LCD and Policy Article Revisions Summary for May 21 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. The policies included are Speech Generating Devices, Transcutaneous Electrical Joint Stimulation Devices (TEJSD), Transcutaneous Electrical Nerve Stimulators (TENS) and Vacuum Erection Devices (VED). Please review each entire LCD and each related PA for complete information.

Speech Generating Devices
LCD
Revision Effective Date: 10/31/2014
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation Language to add covered prior to a beneficiary's Medicare eligibility
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
Revised: Repair to beneficiary-owned DMEPOS

Policy Article
Revision Effective Date: 10/31/2014
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: "When required by state law" from ACA new prescription requirements
Revised: Face-to-Face Requirements for treating practitioner

Transcutaneous Electrical Joint Stimulation Devices (TEJSD)
LCD
Revision Effective Date: 10/31/2014
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation Language to add covered prior to a beneficiary's Medicare eligibility
Revised: Standard Documentation Language for WOPD to make consistent with ACA requirements
DOCUMENTATION REQUIREMENTS:
Revised: Standard Documentation Language for WOPD to make consistent with ACA 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

Policy Article
Revision Effective Date:  10/31/2014
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: "When required by state law" from ACA new prescription requirements

Transcutaneous Electrical Nerve Stimulators (TENS)
LCD
Revision Effective Date: 10/31/2014
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation Language to add covered prior to a beneficiary's Medicare eligibility
DOCUMENTATION REQUIREMENTS:
Revised: Standard Documentation Language for WOPD to make consistent with ACA 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
Added: Repair/Replacement section

Policy Article
Revision Effective Date: 10/31/2014
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: "When required by state law" from ACA new prescription requirements
Revised: Face-to-Face Requirements for treating practitioner

Vacuum Erection Devices (VED)
LCD
Revision Effective Date:  07/01/2015
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Changed coverage indications for L7900 and L7902 to non-covered based on Achieving a Better Life Experience (ABLE) Act of 2014

Policy Article
Revision Effective Date:  07/01/2015
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: Changed coverage to non-covered based on ABLE Act of 2014

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.