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January 18, 2024

Policy Article Revisions Summary for January 18, 2024

Joint DME MAC Publication

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

Surgical Dressings

PA

Surgical DressingsExternal Website

Revision Effective Date: 01/01/2024

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

  • Removed: "Gradient compression stockings (A6530, A6533, A6534, A6535, A6536, A6537, A6538, A6539, A6540, A6541, A6544, A6549)"
  • Added: "Gradient compression stockings (A6530, A6533, A6534, A6535, A6536, A6537, A6538, A6539, A6540, A6541, A6544, A6549) are non-covered under the surgical dressing benefit because they do not meet the statutory definition of a dressing; however, they may be considered for coverage under the lymphedema compression treatment items benefit and billed in accordance with CMS Final Rule CMS-1780-F."

01/18/2024: 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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