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May 9, 2024

Policy Article Revisions Summary for May 9, 2024

Joint DME MAC Publication

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Nebulizers and Therapeutic Shoes for Persons with Diabetes. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

Nebulizers

PA

Nebulizers PAExternal Website

Revision Effective Date: 01/01/2024

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

  • Added: Amikacin liposome noncoverage information

CODING GUIDELINES:

  • Added: “The nebulizer used to administer amikacin liposome must be coded and billed using HCPCS code A9270, noncovered item or service.”

05/09/2024: 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.

Therapeutic Shoes for Persons with Diabetes

PA

Therapeutic Shoes for Persons with Diabetes PAExternal Website

Revision Effective Date: 11/05/2020

MODIFIERS:

  • Added: RT and LT modifier information (relocated from the CODING GUIDELINES section)

CODING GUIDELINES:

  • Removed: RT and LT modifier information

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM codes E11.10 and E11.11 to Group 1 Codes (Effective for claims with dates of service on or after October 1, 2017)

05/09/2024: 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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