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September 22, 2022

Policy Article Revisions Summary for September 22, 2022

Outlined below are the principal changes to the DME MAC Policy Articles (PAs) that have been revised and posted. The policies included are Automatic External Defibrillators, External Infusion Pumps, High Frequency Chest Wall Oscillation Devices, Mechanical In-exsufflation Devices, Oral Anticancer Drugs, Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) and Wheelchair Seating. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

Automatic External Defibrillators

PA

Automatic External Defibrillators PAExternal website

Revision Effective Date: 10/01/2022

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10-CM code I47.2 from Group 1 and Group 2 Codes due to ICD-10-CM code updates
  • Added: ICD-10-CM codes I47.20, I47.21 and I47.29 to Group 1 and Group 2 Codes due to ICD-10-CM code updates

09/22/2022: 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: 10/01/2022

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM code D81.82 to Group 3 Codes due to ICD-10-CM code updates

09/22/2022: 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.

High Frequency Chest Wall Oscillation Devices

PA

High Frequency Chest Wall Oscillation Devices PAExternal website

Revision Effective Date: 10/01/2022

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM codes D81.82, G71.031, G71.032, G71.033, G71.0340, G71.0341, G71.0342, G71.0349, G71.035, G71.038, and G71.039 to Group 1 Codes, due to ICD-10-CM code updates

09/22/2022: 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.

Mechanical In-exsufflation Devices

PA

Mechanical In-exsufflation Devices PAExternal website

Revision Effective Date: 10/01/2022

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM codes G71.031, G71.032, G71.033, G71.0340, G71.0341, G71.0342, G71.0349, G71.035, G71.038, G71.039 to Group 1 Codes due to ICD-10-CM code updates

09/22/2022: 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: 10/01/2022

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Revised: ICD-10-CM code descriptor for C84.40, C84.41, C84.42, C84.43, C84.44, C84.45, C84.46, C84.47, C84.48, C84.49 in Groups 1, 3, 4, 5, 7 Codes due to ICD-10-CM code updates

09/22/2022: 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 Antiemetic Drugs (Replacement for Intravenous Antiemetics)

PA

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) PAExternal website

Revision Effective Date: 10/01/2022

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Revised: ICD-10-CM code descriptor for C84.41, C84.42, C84.43, C84.44, C84.45, C84.46, C84.47, C84.48, C84.49, C94.6 in Group 1 Codes due to ICD-10-CM code updates

09/22/2022: 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.

Wheelchair Seating

PA

Wheelchair Seating PAExternal website

Revision Effective Date: 10/01/2022

CODING GUIDELINES:

  • Added: CAD/CAM technology details to the fabrication technique information
  • Revised: Format of language pertaining to fabrication techniques for cushions

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM codes F03.90, F03.911, F03.918, F03.92, F03.93, F03.94, F03.A11, F03.A18, F03.A2, F03.A3, F03.A4, F03.B11, F03.B18, F03.B2, F03.B3, F03.B4, F03.C11, F03.C18, F03.C2, F03.C3, F03.C4, G31.83, G60.0, Q79.60, Q79.61, Q79.62, Q79.63, Q79.69, Q90.0, Q90.1, Q90.2, and Q90.9 to Group 2 Codes
  • Added: ICD-10-CM codes Q72.01, Q72.02, Q72.03, Q72.11, Q72.12, and Q72.13 to Group 3 Codes
  • Added: ICD-10-CM codes F03.90, F03.911, F03.918, F03.92, F03.93, F03.94, F03.A11, F03.A18, F03.A2, F03.A3, F03.A4, F03.B11, F03.B18, F03.B2, F03.B3, F03.B4, F03.C11, F03.C18, F03.C2, F03.C3, F03.C4, G31.83, G60.0, Q72.01, Q72.02, Q72.03, Q72.11, Q72.12, Q72.13, Q79.60, Q79.61, Q79.62, Q79.63, Q79.69, Q90.0, Q90.1, Q90.2, and Q90.9 to Group 4 Codes
  • Added: ICD-10-CM codes G71.031, G71.032, G71.033, G71.0340, G71.0341, G71.0342, G71.0349, G71.035, G71.038, and G71.039 to Group 2 and Group 4 Codes, due to ICD-10-CM code updates

09/22/2022: 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.

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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