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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 PAExternal Website

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

Nebulizers PAExternal Website

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 PAExternal Website

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 PAExternal Website

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 PAExternal Website

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 PAExternal Website

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

Respiratory Assist Devices PAExternal Website

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

Suction Pumps PAExternal Website

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.

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