Policy Article Revisions Summary for April 1, 2021

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Automatic External Defibrillators, Bowel Management Devices, Heating Pads and Heat Lamps, High Frequency Chest Wall Oscillation Devices, and Walkers. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

Automatic External Defibrillators

PA

Revision Effective Date: 01/01/2020
CODING GUIDELINES:
Revised: Instructions related to KF modifier for K0606 and E0617

04/01/2021: At this time the 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.

Bowel Management Devices

PA

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: Trademark symbols, per AMA guidelines
CODING GUIDELINES:
Removed: Trademark symbols, per AMA guidelines

04/01/2021: At this time the 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.

Heating Pads and Heat Lamps

PA

Revision Effective Date: 01/01/2020
CODING GUIDELINES:
Revised: References to Occupational Safety and Health Administration and Nationally Recognized Testing Laboratory references, to include acronyms

04/01/2021: At this time the 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.

High Frequency Chest Wall Oscillation Devices

PA

Revision Effective Date: 10/01/2020
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Removed: “etc.” from the not all-inclusive list of medical condition examples
CODING GUIDELINES:
Removed: “etc.” from the not all-inclusive list of differing technologies used by E0483 devices
Removed: “etc.” from the not all-inclusive list of components included in A7025

04/01/2021: At this time the 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

PA

Revision Effective Date: 01/01/2020
CODING GUIDELINES:
Added: “(CVR)” after reference to coding verification review
Added: “(PCL)” after reference to “Product Classification List”
Added: Incorrect coding denial language for products billed using HCPCS that require written coding verification review
Revised: Reference to HCPCS code E0159 long description

04/01/2021: At this time the 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.

With the update(s) listed above, Noridian would like to remind users how to find the policy that was previously effective. When billing, the supplier should follow guidance that was effective on the date of service. The below steps can be followed to find all previous policies:

  1. Open the currently effective policy on the Medical Coverage Database (MCD)
    1. Links to the MCD can be found on the Active LCDs page on the Noridian website
      1. There is a link at the top of the Active LCD page that goes to a full list of the LCDs or PAs, depending on which link is selected OR
      2. There are direct links to all LCDs under the ‘LCD ID number and Effective Date’ column
  2. Scroll down to the bottom of the policy
  3. Find the section labeled Public Version(s)
  4. Look for the link to the policy that was effective on the dates of service in question
  5. Click on hyperlink to go to the policy

 

            Last Updated Thu, 29 Apr 2021 16:51:13 +0000