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June 25, 2026

LCD and Policy Article Revisions Summary for June 25, 2026

Joint DME MAC Publication

Outlined below are the principal changes to the DME MAC Local Coverage Determinations (LCDs) and Policy Article (PA) that have been revised and posted. The policies included are External Infusion Pumps and Intravenous Immune Globulin. Please review the entire LCDs and PA for complete information.

External Infusion Pumps

LCD

External Infusion Pumps LCDExternal Website

Revision Effective Date: 07/01/2026

SUMMARY OF EVIDENCE:

  • Removed: Summary of evidence information, due to not being applicable to the non-discretionary updates

ANALYSIS OF EVIDENCE (RATIONALE FOR DETERMINATION):

  • Removed: Analysis of evidence information, due to not being applicable to the non-discretionary updates

HCPCS CODES:

  • Revised: Long description for J1569

BIBLIOGRAPHY:

  • Removed: Bibliography information, due to not being applicable to the non-discretionary updates

06/25/2026: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS HCPCS coding determinations.

Intravenous Immune Globulin

LCD

Intravenous Immune Globulin LCDExternal Website

Revision Effective Date: 07/01/2026

HCPCS CODES:

  • Added: J1577 to Group 1 Codes
  • Revised: Long description of J1569

06/25/2026: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS HCPCS coding determinations.

PA

Intravenous Immune Globulin PAExternal Website

Revision Effective Date: 07/01/2026

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

  • Revised: "IOM 100-2, Ch. 15, §50.6" to "CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 50.6"

CODING GUIDELINES:

  • Revised: Long description for J1569
  • Revised: "Claims for Qivigy (immune globulin intravenous, human-kthm 10% solution) for dates of service on or after September 26, 2025 must be submitted using the HCPCS code J1599" to "Claims for Qivigy (immune globulin intravenous, human-kthm 10% solution) for dates of service from September 26, 2025 to June 30, 2026 must be submitted using the HCPCS code J1599"
  • Added: Direction for billing Qivigy using J1577, effective for dates of service on or after July 1, 2026

06/25/2026: 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 LCDs and/or PAs. For complete information on any topic, you must review the LCDs and/or PAs.

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