LCD and Policy Article Revisions Summary for March 30, 2017

Posted on March 30, 2017

Outlined below are the principal changes to the DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted. The policies included are Canes and Crutches, Cervical Traction Devices, External Breast Prostheses and High Frequency Chest Wall Oscillation Devices. Wheelchair Options/Accessories and Wheelchair Seating included revisions to the PAs only. Please review the entire LCD and related PA for complete information.

Canes and Crutches

LCD

Revision Effective Date: 01/01/2017

COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Removed: Standard Documentation Language

Added: New reference language and directions to Standard Documentation Requirements

Added: General Requirements

DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: General Documentation Requirements

Added: New reference language and directions to Standard Documentation Requirements

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: Direction to Standard Documentation Requirements

Removed: Supplier Manual reference from Miscellaneous

Removed: PIM reference from Appendices

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements article

Policy Article

Revision Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Added: Direction to Standard Documentation Requirements

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements Language Article

 

Cervical Traction Devices

LCD

Revision Effective Date: 01/01/2017

COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Removed: Standard Documentation Language

Added: New reference language and directions to Standard Documentation Requirements

Added: General Requirements

DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: General Documentation Requirements

Added: New reference language and directions to Standard Documentation Requirements

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: Direction to Standard Documentation Requirements

Removed: Information under Miscellaneous and Appendices

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements article

Policy Article

Revision Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Added: 42 CFR 410.38(g) and Modifiers requirements

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements Language Article

 

External Breast Prostheses

LCD

Revision Effective Date: 01/01/2017

COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Removed: Standard Documentation Language

Added: New reference language and directions to Standard Documentation Requirements

Added: General Requirements

Revised: Refill Requirements

DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: General Documentation Requirements

Added: New reference language and directions to Standard Documentation Requirements

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: Direction to Standard Documentation Requirements

Removed: Information under Miscellaneous and Appendices

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements article

Policy Article

Revision Effective Date: 01/01/2017

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Added: Diagnosis and Change in Medical Condition requirements

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements Language Article

 

High Frequency Chest Wall Oscillation Devices

LCD

Revision Effective Date: 01/01/2017

COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Removed: Standard Documentation Language

Added: New reference language and directions to Standard Documentation Requirements

Added: General Requirements

DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: General Documentation Requirements

Added: New reference language and directions to Standard Documentation Requirements

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Removed: Standard Documentation Language

Added: Direction to Standard Documentation Requirements

Removed: Supplier Manual reference under Miscellaneous
Removed: PIM reference under Appendices

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements article

Policy Article

Revision Effective Date: 01/01/2017

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Added: 42 CFR 410.38(g) and Modifier instructions

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements Language Article

 

Wheelchair Options/Accessories

Policy Article

Revision Effective Date: 01/01/2017

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Removed: Non-coverage language for E0950 due to clerical error

 

Wheelchair Seating

Policy Article

Revision Effective Date: 01/01/2017

CODING GUIDELINES:

Revised: Coding guidelines for E0956 due to a narrative description error

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 LCDs and/or Policy Articles.

Last Updated Mar 29 , 2017