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April 29, 2021

LCD and Policy Article Revisions Summary for April 29, 2021

Outlined below are the principal changes to the DME MAC Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted. The policies included are Intravenous Immune Globulin and Urological Supplies. Please review the entire LCDs and related PAs for complete information.

Intravenous Immune Globulin

LCD

Intravenous Immune Globulin LCDExternal Website

Revision Effective Date: 04/01/2021

HCPCS CODES:

  • Added: J1554

04/29/2021: 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.

Urological Supplies

LCD

Urological Supplies LCDExternal Website

Revision Effective Date: 04/01/2021

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:

  • Removed: Trademark symbol from first use of inFlow

HCPCS CODES:

  • Removed: K1010, K1011 and K1012 (effective for DOS on or after 04/01/2021)

04/29/2021: 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

Urological Supplies PAExternal Website

Revision Effective Date: 04/01/2021

GENERAL:

  • Removed: Trademark symbol from first use of inFlow

CODING GUIDELINES:

  • Revised: inFlow HCPCS billing directions for K1010, K1011 and/or K1012 for DOS 10/01/2020 through 03/31/2021
  • Added: Billing direction for inFlow under HCPCS A4335 for DOS on or after 04/01/2021
  • Revised: inFlow replacement language, to include product information instead of K1010, K1011, and K1012

04/29/2021: 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 PAs. For complete information on any topic, you must review the LCDs and/or PAs.

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