Medical Director Articles - 2024

 
Title Brief Description Last Updated
Definitions Used for Off-the-Shelf versus Custom Fitted Prefabricated Orthotics (Braces) - Correct Coding - Revised This article outlines the differences between off-the-shelf versus custom fitted prefabricated orthotics. 10/10/24
Custom Fitted Orthotic HCPCS Codes Without a Corresponding Off-the-Shelf Code - Correct Coding - Revised This article educates suppliers regarding the coding and billing of custom fitted orthotics that do not have a corresponding off-the-shelf equivalent. 10/10/24
Pneumatic Compression Devices - Correct Coding and Billing This article provides correct coding and billing information for pneumatic compression devices. 10/03/24
Retirement of Pneumatic Compression Devices Local Coverage Determination (LCD) and Related Policy Article - Effective November 14, 2024 This article announces the retirement of the pneumatic compression devices LCD and Policy Article effective November 14, 2024. 10/03/24
Policy Article Revision Summary for September 26, 2024 This article outlines principal changes to the DME MAC Policy Article that has been revised and posted. 09/26/24
2024 HCPCS Code Update - October Edition - Correct Coding This article identifies changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for October 2024. 09/26/24
Policy Article Revision Summary for September 12, 2024 This article outlines principal changes to the DME MAC Policy Articles that has been revised and posted. 09/12/24
Prior Authorization and Code Verification Review Requirement for Lower Limb Orthoses (L1843, L1845, L1951) and Spinal Orthoses (L0631, L0637, L0639) The DME MACs are issuing a Prior Authorization and Coding Verification Requirement for L1843, L1845, L1951, L0631, L0637, L0639 effective for claims with dates of service on or after December 1, 2024. 09/05/24
Policy Article Revisions Summary for August 29, 2024 This article outlines principal changes to the DME MAC Policy Articles that has been revised and posted. 08/29/24
Correct Coding of Elbow, Shoulder, Shoulder-Elbow-Wrist-Hand and Shoulder-Elbow-Wrist-Hand-Finger Braces (Orthoses) - Revised Based on recent analysis of claims submitted to the DME MAC for upper extremity braces, the DME MACs and the PDAC Contractor want to remind DMEPOS suppliers about the correct coding for these products. 08/22/24
Policy Article Revisions Summary for August 8, 2024 This article outlines principal changes to the DME MAC Policy Articles that has been revised and posted. 08/08/24
LCD Revisions Summary for August 1, 2024 This article outlines principal changes to the DME MAC LCD that has been revised and posted. 08/01/24
LCD and Policy Article Revisions Summary for July 18, 2024 This article outlines principal changes to the DME MAC LCD and Policy Articles that has been revised and posted. 07/18/24
Lower Limb Prostheses - Final LCD and Response to Comments (RTC) Article Published This article announces the Final Lower Limb Prostheses LCD and Response to Comments Article. 07/18/24
RETIRED - ALYGLO® (immune globulin intravenous, human-stwk), 10% Liquid - Correct Coding and Coverage Claims for ALYGLO® submitted to Medicare for dates of service on or after December 15, 2023 should be submitted using HCPCS code J1599. 07/11/24
Policy Article Revisions Summary for June 27, 2024 This article outlines principal changes to the DME MAC Policy Article that has been revised and posted. 06/27/24
Policy Article Revisions Summary for June 20, 2024 This article outlines principal changes to the DME MAC Policy Article that has been revised and posted. 06/20/24
Policy Article Revisions Summary for June 13, 2024 This article outlines principal changes to the DME MAC Policy Article that has been revised and posted. 06/13/24
Policy Article Revisions Summary for June 6, 2024 This article outlines principal changes to the DME MAC Policy Articles that have been revised and posted. 06/06/24
RETIRED - Code Verification Review Requirement for Lower Limb Orthoses (L1843, L1951) and Osteogenesis Stimulator (E0747, E0748, E0760) The DME MACs are issuing a Coding Verification Requirement for L1843, L1951, E0747, E0748, and E0760 effective for claims with dates of service on or after December 1, 2024. 05/30/24
Policy Article Revisions Summary for May 16, 2024 This article outlines principal changes to the DME MAC Policy Articles that have been revised and posted. 05/16/24
Policy Article Revisions Summary for May 9, 2024 This article outlines principal changes to the DME MAC Policy Articles that have been revised and posted. 05/09/24
Code Verification Review Requirement for Multi-Functional Ventilators The only products which may be billed using the multi-function ventilator HCPCS codes are those that have received mandatory code verification review and are listed on the Product Classification List (PCL) of the Pricing. 05/09/24
Correct Billing and Coding of Ventilators Equipment with multifunction capability creates the possibility of errors in claims submitted for these items. This article will discuss the application of Medicare proper coding and payment rules for ventilators. 05/09/24
