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April 1, 2021

Policy Article Revisions Summary for April 1, 2021

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, Bowel Management Devices, Heating Pads and Heat Lamps, High Frequency Chest Wall Oscillation Devices, and Walkers. 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: 01/01/2020

CODING GUIDELINES:

  • Revised: Instructions related to KF modifier for K0606 and E0617

04/01/2021: 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.

Bowel Management Devices

PA

Bowel Management Devices PAExternal Website

Revision Effective Date: 01/01/2020

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

  • Removed: Trademark symbols, per AMA guidelines

CODING GUIDELINES:

  • Removed: Trademark symbols, per AMA guidelines

04/01/2021: 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.

Heating Pads and Heat Lamps

PA

Heating Pads and Heat Lamps PA

Revision Effective Date: 01/01/2020

CODING GUIDELINES:

  • Revised: References to Occupational Safety and Health Administration and Nationally Recognized Testing Laboratory references, to include acronyms

04/01/2021: 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.

High Frequency Chest Wall Oscillation Devices

PA

High Frequency Chest Wall Oscillation Devices PAExternal Website

Revision Effective Date: 10/01/2020

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

  • Removed: "etc." from the not all-inclusive list of medical condition examples

CODING GUIDELINES:

  • Removed: "etc." from the not all-inclusive list of differing technologies used by E0483 devices
  • Removed: "etc." from the not all-inclusive list of components included in A7025

04/01/2021: 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.

Walkers

PA

Walkers PAExternal Website

Revision Effective Date: 01/01/2020

CODING GUIDELINES:

  • Added: "(CVR)" after reference to coding verification review
  • Added: "(PCL)" after reference to "Product Classification List"
  • Added: Incorrect coding denial language for products billed using HCPCS that require written coding verification review
  • Revised: Reference to HCPCS code E0159 long description

04/01/2021: 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 PAs. For complete information on any topic, you must review the LCDs and/or PAs.

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