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February 23, 2023

LCD and Policy Article Revisions Summary for February 23, 2023

Outlined below are the principal changes to the DME MAC Local Coverage Determination (LCD) and Policy Article (PA) that have been revised and posted. The policy included is Oxygen and Oxygen Equipment. Please review the entire LCD and related PA for complete information.

Oxygen and Oxygen Equipment

LCD

Oxygen and Oxygen Equipment LCDExternal website

Revision Effective Date: 04/01/2023

CODING INFORMATION:

  • Added: N1, N2 and N3 modifiers

02/23/2023: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are non-discretionary updates to CMS HCPCS coding determinations.

PA

Oxygen and Oxygen Equipment PAExternal website

Revision Effective Date: 04/01/2023

DOCUMENTATION FOR CONTINUED PAYMENT OF OXYGEN AFTER INITIAL COVERAGE:

  • Revised: Documentation requirements for Group II and Group III to remove re-evaluation and specify documentation of testing requirements (effective 09/27/2021)

MODIFIERS:

  • Added: N1, N2 and N3 modifier instructions
  • Revised: Direction regarding the use of the KX modifier on or after April 1, 2023

02/23/2023: At this time the 21st Century Cures Act applies to new and revised LCDs 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/or PAs. For complete information on any topic, you must review the LCDs and/or PAs.

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