LCD and Policy Article Revisions Summary for May 2, 2024 This article outlines principal changes to the DME MAC LCDs and Policy Articles that have been revised and posted. 05/02/24
RETIRED - Correct Coding of ActaStim-S Spine Fusion Stimulator This article outlines principal changes to the DME MAC LCDs and Policy Articles that have been revised and posted. 05/02/24
2024 HCPCS Code Update - April Edition - Correct Coding This article identifies changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for April 2024. 04/11/24
LCD Revisions Summary for April 4, 2024 This article outlines principal changes to the DME MAC LCD that has been revised and posted. 04/04/24
PureWick Urine Collection System - Coding and Billing Instructions - Revised This article provides revised coding and billing instructions for Purewick. 03/28/24
Policy Article Revisions Summary for March 21, 2024 This article outlines principal changes to the DME MAC Policy Articles that have been revised and posted. 03/21/24
Policy Article Revisions Summary for March 14, 2024 This article outlines principal changes to the DME MAC Policy Articles that have been revised and posted. 03/14/24
Policy Article Revisions Summary for March 7, 2024 This article outlines principal changes to the DME MAC Policy Article that has been revised and posted. 03/07/24
Policy Article Revisions Summary for February 29, 2024 This article outlines principal changes to the DME MAC Policy Article that has been revised and posted. 02/29/24
Lymphedema Compression Treatment Items - Correct Coding and Billing - Revised This article provides billing and coding guidance pertinent to lymphedema compression treatment items, based on the Centers for Medicare & Medicaid Services’ (CMS’) Final Rule CMS-1780-F and provides a revised denial statement for garments, related supplies and accessories for non-lymphedema diagnoses. 02/29/24
External Infusion Pumps and Related Drugs - Revised This revised article outlines how drugs are covered under the DME benefit for an external infusion pump. 02/22/24
External Upper Limb Tremor Stimulator Therapy - Final LCD and Response to Comments (RTC) Article Published This article announces the final LCD and Response to Comments articles is published. 02/22/24
LCD Revisions Summary for February 15, 2024 This article outlines principal changes to the DME MAC LCD that has been revised and posted. 02/15/24
Open Meeting Agenda - Lower Limb Prostheses Proposed Local Coverage Determination (LCD) This article announces the agenda for the LLP open meeting scheduled for February 22, 2024. 02/08/24
Policy Article Revisions Summary for February 8, 2024 This article outlines principal changes to the DME MAC Policy Articles that has been revised and posted. 02/08/24
3-D Printed Orthotic Devices - Correct Coding This article addresses recent inquiries and concerns regarding additive manufacturing (i.e., 3D printing) of orthotic devices. 02/01/24
RETIRED - Definitions Used for Off-the-Shelf versus Custom Fitted Prefabricated Orthotics (Braces) - Correct Coding - Revised This article outlines the differences between off-the-shelf versus custom fitted prefabricated orthotics. 02/01/24
RETIRED - External Infusion Pumps and Related Drugs This article outlines how drugs are covered under the DME benefit for an external infusion pump. 01/25/24
Lymphedema Compression Treatment Items Requirement for Registration with the Food and Drug Administration This article reminds suppliers that a medical device, including lymphedema compression treatment items, at a minimum, must be registered with the FDA. 01/25/24
LCD Revisions Summary for January 25, 2024 This article outlines principal changes to the DME MAC LCDs that has been revised and posted. 01/25/24
Policy Article Revisions Summary for January 18, 2024 This article outlines principal changes to the DME MAC Policy Article that has been revised and posted. 01/18/24
Open Meeting Announcement - Lower Limb Prostheses Proposed Local Coverage Determination (LCD) This article announces an open meeting for the proposed Lower Limb Prostheses LCD. 01/18/24
Proposed Local Coverage Determination (LCD) Released for Comment - Lower Limb Prostheses This article announces the release of the proposed Lower Limb Prostheses LCD. 01/18/24
RETIRED - Home Assessment for Manual Wheelchairs - Reminder This article reminds suppliers of the home assessment for manual wheelchairs and to fully document the home assessment. 01/18/24
Items Provided on a Recurring Basis and Request for Refill Requirements - Annual Reminder - January 2024 This article is an annual reminder regarding request for refill requirements as required by the CMS Internet Only Manual (IOM) publication 100-04, Chapter. 20, Section. 200 01/04/24
2024 HCPCS Code Update - January Edition - Correct Coding This article identifies changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for January 2024. 01/04/24
Last Updated Oct 10 , 2024