December 18, 2008
LCD and Policy Article Revisions
Summary for December 18, 2008
Outlined below is a summary of the principal changes to several DME Local Coverage Determinations (LCDs) and Policy Articles (PAs) that have been revised and posted. Please review the entire LCD and each related Policy Article for complete information.
Patient Lifts
LCD
Revision Effective Date: 01/01/2009
INDICATIONS AND LIMITATIONS OF COVERAGE:
- Removed: Least costly alternative statement for E0635
- Revised: Coverage criteria for E0636
- Added: Coverage criteria for E0639 and E0640
DOCUMENTATION REQUIREMENTS:
- Added: KX modifier requirement for E0636
Policy Article
Revision Effective Date: 01/01/2009
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
- Deleted: Noncoverage statement for E0639, E0640
- Added: Noncoverage statement about home modifications.
- Revised: E0625 noncoverage statement.
CODING GUIDELINES:
- Added: Definition for E0636, E0639, and E0640.
- Revised: Definition of E1035
- Added: Requirement for PDAC coding verification review for E0636, E0639, E0640, and E1035
- Reformatted bundling table
- Added E0639 and E0640 to table.
- Changed: SADMERC to PDAC
Positive Airway Pressure Devices for the Treatment of Obstructive Sleep Apnea
LCD
Revision Effective Date: 1/1/2009 except where noted otherwise in the LCD.
INDICATIONS AND LIMITATIONS OF COVERAGE:
- Revised: Criteria for Type IV home sleep test device
- Added: Coverage requirements for beneficiaries enrolling in Medicare and needed replacement PAP device and/or accessories.
DOCUMENTATION:
- Added: Requirements for beneficiaries enrolling in Medicare and needed replacement PAP device and/or accessories.
APPENDICES:
- Added: List of approved Type IV devices that do not report AHI/RDI based on direct measurement of airflow or thoracoabdominal movement.
- Covered Type IV device list to include WatchPAT-100
Note: The information contained in this article is only a summary of revisions to LCDs and Policy Articles. For complete information on any topic, you must review the LCD and/or article.
