Asked Questions - Final Rule CMS-1713-F - Standard Written Orders The following FAQs address some of the questions received by the DME MACs regarding Final Rule CMS-1713-F and the Standard Written Order requirements 03/12/20
2020 HCPCS Code Annual Update - Correct Coding - Revised This article identifies changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for 2020 02/20/20
Completion of Certificates of Medical Necessity (CMN) - Annual Reminder [PDF] Annual reminder regarding the completion of the Certificate of Medical Necessity, commonly known as CMNs, which are documents used by the DME MACs to assist in gathering information about the medical necessity of an item. 01/23/20
Items Provided on a Recurring Basis and Request for Refill Requirements Annual reminder for all DMEPOS items and supplies provided on a recurring basis, billing must be based on prospective, not retrospective use. 01/22/20
Open Meeting Announcement - Urological Supplies (DL33803) This article announces the Open Meeting for Urological Supplies (DL33803) 01/16/20
Oxygen and Oxygen Equipment, Nebulizers, External Infusion Pumps and Urological Supplies Open Meeting Agenda This article provides the agenda for the upcoming Open Meeting on January 28, 2020 01/16/20

Last Updated Thu, 23 Jul 2020 13:51:38 +0000