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July 6, 2023

Policy Article Revisions Summary for July 6, 2023

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

Oral Anticancer Drugs

PA

Oral Anticancer Drugs PAExternal Website

Revision Effective Date: 07/06/2023

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10 codes C7A.00, C7A.010, C7A.011, C7A.012, C7A.019, C7A.020, C7A.021, C7A.022, C7A.023, C7A.024, C7A.025, C7A.026, C7A.029, C7A.091, C7A.092, C7A.093, C7A.094, C7A.095, C7A.096, C7A.098, C7A.1, C7A.8, C7B.8, E34.0, Z85.020, Z85.030, Z85.040, Z85.060, Z85.230 to Group 2 Codes
  • Added: ICD-10 codes C75.5, C7B.8 to Group 3 Codes
  • Added: ICD-10 codes C74.10, C74.11, C74.12, C74.90, C74.91, C74.92, C75.5, C7A.00, C7A.010, C7A.011, C7A.012, C7A.019, C7A.020, C7A.021, C7A.022, C7A.023, C7A.024, C7A.025, C7A.026, C7A.029, C7A.091, C7A.092, C7A.093, C7A.094, C7A.095, C7A.096, C7A.098, C7A.8, C7B.8, E34.0, Z85.020, Z85.030, Z85.040, Z85.060, Z85.110, Z85.230 to Group 8 Codes

07/06/2023: 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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