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December 28, 2023

LCD and Policy Article Revisions Summary for December 28, 2023

Joint DME MAC Publication

Outlined below are the principal changes to the DME MAC Local Coverage Determination (LCD) and Policy Articles (PAs) that have been revised and posted. The policies included are Lower Limb Prostheses and Power Mobility Devices. Please review the entire LCDs and related PAs for complete information.

Lower Limb Prostheses

LCD

Lower Limb Prostheses LCDExternal Website

Revision Effective Date: 01/01/2024

HCPCS CODES:

  • Added: HCPCS codes L5615 and L5926

12/28/2023: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS HCPCS coding determinations.

PA

Lower Limb ProsthesesExternal Website

Revision Effective Date: 01/01/2024

CODING GUIDELINES:

  • Added: HCPCS code L5926 coding guideline information

12/28/2023: 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.

Power Mobility Devices

PA

Power Mobility DevicesExternal Website

Revision Effective Date: 05/16/2023

CODING GUIDELINES:

  • Revised: No Power Options definition, from "A category of PWCs that is incapable of accommodating a power tilt, recline, seat elevation, or standing system. If a PWC can only accept power elevating legrests, it is considered to be a No Power Option chair." to "No Power Options – A category of PWCs that is incapable of accommodating a power tilt, recline, or standing system. If a PWC can only accept power elevating legrests and/or seat elevation, it is considered to be a No Power Option chair."
  • Revised: Group 2 no power option PWC information, by removing "seat elevation" from the options the PWC is incapable of accommodating
  • Revised: Group 3 and 4 no power option PWC information, by removing "seat elevation" from the options the PWC is incapable of accommodating

12/28/2023: 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/or PAs. For complete information on any topic, you must review the LCDs and/or PAs.

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