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April 14, 2022

Policy Article Revisions Summary for April 14, 2022

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Ankle-Foot/Knee-Ankle-Foot Orthosis, Automatic External Defibrillators, Bowel Management Devices, Canes and Crutches, Cervical Traction Devices, Cold Therapy, Commodes, Enteral Nutrition, External Breast Prostheses, External Infusion Pumps, Eye Prostheses, Facial Prostheses, Glucose Monitors, Heating Pads and Heat Lamps, High Frequency Chest Wall Oscillation Devices, Hospital Beds and Accessories, Immunosuppressive Drugs, Infrared Heating Pad Systems, Intrapulmonary Percussive Ventilation System, Intravenous Immune Globulin, Knee Orthoses, Lower Limb Prostheses, Manual Wheelchair Bases, Mechanical In-exsufflation Devices, Nebulizers, Negative Pressure Wound Therapy Pumps, Oral Anticancer Drugs, Oral Appliances for Obstructive Sleep Apnea, Orthopedic Footwear, Osteogenesis Stimulators, Ostomy Supplies, Oxygen and Oxygen Equipment, Parenteral Nutrition, Patient Lifts, Pneumatic Compression Devices, Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea, Power Mobility Devices , Pressure Reducing Support Surfaces - Group 1, Pressure Reducing Support Surfaces - Group 2, Pressure Reducing Support Surfaces - Group 3, Refractive Lenses, Respiratory Assist Devices, Seat Lift Mechanisms, Speech Generating Devices (SGD), Spinal Orthoses: TLSO and LSO, Standard Documentation Requirements for All Claims Submitted to DME MACs, Suction Pumps, Surgical Dressings, Therapeutic Shoes for Persons with Diabetes, Tracheostomy Care Supplies, Transcutaneous Electrical Joint Stimulation Devices (TEJSD), Transcutaneous Electrical Nerve Stimulators (TENS), Tumor Treatment Field Therapy (TTFT), Urological Supplies, Vacuum Erection Device (VED), Walkers, Wheelchair Options/Accessories, and Wheelchair Seating. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

Ankle-Foot/Knee-Ankle-Foot Orthosis

PA

Ankle-Foot/Knee-Ankle-Foot Orthosis PAExternal Website

Revision Effective Date: 02/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Automatic External Defibrillators

PA

Automatic External Defibrillators PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

MODIFIERS:

  • Added: Instructions related to KF modifier for K0606 and E0617
  • Revised: “KX, GA, AND GZ MODIFIERS:” to “KX, GA, GZ and KF MODIFIERS:”

CODING GUIDELINES:

  • Removed: Instructions related to KF modifier for K0606 and E0617

04/14/2022: 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.

Bowel Management Devices

PA

Bowel Management Devices PAExternal Website

Revision Effective Date: 10/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Canes and Crutches

PA

Canes and Crutches PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Cervical Traction Devices

PA

Cervical Traction Devices PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Cold Therapy

PA

Cold Therapy PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Commodes

PA

Commodes PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Enteral Nutrition

PA

Enteral Nutrition PAExternal Website

Revision Effective Date: 09/05/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

External Breast Prostheses

PA

External Breast Prostheses PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

External Infusion Pumps

PA

External Infusion Pumps PAExternal Website

Revision Effective Date: 02/28/2022

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Eye Prostheses

PA

Eye Prostheses PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Facial Prostheses

PA

Facial Prostheses PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Glucose Monitors

PA

Glucose Monitors PAExternal Website

Revision Effective Date: 02/28/2022

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Heating Pads and Heat Lamps

PA

Heating Pads and Heat Lamps PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

High Frequency Chest Wall Oscillation Devices

PA

High Frequency Chest Wall Oscillation Devices PAExternal Website

Revision Effective Date: 10/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Hospital Beds and Accessories

PA

Hospital Beds and Accessories PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Immunosuppressive Drugs

PA

Immunosuppressive Drugs PAExternal Website

Revision Effective Date: 01/01/2020:

