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July 27, 2023

LCD Revisions Summary for July 27, 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 LCDExternal Website

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 of the lymphedema extending onto the chest, trunk and/or abdomen, then reimbursement for an E0652 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. When and only when no significant improvement has occurred in the most recent four weeks and the coverage criteria above are still met, an E0652 is eligible for reimbursement.”

07/27/2023: 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.

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