May 9, 2024
Policy Article Revisions Summary for May 9, 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 Nebulizers and Therapeutic Shoes for Persons with Diabetes. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.
Nebulizers
PA
Revision Effective Date: 01/01/2024
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
- Added: Amikacin liposome noncoverage information
CODING GUIDELINES:
- Added: “The nebulizer used to administer amikacin liposome must be coded and billed using HCPCS code A9270, noncovered item or service.”
05/09/2024: 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.
Therapeutic Shoes for Persons with Diabetes
PA
Therapeutic Shoes for Persons with Diabetes PA
Revision Effective Date: 11/05/2020
MODIFIERS:
- Added: RT and LT modifier information (relocated from the CODING GUIDELINES section)
CODING GUIDELINES:
- Removed: RT and LT modifier information
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
- Added: ICD-10-CM codes E11.10 and E11.11 to Group 1 Codes (Effective for claims with dates of service on or after October 1, 2017)
05/09/2024: 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.