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September 24, 2020

Policy Article Revisions Summary for September 24, 2020

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Ankle-Foot/Knee-Ankle-Foot Orthoses, High Frequency Chest Wall Oscillation Devices, Mechanical In-exsufflation Devices and Wheelchair Seating. Please review the entire LCDs and related PAs for complete information.

Ankle-Foot/Knee-Ankle-Foot Orthoses

PA

Ankle-Foot/Knee-Ankle-Foot Orthoses PA

Revision Effective Date: 10/01/2020

MISCELLANEOUS:

  • Clarified: Custom fabricated items that do not have specific HCPCS codes require additional information in claim narrative
  • Added: Statement referring to the LCD-related Standard Documentation Requirements article for more information

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: Non-specific ICD-10 codes M24.573 and M24.576 from Group 1 codes
  • Removed: Non-specific ICD-10 code M14.679 from Group 2 codes

09/24/2020: 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.

High Frequency Chest Wall Oscillation Devices

PA

High Frequency Chest Wall Oscillation Devices PA

Revision Effective Date: 10/01/2020

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10 code G71.2 from Group 1 codes, due to annual ICD-10 Code updates
  • Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, and G71.29 to Group 1 codes, due to annual ICD-10 Code updates

09/24/2020: 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.

Mechanical In-exsufflation Devices

PA

Mechanical In-exsufflation Devices PA

Revision Effective Date: 10/01/2020

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10 code G71.2 from Group 1, due to annual ICD-10 Code updates
  • Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, G71.29 to Group 1 codes, due to annual ICD-10 Code updates

09/24/2020: 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.

Wheelchair Seating

PA

Wheelchair Seating PA

Revision Effective Date: 10/01/2020

CODING GUIDELINES:

  • Added: RT and LT modifier billing instructions, for use when applicable

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10 codes G11.1 and G71.2 from Group 2 and Group 4 codes, due to annual ICD-10 Code updates
  • Added: ICD-10 codes G11.10, G11.11, and G11.19 to Group 2 and Group 4 codes, due to annual ICD-10 Code updates
  • Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, and G71.29 to Group 2 and Group 4 codes, due to annual ICD-10 Code updates

09/24/2020: 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.

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.

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