LCD and Policy Article Revisions Summary for March 26, 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.

Canes and Crutches

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
Revised: Repair to beneficiary-owned DMEPOS

Cold Therapy

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 Standard Documentation Language

External Infusion Pumps

LCD

Revision Effective Date: 01/01/2015 (March 2015 Publication)
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Added: Maximum utilization for Blinatumomab; inadvertently omitted
DOCUMENTATION REQUIREMENTS:
Revised: Instructions for Revised DIF
Added: Instructions for Recertification DIF

Policy Article

Revision Effective Date: 01/01/2015 (March 2015 Publication)
CODING GUIDELINES:
Revised: Units of service for and blinatumomab
Added: Instructions for least wastage of blinatumomab; inadvertently omitted from previous publication

Infrared Heating Pad System

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:
Added: Added Appendices verbiage

Manual Wheelchair Bases

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 Refill Documentation
Added: Equipment Retained from a Prior Payer
Revised: Repair to beneficiary-owned DMEPOS

Policy Article

Revision Effective Date: 10/31/2014
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES
Removed: "When required by state law" from ACA new prescription requirements
Revised: Face-to-Face Requirements for treating practitioner

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 Jun 25 , 2018