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

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

End User License Agreement

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July 13, 2023

LCD Revisions Summary for July 13, 2023

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

Pneumatic Compression Devices

LCD

Pneumatic Compression Devices LCD

Revision Effective Date: 06/07/2022

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

Removed: “At the end of the four-week trial, if there has been improvement, then reimbursement for a PCD is not justified. Where improvement has occurred, the trial of conservative therapy must be continued with subsequent reassessment at intervals at least a week apart. Only when no significant improvement has occurred in the most recent four weeks and the coverage criteria above are still met, may the lymphedema be considered unresponsive to conservative therapy, and coverage for a PCD considered.”
Removed: “At a minimum, re-assessments conducted for a trial must include detailed measurements, obtained in the same manner and with reference to the same anatomic landmarks, prior to and at the conclusion of the various trials and therapy, with bilateral comparisons where appropriate.”

07/13/2023: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates based on CMS direction as a result of the United States District Court, District of Columbia decision in Greenwald v. Becerra (Decided June 7, 2022)

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.