LCD and Policy Article Revisions Summary for May 25 2017 - JD DME
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.
