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September 12, 2024

Policy Article Revisions Summary for September 12, 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 Glucose Monitor, Oral Anticancer Drugs, Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics), Osteogenesis Stimulators and Wheelchair Seating. Please review the entire Local Coverage Determinations (LCDs) and related PAs for complete information.

Glucose Monitor

PA

Glucose Monitor PAExternal Website

Revision Effective Date: 10/01/2024

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM codes E10.A0, E10.A1 and E10.A2 to Group 1 Codes, due to ICD-10-CM code updates

09/12/2024: 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 Anticancer Drugs

PA

Oral Anticancer Drugs PAExternal Website

Revision Effective Date: 10/01/2024

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10-CM codes C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.2, C88.3, C88.4, C88.8, C88.9 from Group 1 and Group 4, due to ICD-10-CM code updates
  • Removed: ICD-10-CM code E34.0 from Group 2, due to ICD-10-CM code updates
  • Removed: ICD-10-CM codes C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.2, C88.3, C88.4, C88.8, C88.9 from Group 3, due to ICD-10-CM code updates
  • Removed: ICD-10-CM codes C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.4 from Group 5, due to ICD-10-CM code updates
  • Removed: ICD-10-CM codes C88.0, C88.2, C88.3, C88.8, C88.9 from Group 6, due to ICD-10-CM code updates
  • Removed: ICD-10-CM codes C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.4 from Group 7, due to ICD-10-CM code updates
  • Removed: ICD-10-CM codes C83.39, E34.0 from Group 8, due to ICD-10-CM code updates
  • Removed: ICD-10-CM codes C83.39, C88.2, C88.3, C88.8, C88.9 from Group 9, due to ICD-10-CM code updates
  • Removed: ICD-10-CM codes E08.649, E16.0, E16.1, E16.3 from Group 2 and Group 8
  • Added: ICD-10-CM codes C81.00, C81.01, C81.02, C81.03, C81.04, C81.05, C81.06, C81.07, C81.08, C81.09, C81.0A, C81.10, C81.11, C81.12, C81.13, C81.14, C81.15, C81.16, C81.17, C81.18, C81.19, C81.1A, C81.20, C81.21, C81.22, C81.23, C81.24, C81.25, C81.26, C81.27, C81.28, C81.29, C81.2A, C81.30, C81.31, C81.32, C81.33, C81.34, C81.35, C81.36, C81.37, C81.38, C81.39, C81.3A, C81.40, C81.41, C81.42, C81.43, C81.44, C81.45, C81.46, C81.47, C81.48, C81.49, C81.4A, C81.70, C81.71, C81.72, C81.73, C81.74, C81.75, C81.76, C81.77, C81.78, C81.79, C81.7A, C81.90, C81.91, C81.92, C81.93, C81.94, C81.95, C81.96, C81.97, C81.98, C81.99, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91 to Group 1, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes E34.00, E34.01, E34.09 to Group 2, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.00, C88.01, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91 to Group 3, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91 to Group 4, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.00, C88.01, C88.40, C88.41 to Group 5, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C88.00, C88.01, C88.20, C88.21, C88.30, C88.31, C88.80, C88.81, C88.90, C88.91 to Group 6, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.40, C88.41 to Group 7, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C83.8A, C84.0A, C84.1A, C83.390, C83.398, E34.00, E34.01, E34.09 to Group 8, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C83.8A, C83.390, C83.398, C88.20, C88.21, C88.30, C88.31, C88.80, C88.81, C88.90, C88.91 to Group 9, due to ICD-10-CM code updates

09/12/2024: 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 Antiemetic Drugs (Replacement for Intravenous Antiemetics)

PA

Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) PAExternal Website

Revision Effective Date: 10/01/2024

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Removed: ICD-10-CM code C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.2, C88.3, C88.4, C88.8, C88.9 from Group 1 Codes, due to ICD-10-CM code updates
  • Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.00, C88.01, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91 to Group 1 Codes, due to ICD-10-CM code updates

09/12/2024: 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 VERIFICATION REVIEW:

  • Removed: Section header and PDAC CVR information
  • Removed: Coding verification review information for HCPCS codes E0747, E0748 and E0760, effective for DOS on or after 12/01/2024

09/12/2024: 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.

Wheelchair Seating

PA

Wheelchair Seating PAExternal Website

Revision Effective Date: 10/01/2024

ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:

  • Added: ICD-10-CM code M62.85 to Group 2 and Group 4 Codes, due to ICD-10-CM code updates

09/12/2024: 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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