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Infrared Heating Pad Systems

PA

Infrared Heating Pad Systems PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Intrapulmonary Percussive Ventilation System

PA

Intrapulmonary Percussive Ventilation System PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Intravenous Immune Globulin

PA

Intravenous Immune Globulin PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Knee Orthoses

PA

Knee Orthoses PAExternal Website

Revision Effective Date: 02/01/2021

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

  • Revised: “equipment” to “orthosis”
  • Revised: “Knee Orthosis” to “Knee orthosis (KO)”
  • Revised: “Braces Benefit” to “braces benefit”
  • Revised: “knee orthoses” to “KO”
  • Revised: “coding guideline” to “CODING GUIDELINES section”
  • Revised: “(See definitions below.)” to “(See definitions in the CODING GUIDELINES section below.)”
  • Revised: “(See Policy Specific Documentation Requirements section below)” to “(See the POLICY SPECIFIC DOCUMENTATION REQUIREMENTS” section below)”
  • Revised: “CAD-CAM” to “computer-aided design/computer-added manufacturing (CAD/CAM)”

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:

  • Revised: “these items” to “orthoses”
  • Revised: “off-the-shelf” to “OTS”
  • Revised: “Coding Guidelines” to “CODING GUIDELINES section below”
  • Added: “(as defined in the CODING GUIDELINES section below)”

MODIFIERS:

  • Revised: “KX, GA, and GZ MODIFIERS” to “KX, GA, GZ, LT and RT MODIFIERS:”
  • Revised: “knee orthoses” to “the KO”
  • Added: Statement regarding use of RT and LT, with reference to CODING GUIDELINES section for additional information

MISCELLANEOUS:

  • Added: “MISCELLANEOUS” section regarding billing of custom fabricated items without a specific HCPCS code
  • Added: Billing information for all orthoses with the same date of service on the same claim

CODING GUIDELINES:

  • Revised: “Braces Benefit “ to “braces benefit”
  • Added: “See “more than minimal self-adjustment” definition below for additional information.” to paragraph referencing the term “minimal self-adjustment”
  • Revised: “custom-fit” to “custom fitted”
  • Revised: “off-the-shelf (OTS)” to “OTS”
  • Revised: Language describing parallel code set availability for identical types of products
  • Added: “(e.g., L1832, L1833, L1845, L1846, L1847 and L1848)” to language describing parallel code set availability for identical types of products
  • Added: Language describing kits
  • Added: Long HCPCS descriptions to coding guidelines for L1810, L1812, L1820, L1830, L1831, L1847, L1848, L1832, L1833, L1834, L1836, L1840, L1843, L1844, L1851, L1845, L1846, L1852, L1850, L1860, L2755, L2820, L2830, L2320, L2330, L4002
  • Revised: “Durable Medical Equipment” to “durable medical equipment”
  • Revised: codes” to “code”
  • Revised: “Braces” to “braces”
  • Removed: Coding verification review information in reference to HCPCS codes L1845 and L1852

CODING VERIFICATION REVIEW:

  • Added: Section header and PDAC coding verification review information
  • Revised: PDAC coding verification review information for HCPCS code L1845, to include effective for DOS on or after 07/01/2008
  • Revised: PDAC coding verification review information for HCPCS code L1852, to include effective for DOS on or after 01/01/2017
  • Added: PDAC coding verification review information for HCPCS codes L1832, L1833, and L1851, effective for DOS on or after 10/10/2022

04/14/2022: 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.

