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May 16, 2024

Policy Article Revisions Summary for May 16, 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 High Frequency Chest Wall Oscillation Devices, Mechanical In-exsufflation Devices, Nebulizers, Oral Appliances for Obstructive Sleep Apnea, Osteogenesis Stimulators, Oxygen and Oxygen Equipment, Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea, Respiratory Assist Devices and Suction Pumps. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

High Frequency Chest Wall Oscillation Devices

PA

High Frequency Chest Wall Oscillation Devices PAExternal Website

Revision Effective Date: 05/04/2023

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Section header and PDAC coding verification review (CVR) information, including CVR information pertaining to products coded E0467

05/16/2024: 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.

Mechanical In-exsufflation Devices

PA

Mechanical In-exsufflation Devices PAExternal Website

Revision Effective Date: 10/01/2023

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Section header and PDAC coding verification review (CVR) information, including CVR information pertaining to products coded E0467

05/16/2024: 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.

Nebulizers

PA

Nebulizers PAExternal Website

Revision Effective Date: 01/01/2024

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Section header and PDAC coding verification review (CVR) information, including CVR information pertaining to products coded E0467

05/16/2024: 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.

Oral Appliances for Obstructive Sleep Apnea

PA

Oral Appliances for Obstructive Sleep Apnea PAExternal Website

Revision Effective Date: 08/08/2021

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Direction for HCPCS Code E0467 from section

05/16/2024: 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.

Osteogenesis Stimulators

PA

Osteogenesis Stimulators PAExternal Website

Revision Effective Date: 07/02/2023

CODING GUIDELINES:

  • Added: Statement regarding disposable equipment must be billed with A9270

05/16/2024: 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.

Oxygen and Oxygen Equipment

PA

Oxygen and Oxygen Equipment PAExternal Website

Revision Effective Date: 04/01/2023

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Direction for HCPCS Code E0467 from section

05/16/2024: 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.

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

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Section header and PDAC coding verification review (CVR) information, including CVR information pertaining to products coded E0467

05/16/2024: 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.

Respiratory Assist Devices

PA

Respiratory Assist Devices PAExternal Website

Revision Effective Date: 08/08/2021

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Section header and PDAC coding verification review (CVR) information, including CVR information pertaining to products coded E0467

05/16/2024: 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.

Suction Pumps

PA

Suction Pumps PAExternal Website

Revision Effective Date: 04/01/2023

CODING GUIDELINES:

  • Removed: Coding and billing information pertaining to multifunction ventilators coded E0467

CODING VERIFICATION REVIEW:

  • Removed: Direction for HCPCS Code E0467 from section

05/16/2024: 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.

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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