LCD and Policy Article Revisions Summary for September 27, 2018 - JA DME
LCD and Policy Article Revisions Summary for September 27, 2018
Outlined below are the principal changes to the DME MAC Local Coverage Determinations (LCD) for High Frequency Chest Wall Oscillation Devices, Mechanical In-exsufflation Devices, and Wheelchair Seating as well as Policy Articles (PA) for Oral Anticancer Drugs and Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) that have been revised and posted. Please review the entire LCD and related PA for complete information.
High Frequency Chest Wall Oscillation Devices
LCD
Revision Effective Date: 10/01/2018
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 Code G71.0 due to annual ICD-10 Code updates
Added: New expanded ICD-10 codes for those removed
09/27/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
Mechanical In-exsufflation Devices
LCD
Revision Effective Date: 10/01/2018
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 Code G71.0 due to annual ICD-10 Code updates
Added: New expanded ICD-10 codes for those removed.
09/27/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
Wheelchair Seating
LCD
Revision Effective Date: 10/01/2018
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 code G71.0 from Group 2 and Group 4 due to annual ICD-10 Code updates
Added: New expanded ICD-10 codes, to Group 2 and Group 4, for those removed
09/27/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
Oral Anticancer Drugs
PA
Revision Effective Date: 10/01/2018
ICD-10 Codes that are Covered
Removed: Group 3: C4A.11, C4A.12, C44.102, C44.109, C44.112, C44.119, C44.122, C44.129, C44.192, C44.199, Group 4: C4A.11, C4A.12, Group 6: C43.11, C43.12, D03.11, D03.12, Group 8: C43.11, C43.12, D03.11, D03.12, Group 9: C4A.11, C4A.12
Added: New expanded ICD-10 codes for those removed
09/27/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics)
PA
Revision Effective Date: 10/01/2018
ICD-10 Codes that are Covered
Removed: Non-specific ICD-10 codes no longer valid for submission: C43.11, C43.12, C4A.11, C4A.12, C44.102, C44.109, C44.112, C44.119, C44.122, C44.129, C44.192, C44.199, D03.11, D03.12, D04.11, D04.12
Added: New expanded ICD-10 codes for those removed
09/27/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, 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.
