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September 21, 2023

Policy Article Revisions Summary for September 21, 2023

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Automatic External Defibrillators, External Infusion Pumps, Mechanical In-exsufflation Devices, Oral Anticancer Drugs, Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) and Wheelchair Seating. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

Automatic External Defibrillators

PA

Automatic External Defibrillators PAExternal Website

Revision Effective Date: 10/01/2023

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM code I21.B to Groups 1 and 2 Codes due to ICD-10-CM code updates

09/21/2023: 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.

External Infusion Pumps

PA

External Infusion Pumps PAExternal Website

Revision Effective Date: 10/01/2023

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10-CM code G20 from Group 4 Codes due to ICD-10-CM code updates
  • Added: ICD-10-CM codes G20.A1, G20.A2, G20.B1, G20.B2 to Group 4 Codes due to ICD-10-CM code updates

09/21/2023: 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.

Mechanical In-exsufflation Devices

PA

Mechanical In-exsufflation Devices PAExternal Website

Revision Effective Date: 10/01/2023

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM code E74.05 to Group 1 Codes due to ICD-10-CM code updates

09/21/2023: At this time 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.

Oral Anticancer Drugs

PA

Oral Anticancer Drugs PAExternal Website

Revision Effective Date: 10/01/2023

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10-CM code D48.1 from Group 7 Codes due to ICD-10-CM code updates
  • Added: ICD-10-CM codes D48.110, D48.111, D48.112, D48.113, D48.114, D48.115, D48.116, D48.117, D48.118, D48.119, D48.19 to Group 7 Codes due to ICD-10-CM code updates

09/21/2023: 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.

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics)

PA

Oral Antiemetic Drugs PAExternal Website

Revision Effective Date: 10/01/2023

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10-CM code D48.1 from Group 1 Codes due to ICD-10-CM code updates
  • Added: ICD-10-CM codes D48.110, D48.111, D48.112, D48.113, D48.114, D48.115, D48.116, D48.117, D48.118, D48.119, D48.19 to Group 1 Codes due to ICD-10-CM code updates

09/21/2023: 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.

Wheelchair Seating

PA

Wheelchair Seating PAExternal Website

Revision Effective Date: 10/01/2023

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10-CM codes G20 and G37.8 from Group 2 and Group 4 Codes, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes E75.27, E75.28, G20.A1, G20.A2, G20.B1, G20.B2, G20.C, G31.80, G31.86, G37.81, and G37.89 to Group 2 and Group 4 Codes, due to ICD-10-CM code updates
  • Added: ICD-10-CM code G31.89 to Group 2 and Group 4 Codes

09/21/2023: 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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