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January 18, 2024

Open Meeting Announcement – Lower Limb Prostheses Proposed Local Coverage Determination (LCD)

Joint DME MAC Publication

On Thursday, February 22, 2024 at 10 am ET, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) will host a virtual public meeting to solicit stakeholder comments for the following proposed LCD:

Lower Limb Prostheses (DL33787) – Proposing modifications to the coverage criteria for microprocessor-controlled prosthetic knees (MPKs), to include coverage for Medicare Functional Classification Level (MFCL) 2 beneficiaries with lower limb amputations who require a prosthetic knee; proposing modifications to the coverage criteria for prosthetic feet in order to allow coverage of a compatible foot when coverage criteria for an MPK are met; proposing addition of GA, GY, GZ, and KX modifiers to the Coding Information section of the LCD.

This virtual meeting is for the oral presentation of comments and for stakeholders interested in listening to the comments.

Registration for the virtual meeting opens January 18, 2024 and is available online at: https://cvent.me/lMqY5rExternal Website.

Registration will remain open until the start time of the open meeting.

  • Stakeholders interested in presenting oral comments during the virtual open meeting must submit early registration by Thursday, February 1, 2024 at 5pm ET.
  • Stakeholders interested in listening to the comments may either register (before the open meeting start time) or choose to solely dial into the meeting. By registering for the meeting, stakeholders can view the web presentation while the meeting takes place.

Note: The DME MACs publish the open meeting recording to their contractor websites; therefore, all stakeholders will be able to view the recording regardless of whether they attended the meeting (via web and/or phone).

The following teleconference information is available for those who choose to solely dial into the meeting.

Conference dial-in number:

US Toll Free: 1-866-901-6455
Access Code: 956-268-529

Note: For all who register, teleconference information will be emailed to you.

Stakeholders who indicate, in their registration, that they intend to present oral comments:

  • By registering, you consent to your oral comments being recorded at the virtual meeting. We ask that comments from the same organization/manufacturer be consolidated and presented by a single representative or spokesperson.
  • Any material (such as slides) you intend to present during the virtual open meeting must be sent to DMEOpenMeeting@noridian.com by Thursday, February 8, 2024 at 5 pm ET. In the body of the email, please include the name of the presenter and the represented organization, if applicable. If you submit material in the form of a slide deck, please ensure that the slides are compatible with PowerPoint and are formatted in 16:9 aspect ratio.
  • You must not include any protected health information (PHI) or personally identifiable information (PII) in your oral comments or presentation material.

The amount of time allotted for oral commenters' presentations will be determined by the number of oral commenters registered. Prior to the virtual meeting, information regarding the allotted speaking time and order of oral commenters will be provided to those who registered to present oral comments.

IMPORTANT REMINDERS: Suppliers and clinicians are cautioned not to make any changes based upon information contained in a proposed LCD. The content of a proposed LCD may be revised based upon the written comments received during the comment period. In order for oral comments to be included in the review and consideration of the proposed LCD, these comments must also be submitted in writing through the formal comment process during the comment period. When all written comments have been reviewed, revisions will be considered. Information related to the written comment process is available at Proposed Local Coverage Determination (LCD) Released for Comment – Lower Limb Prostheses.

Refer to each DME MAC website for additional information, including access to the proposed LCD.

Thank you for your participation in our policy development process.

Smitha M. Ballyamanda, MD, CAQSM
Medical Director, DME MAC Jurisdiction A
Noridian Healthcare Solutions, LLC

Robert D. Hoover, Jr., MD, MPH, FACP
Medical Director, DME MAC Jurisdiction C
CGS Administrators, LLC

Sunil V. Lalla, MD, FACS, CPC
Medical Director, DME MAC Jurisdiction B
CGS Administrators, LLC

Angela S. Jenny, DO
Medical Director, DME MAC, Jurisdiction D
Noridian Healthcare Solutions, LLC

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