LCD and Policy Article Revisions Summary for October 2 2014 - JD DME

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 the entire LCDs and related PAs for complete information.

External Infusion Pumps

LCD

Revision Effective Date: 11/01/2014

DOCUMENTATION REQUIREMENTS:

Removed: Suggested form for inotrope information

Knee Orthoses

LCD

Revision Effective Date: 10/01/2014

COVERAGE INDICATIONS, LIMITATIONS, and/or MEDICAL NECESSITY:

Added: Codes K0901 and K0902 to Prefabricated Knee Orthoses section

Added: Base Codes K0901 and K0902 to Addition Codes tables

Added: Codes K0901 and K0902 to the requirement (1) for custom fabricated knee orthosis with an adjustable flexion and extension joint

HCPCS CODES:

Added: Codes K0901 and K0902

ICD-9 CODES THAT SUPPORT MEDICAL NECESSITY:

Added: Codes K0901 and K0902 to Group 4 Codes

Policy Article

Revision Effective Date: 10/01/2014

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Added: Codes K0901 and K0902 to Correct coding of prefabricated knee orthoses

Added: Reasonable Useful Lifetime for codes K0901 and K0902

CODING GUIDELINES:

Added: Codes K0901 and K0902 to coding guidelines

Added: Base Codes K0901 and K0902 to Addition Codes table

Therapeutic Shoes for Persons with Diabetes

Policy Article

Revision Effective Date:  11/01/2014

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Revised:  Criterion 5 (in-person fitting requirement)

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