LCD and Policy Article Revisions Summary for March 12, 2015

Outlined below are the principal changes to DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted.  Please review each entire LCD and each related PA for complete information.

Negative Pressure Wound Therapy Pumps

LCD

Revision Effective Date: 10/31/2014
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation Language to add covered prior to a beneficiary's Medicare eligibility
DOCUMENTATION REQUIREMENTS:
Revised: Standard Documentation Language to add who can enter date of delivery date on the POD
Added: Instructions for Equipment Retained from a Prior Payer
Added: Repair/Replacement section
Removed: ICD-9 CM reference

Policy Article

Revision Effective Date:  01/01/2015
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Added: HCPCS Code A9272 (code effective 01/01/2012) to statement regarding denial of disposable wound suction pumps and related supplies
CODING GUIDELINES:
Added: Instructions for billing disposable wound suction system
Revised: Instructions for billing supplies used with disposable wound suction systems

Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea

LCD

Revision Effective Date: 10/31/2014
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Language
Added: Language from RAD LCD allowing Sleep study Types II, III, IV testing in facility setting
DOCUMENTATION REQUIREMENTS:
Revised: Standard Language

Policy Article

Revision Effective Date: 10/31/2014
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Added: Standard language reference to benefit category citation in Social Security Act.
Added: Statutory denial for liners
Revised: Face-to-Face Standard Language
CODING GUIDELINES:
Added:  Correct coding of liners
Added:  Correct coding of monitoring technology

Note: The information contained in this article is only a summary of revisions to the LCDs and Policy Articles.  For complete information on any topic, you must review the LCD and/or Policy Article.

Last Updated Wed, 31 Aug 2016 13:36:24 +0000