License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

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The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

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POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

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November 28, 2022

Policy Article Revisions Summary for November 24, 2022

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Intravenous Immune Globulin and Standard Documentation Requirements for All Claims Submitted to DME MACs. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

Intravenous Immune Globulin

PA

Revision Effective Date: 10/01/2022

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

Added: ICD-10-CM code D81.82 to Group 1 codes due to ICD-10-CM code updates

11/24/2022: 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.

Standard Documentation Requirements for All Claims Submitted to DME MACs

PA

Revision Effective Date: 01/01/2023

MEDICAL RECORD DOCUMENTATION:

Added: "(for DOS prior to 01/01/2023)" after "CMN"
Added: "prior to DOS 01/01/2023" in the second reminder bullet after "CMN"

CONTINUED MEDICAL NEED:

Added: Bullet justifying continued medical need to include an order/prescription for repairs
Added: "obtained prior to DOS 01/01/2023" in the third bullet of items that justify continued need after "CMN or DIF"

CERTIFICATE OF MEDICAL NECESSITY (CMN) & DME INFORMATION FORM (DIF):

Added: Billing information relevant to CMNs and DIFs, for DOS affected by the CMN and DIF elimination

REPLACEMENT:

Added: "(prior to DOS 01/01/2023)" after "CMN"

11/24/2022: 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.