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

End User License Agreement

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November 30, 2023

LCD and Policy Article Revisions Summary for November 30, 2023

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

Intravenous Immune Globulin

LCD

Intravenous Immune Globulin LCD

Revision Effective Date: 01/01/2024

COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:

Removed: Denial statement regarding IVIG used with an infusion pump

HCPCS CODES:

Added: Q2052 (in Group 1 Paragraph text)

11/30/2023: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS Final Rule CMS-1780-F.

PA

Intravenous Immune Globulin PA

Revision Effective Date: 01/01/2024

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

Added: Services, supplies and accessories to noncovered statement when statutory criteria not met
Removed: Statement to refer to the LCD when IVIG administered with an infusion pump and statutory criteria not met
Removed: Statement regarding IVIG benefit limited to IVIG itself
Added: Services, supplies and accessories are billed with HCPCS code Q2052 and only one unit of service shall be paid per infusion date of service

CODING GUIDELINES:

Removed: Use of HCPCS code A4223 instructions when IVIG not administered with an infusion pump
Removed: Reference to the External Infusion Pump LCD and Policy Article when IVIG is administered with an infusion pump
Added: Coding instructions for Q2052

11/30/2023: 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.