LCD and Policy Article Revisions Summary for February 20, 2020

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: Ankle-Foot/Knee-Ankle-Foot Orthosis, Eye Prostheses, Facial Prostheses, Glucose Monitors, Manual Wheelchair Bases, Orthopedic Footwear, Ostomy Supplies, Parenteral Nutrition, Patient Lifts, Pneumatic Compression Devices, Suction Pumps and Walkers. Please review the entire LCDs and related PAs for complete information.

Ankle-Foot/Knee-Ankle-Foot Orthosis

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Revised: Format of HCPCS code references, from code ‘spans' to individually-listed HCPCS
Revised: Order information as a result of Final Rule 1713
HCPCS CODES:
Revised: HCPCS L2006 code description per quarterly HCPCS code update
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713, HCPCS code changes, and non-substantive corrections (listing individual HCPCS codes instead of a HCPCS code-span). During the exercise of listing individual HCPCS codes, L2006 had been inadvertently added because it fell within a code span and is being deleted.

PA

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Revised: "ordering physician's" to "treating practitioner's"
Revised: "physician's" to "practitioner's"
Revised: Format of HCPCS code references, from code ‘spans' to individually-listed HCPCS
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code ‘spans' to individually-listed HCPCS
Added: Coding Guidelines for L1900, L1902, L1904, L1907, L1910, L1920, L1930, L1932, L1940, L1945, L1950, L1951, L1970, L1971, L1980, and L1990
Revised: L1906 Coding Guideline
Revised: L2006 Coding Guideline per quarterly HCPCS code update
Removed: HCPCS K0903
Added: HCPCS A5514, crosswalk from K0903
Removed: Reference of effective DOS for K0903
Added: Reference of effective DOS for A5514

02/20/2020: 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.

Eye Prostheses

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

PA

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: "physician's" to "treating practitioner's"
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Facial Prostheses

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

PA

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Glucose Monitors

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Removed: Statement to refer to ICD-10 Codes that are Covered section in the LCD-related PA
Added: Statement to refer to ICD-10 code list in the LCD-related Policy Article
Revised: "physician" to "treating practitioner"
Revised: "treating physician" to "treating practitioner"
Revised: "month" to "30 days," as clarification of billing K0553
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
Revised: Order information as a result of Final Rule 1713
REFILL REQUIREMENTS:
Revised: "ordering physician" to "treating practitioner"
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO
APPENDICES:
Revised: "physician" to "practitioner"

02/20/2020: Pursuant to the 21st Century Cures Act , these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713, HCPCS code changes, and non-substantive corrections (listing individual HCPCS codes instead of a HCPCS code-span).

PA

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: STATUTORY ORDER REQUIRMENTS section
Removed: REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO 42 CFR 410.38(g) section
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
MODIFIERS:
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
CODING GUIDELINES:
Clarified: Coding guideline related to K0553 billing timeline
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Manual Wheelchair Bases

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Revised: Format of HCPCS codes, from ‘code spans' to individually-listed HCPCS
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713, HCPCS code changes, and non-substantive corrections (listing individual HCPCS codes instead of a HCPCS code-span).

PA

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: "physician" to "practitioner"
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO 42 CFR 410.38(g):
Removed: Section due to Final Rule 1713
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Revised: Format of HCPCS code references, from code 'spans' to individually-listed HCPCS
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code 'spans' to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Orthopedic Footwear

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Statement to refer to ICD-10 code list in the LCD-related Policy Article
GENERAL:
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: "Prescriptions (orders)" to "SWO"

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

PA

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
Removed: Therapeutic Shoes for Persons with Diabetes codes, leaving reference to the policy
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
Removed: Therapeutic Shoes for Persons with Diabetes codes, leaving reference to the policy
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Ostomy Supplies

LCD

Revision Effective Date: 01/01/2020
GENERAL:
Revised: Order information as a result of Final Rule 1713
REFILL REQUIREMENTS:
Revised: "ordering physicians" to "treating practitioners"
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: "Prescriptions (orders)" to "SWO"

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

PA

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"
02/20/2020: 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

Parenteral Nutrition

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Revised: "ordering physician" to "treating practitioner"
NUTRIENTS:
Revised: "ordering physician" to "treating practitioner"
Revised: Format of HCPCS codes, from ‘code spans' to individually-listed HCPCS
EQUIPMENT AND SUPPLIES:
Revised: Format of HCPCS code references, from ‘code spans' to individually-listed HCPCS
GENERAL:
Revised: Order information as a result of Final Rule 1713
REFILL REQUIREMENTS:
Revised: "ordering physicians" to "treating practitioners"
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: "Prescriptions (orders)" to "SWO"

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713, HCPCS code changes, and non-substantive corrections (listing individual HCPCS codes instead of a HCPCS code-span).

PA

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: "attending physician" to "treating practitioner"
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Revised: "physician" to "treating practitioner"
Revised: Format of HCPCS code references, from ‘code spans' to individually-listed HCPCS
DME INFORMATION FORM (DIF):
Revised: "ordering physician" to "treating practitioner"
Revised: Format of HCPCS code references, from ‘code spans' to individually-listed HCPCS
CODING GUIDELINES:
Revised: Format of HCPCS code references, from ‘code spans' to individually-listed HCPCS

02/20/2020: 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.

Patient Lifts

LCD

Revision Effective Date: 01/01/2020
GENERAL:
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: "Prescriptions (orders)" to "SWO"

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

PA

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO 42 CFR 410.38(g) section
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CODING GUIDELINES:
Revised: Format of HCPCS code references, from ‘code spans' to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Pneumatic Compression Devices

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: "prescribing physician" to "treating practitioner"
Revised: "physician" to "practitioner"
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
GENERAL:
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: "Prescriptions (orders)" to "SWO"

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713, HCPCS code changes, and non-substantive corrections (listing individual HCPCS codes instead of a HCPCS code-span).

PA

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO 42 CFR 410.38(g):
Remove: Entire section based on Final Rule 1713
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CERTIFICATE OF MEDICAL NECESSITY (CMN):
Revised: Section header to remove PIM reference
Revised: "physician" to "treating practitioner"
Revised: Detailed Written Order to SWO
Removed: CMN DME form version number
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Suction Pumps

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Removed: Statement to refer to ICD-10 Codes that are Covered section in the LCD-related PA
Added: Statement to refer to ICD-10 code list in the LCD-related Policy Article
GENERAL:
Revised: Order information as a result of Final Rule 1713
REFILL REQUIREMENTS:
Revised: "ordering physicians" to "treating practitioners"
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUMENTATION REQUIREMENTS:
Revised: "Prescriptions (orders)" to "SWO"

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

PA

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CODING GUIDELINES:
Revised: Format of HCPCS code references, from ‘code spans' to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"
02/20/2020: 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.

Walkers

LCD

Revision Effective Date: 01/01/2020
COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
Revised: Order information as a result of Final Rule 1713
CODING INFORMATION:
Removed: Field titled "Bill Type"
Removed: Field titled "Revenue Codes"
Removed: Field titled "ICD-10 Codes that Support Medical Necessity"
Removed: Field titled "ICD-10 Codes that DO NOT Support Medical Necessity"
Removed: Field titled "Additional ICD-10 Information"
DOCUMENTATION REQUIREMENTS:
Revised: "physician's" to "treating practitioner's"
GENERAL DOCUENTATION REQUIREMENTS:
Revised: Prescriptions (orders) to SWO

02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.

PA

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code ‘spans' to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

02/20/2020: 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.

Last Updated Feb 19, 2020