Article Detail - JD DME

The Noridian Medicare Pneumatic Compression Devices (PCD) webpage provides detailed guidance on the coverage, coding, and documentation requirements for PCDs under Medicare. These devices are used primarily for treating conditions like lymphedema and chronic venous insufficiency.

Key highlights include:

• Coverage Criteria: As of November 14, 2024, the Local Coverage Determination (LCD) and related policy articles have been retired. Coverage is now governed by National Coverage Determination (NCD) 280.6. This outlines general and specific criteria for devices coded E0650, E0651, and E0652.
• Documentation Requirements: Providers must document the patient’s diagnosis, symptoms, prior treatments, and response to initial PCD use. A four-week trial with compression therapy is required before prescribing devices.
• Device-Specific Guidance:
  • E0652: Requires documentation of unique patient characteristics that justify the need for a more advanced device.
  • E0675: Lacks specific policy guidance; claims are reviewed individually and may require appeals if denied.
• Checklists and Tools: The site includes clinician checklists and documentation templates to assist with compliance and reduce claim denials.

This resource is essential for suppliers and clinicians to ensure proper Medicare billing and reimbursement for PCDs.