LCD and Policy Article Revisions Summary for February 26 2015 - JA DME

Outlined below are the principal changes to DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted.  Please review each entire LCD and each related PA for complete information.

Lower Limb Prostheses

LCD

Revision Effective Date: 01/01/2015
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Added: Standard language regarding Medicare coverage
HCPCS CODING:
Revised: HCPCS Narrative of L7367
DOCUMENTATION REQUIREMENTS:
Added: Continued need, continued use, and Prior Payer verbiage and updated standard language documentation
Revised: Repair/Replacement verbiage

Power Mobility Devices

LCD

Revision Effective Date: 01/01/2015
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation Language to add covered prior to a beneficiary's Medicare eligibility
HCPCS CODES:
Revised: HCPCS Narrative for E0986
DOCUMENTATION REQUIREMENTS:
Revised: Standard Documentation Language to add who can enter date of delivery date on the POD
Added: Instructions for equipment retained from a prior payer and repair/replacement verbiage

Policy Article

Revision Effective Date: 01/01/2015
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: HCPCS Narrative for E0986 and updated standard language documentation

Refractive Lenses

LCD

Revision Effective Date: 01/01/2015
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation Language regarding Medicare coverage
HCPCS CODING:
Revised: HCPCS V2799 Narrative
DOCUMENTATION REQUIREMENTS:
Revised: Standard Documentation Language to add who can enter date of delivery date on the POD
Added: Continued need, continued use, request for refill documentation requirements and repair/replacement
Revised: Changed ICD-9 reference to diagnosis

Policy Article

Revision Effective Date: 05/01/2013 (February 2015 Publication)
Removed: Reference to ICD-9 located in the narrative

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 LCD and/or Policy Article.