License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

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POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

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February 8, 2024

Policy Article Revisions Summary for February 8, 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 External Infusion Pumps and Standard Documentation Requirements for All Claims Submitted to DME MACs. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

External Infusion Pumps

PA

External Infusion Pumps PA

Revision Effective Date: 01/12/2024

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

Added: "J1575" to Group 6 Paragraph

02/08/2024: 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.

Standard Documentation Requirements for All Claims Submitted to DME MACs

PA

Standard Documentation Requirements for All Claims Submitted to DME MACs PA

Revision Effective Date: 01/01/2024

DOCUMENTATION REQUIREMENTS:

Removed: "a CMN (if applicable), a DIF (if applicable)"

MEDICAL RECORD DOCUMENTATION:

Removed: "and CMNs (for DOS prior to 01/01/2023)"
Removed: "including CMS CMNs prior to DOS 01/01/2023"

CONTINUED MEDICAL NEED:

Removed: "A properly completed CMN or DIF obtained prior to DOS 01/01/2023, with an appropriate length of need specified"

CERTIFICATE OF MEDICAL NECESSITY (CMN) & DME INFORMATION FORM (DIF):

Removed: Section header and entire section

REPAIRS/REPLACEMENTS:

Removed: "CMN and/or"
Removed: "and/or new CMN (prior to DOS 01/01/2023)"

02/08/2023: 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.