Skip to main content
Corporate
CGS Administrators, LLC

IVR: 866.238.9650 Customer Service and myCGS: 866.270.4909

December 26, 2019

LCD and Policy Article Revisions Summary for December 26, 2019

Outlined below are the principal changes to the DME MAC External Breast Prostheses Local Coverage Determination (LCD) and Policy Article (PA) that has been revised and posted. Please review the entire LCD and related PA for complete information.

External Breast Prostheses

LCD

External Breast Prostheses LCDExternal Website

Revision Effective Date: 01/01/2020

COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:

  • Removed: Statement to refer to ICD-10 Codes that are Covered section in the LCD-related PA
  • Added: Statement to refer to ICD-10 code list in the LCD-related Policy Article

HCPCS CODES:

  • Revised: Code description for HCPCS code L8032 in Group 1 listing
  • Added: HCPCS code L8033 in Group 1 listing

Policy Article

External Breast Prostheses Policy ArticleExternal Website

Revision Effective Date: 01/01/2020

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

  • Revised: Section header "ICD-10 Codes that are Covered" updated to "ICD-10 Codes that Support Medical Necessity"

ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:

  • Revised: Section header "ICD-10 Codes that are Not Covered" updated to "ICD-10 Codes that DO NOT Support Medical Necessity"

12/26/2019: 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 PAs. For complete information on any topic, you must review the LCDs and/or PAs.

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved