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April 16, 2026

LCD and Policy Article Revisions Summary for April 16, 2026

Joint DME MAC Publication

Outlined below are the principal changes to the DME MAC Local Coverage Determination (LCD) and Policy Article (PA) that have been revised and posted. The policy included is Bowel Management Devices. Please review the entire LCD and PA for complete information.

Bowel Management Devices

LCD

Bowel Management Devices LCDExternal Website

Revision Effective Date: 04/01/2026

COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:

  • Revised: Reference location language for Medicare National Coverage Determinations (NCD) Manual, LCD-related Policy Article, and Medicare Program Integrity Manual (PIM), as clarification

HCPCS CODES:

  • Added: A4479 to Group 1 Codes

04/16/2026: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates to CMS HCPCS coding determinations.

PA

Bowel Management Devices PAExternal Website

Revision Effective Date: 04/01/2026

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:

  • Revised: Reference location for Medicare National Coverage Determinations (NCD) Manual, as clarification

CODING GUIDELINES:

  • Added: Coding guideline information for A4479
  • Added: Information when billing claims with dates of service on or after April 1, 2026 for A4479 and A4453

04/16/2026: 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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