LCD and Policy Article Revisions Summary for May 25, 2017

Posted on May 25, 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 Negative Pressure Wound Therapy Pumps and Pressure Reducing Support Surfaces - Group 2. The Standard Documentation Requirements for All Claims Submitted to the DME MACs PA was also updated. Please review the entire LCD and related PA for complete information.

Negative Pressure Wound Therapy Pumps
LCD
Revision Effective Date: 05/25/2017

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

Removed: General instructions regarding WOPD

Policy Article
Revision Effective Date: 05/25/2017

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Removed: WOPD requirement

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Removed: WOPD requirement

 

Pressure Reducing Support Surfaces - Group 2
LCD

Revision Effective Date: 05/25/2017

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 section

Removed: PIM reference under Appendices section

Revised: Pressure ulcer staging criteria per NPUAP 2016 Staging Consensus Conference

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements article

Policy Article
Revision Effective Date: 05/25/2017

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

Added: Modifier requirements

RELATED LOCAL COVERAGE DOCUMENTS:

Added: LCD-related Standard Documentation Requirements Language Article

 

Standard Documentation Requirements for All Claims Submitted to DME MACs
Revision Effective Date: 05/25/2017

WRITTEN ORDERS PRIOR TO DELIVERY (WOPD)

Removed: Requirement for "Standard WOPD" for specific items identified by CMS or DME MACs such as Negative Pressure Wound Therapy (NPWT)

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 Wed, 24 May 2017 09:54:12 +0000