LCD and Policy Article Revisions Summary for December 21, 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 Lower Limb Prostheses, Wheelchair Options and Accessories, and Wheelchair Seating. The Standard Documentation Requirements for All Claims Submitted to the DME MACs PA was also updated. Please review the entire LCDs and related PAs for complete information.
 

Lower Limb Prostheses
LCD
Revision Effective Date: 01/01/2018

HCPCS CODES:
Added: L7700 to Group 1 Codes per annual HCPCS code release

12/21/2017: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

PA
Revision Effective Date: 01/01/2018

CODING GUIDELINES:
Added: Coding guidelines and bundling information for L7700

12/21/2017: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
 

Wheelchair Options and Accessories  
LCD
Revision Effective Date: 01/01/2018
HCPCS CODES:
Added: E0954 to Group 2 codes

12/21/2017: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

PA
Revision Effective Date: 01/01/2018

CODING GUIDELINES:
Added: HCPCS code E0954
Added: HCPCS code E0954 to bundling table

12/21/2017: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.

Wheelchair Seating
LCD
Revision Effective Date: 01/01/2018

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Added: E0953 to positioning items
HCPCS CODES:
Added: E0953 to Group 3 (Positioning Accessories) codes per 2018 annual HCPCS code updates
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Added: E0953 to paragraphs for Group 2 and Group 3 codes

12/21/2017: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

PA  
Revision Effective Date: 01/01/2018
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS
Added: E0953 to modifier instructions
CODING GUIDELINES:
Added: E0953 coding instructions

12/21/2017: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.

Standard Documentation Requirements for All Claims Submitted to the DME MACs
PA
Revision Effective Date: 12/21/2017

PROOF OF DELIVERY:
Revised: Description of item being delivered

12/21/2017: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.

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

Last Updated Fri, 26 Oct 2018 13:43:18 +0000