Lower Limb Prostheses

PA

Lower Limb Prostheses PAExternal Website

Revision Effective Date: 08/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Manual Wheelchair Bases

PA

Manual Wheelchair Bases PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Mechanical In-exsufflation Devices

PA

Mechanical In-exsufflation Devices PAExternal Website

Revision Effective Date: 10/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Nebulizers

PA

Nebulizers PAExternal Website

Revision Effective Date: 05/17/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Negative Pressure Wound Therapy Pumps

PA

Negative Pressure Wound Therapy Pumps PAExternal Website

Revision Effective Date: 08/15/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Oral Anticancer Drugs

PA

Oral Anticancer Drugs PAExternal Website

Revision Effective Date: 10/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Oral Appliances for Obstructive Sleep Apnea

PA

Oral Appliances for Obstructive Sleep Apnea PAExternal Website

Revision Effective Date: 08/08/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Orthopedic Footwear

PA

Orthopedic Footwear PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Osteogenesis Stimulators

PA

Osteogenesis Stimulators PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Ostomy Supplies

PA

Ostomy Supplies PAExternal Website

Revision Effective Date: 01/01/2022

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

CODING GUIDELINES:

  • Added: Code description for HCPCS codes A4436 and A4437

04/14/2022: 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.

Oxygen and Oxygen Equipment

PA

Oxygen and Oxygen Equipment PAExternal Website

Revision Effective Date: 08/02/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Parenteral Nutrition

PA

Parenteral Nutrition PAExternal Website

Revision Effective Date: 09/05/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Patient Lifts

PA

Patient Lifts PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Pneumatic Compression Devices

PA

Pneumatic Compression Devices PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea

PA

Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea PAExternal Website

Revision Effective Date: 08/08/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Power Mobility Devices

PA

Power Mobility Devices PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Pressure Reducing Support Surfaces - Group 1

PA

Pressure Reducing Support Surfaces - Group 1 PAExternal Website

Revision Effective Date: 05/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Pressure Reducing Support Surfaces - Group 2

PA

Pressure Reducing Support Surfaces - Group 2 PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Pressure Reducing Support Surfaces - Group 3

PA

Pressure Reducing Support Surfaces - Group 3 PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Refractive Lenses

PA

Refractive Lenses PAExternal Website

Revision Effective Date: 10/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Respiratory Assist Devices

PA

Respiratory Assist Devices PAExternal Website

Revision Effective Date: 08/08/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Seat Lift Mechanisms

PA

Seat Lift Mechanisms PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Speech Generating Devices (SGD)

PA

Speech Generating Devices (SGD) PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Spinal Orthoses: TLSO and LSO

PA

Spinal Orthoses: TLSO and LSO PAExternal Website

Revision Effective Date: 02/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Standard Documentation Requirements for All Claims Submitted to DME MACs

PA

Standard Documentation Requirements for All Claims Submitted to DME MACs PAExternal Website

Revision Effective Date: 04/06/2020

WRITTEN ORDERS PRIOR TO DELIVERY (WOPD):

  • Added: “The current required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Suction Pumps

PA

Suction Pumps PAExternal Website

Revision Effective Date: 08/15/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Surgical Dressings

PA

Surgical Dressings PAExternal Website

Revised Effective Date: 05/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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 PAExternal Website

Revision Effective Date: 11/05/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Tracheostomy Care Supplies

PA

Tracheostomy Care Supplies PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Transcutaneous Electrical Joint Stimulation Devices (TEJSD)

PA

Transcutaneous Electrical Joint Stimulation Devices (TEJSD) PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Transcutaneous Electrical Nerve Stimulators (TENS)

PA

Transcutaneous Electrical Nerve Stimulators (TENS) PAExternal Website

Revision History Effective Date: 11/20/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Tumor Treatment Field Therapy (TTFT)

PA

Tumor Treatment Field Therapy (TTFT) PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Urological Supplies

PA

Urological Supplies PAExternal Website

Revised Effective Date: 04/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Vacuum Erection Device (VED)

PA

Vacuum Erection Device (VED) PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Revised: “provides” to “provide”
  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Walkers

PA

Walkers PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Wheelchair Options/Accessories

PA

Wheelchair Options/Accessories PAExternal Website

Revision Effective Date: 01/01/2020

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

Wheelchair Seating

PA

Wheelchair Seating PAExternal Website

Revision Effective Date: 10/01/2021

REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):

  • Removed: “The link will be located here once it is available.”
  • Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list

04/14/2022: 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.

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