November 11, 2021
Policy Article Revisions Summary for November 11, 2021
Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Oxygen and Oxygen Equipment, Nebulizers, Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea, High Frequency Chest Wall Oscillation Devices, Mechanical In-exsufflation Devices, Oral Appliances for Obstructive Sleep Apnea, Respiratory Assist Devices, and Suction Pumps.
Oxygen and Oxygen Equipment
PA
Oxygen and Oxygen Equipment PA
Revision Effective Date: 08/02/2020
CODING GUIDELINES:
- Moved: E1405 and E1406 coding verification review (CVR) language to coding verification review section
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC CVR information
- Added: CVR requirement for products coded E1405, E1406 and E0467
11/11/2021: 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.
Nebulizers
PA
Revision Effective Date: 05/17/2020
CODING GUIDELINES:
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC coding verification review (CVR) information
- Added: CVR requirement for products coded E0467
11/11/2021: 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.
Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
PA
Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea PA
Revision Effective Date: 08/08/2021
CODING GUIDELINES:
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC coding verification review (CVR) information
- Added: CVR requirement for products coded E0467
11/11/2021: 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.
High Frequency Chest Wall Oscillation Devices
PA
High Frequency Chest Wall Oscillation Devices PA
Revision Effective Date: 10/01/2021
CODING GUIDELINES:
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC coding verification review (CVR) information
- Added: CVR requirement for products coded E0467
11/11/2021: 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.
Mechanical In-exsufflation Devices
PA
Mechanical In-exsufflation Devices PA
Revision Effective Date: 10/01/2021
CODING GUIDELINES:
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC coding verification review (CVR) information
- Added: CVR requirement for products coded E0467
11/11/2021: 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.
Oral Appliances for Obstructive Sleep Apnea
PA
Oral Appliances for Obstructive Sleep Apnea PA
Revision Effective Date: 08/08/2021
CODING GUIDELINES:
- Moved: E0486 code verification review (CVR) language to coding verification review section
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC CVR information
- Added: CVR requirement for products coded E0486 and E0467.
11/11/2021: 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.
Respiratory Assist Devices
PA
Revision Effective Date: 08/08/2021
CODING GUIDELINES:
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC coding verification review (CVR) information
- Added: CVR requirement for products coded E0467.
11/11/2021: 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.
Suction Pumps
PA
Revision Effective Date: 08/15/2021
CODING GUIDELINES:
- Moved: K0743 coding verification review (CVR) language to coding verification review section
- Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
- Added: Section header and PDAC CVR information
- Added: CVR requirement for products coded K0743 and E0467
11/11/2021: 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 PAs. For complete information on any topic, you must review the PAs.