June 25, 2009 - Updated July 1, 2009
LCD and Policy Article Revisions Summary for June 25, 2009
Outlined below are the principal changes to several DME MAC 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.
Automatic External Defibrillators
Local Coverage Determination:
Revision Effective Date:
- 09/01/2009
HCPCS Modifiers:
- Added: GA and GZ modifiers
- Revised: KX Modifier
- Separated: Range of ICD-9 996.04 – 996.61
Documentation Requirements
- Added: Instructions for use of GA and GZ modifiers
Policy Article
Revision Effective Date:
- 09/01/2009
Coding Guidelines:
- Changed: SADMERC to PDAC
Canes and Crutches
Policy Article
Revision Effective Date:
- 07/01/2009
Coding Guidelines:
- Changed: SADMERC To PDAC
Cervical Traction Devices
Local Coverage Determination
Revision Effective Date:
- 09/01/2009
Indication and Limitations of Coverage:
- Removed: E0856 from range of covered codes
HCPCS Codes and Modifiers:
- Added: GA and GZ modifiers
Revised:
- KX modifier
Documentation Requirements:
- Added: instruction for the use of GA And GZ modifiers
Policy Article
Revision Effective Date:
- 09/01/2009
Coding Guidelines:
- Changed SADMERC to PDAC
Cold Therapy
Policy Article
Revision Effective Date:
- 07/01/2009
Coding Guidelines:
- Changed: SADMERC to PDAC
Commodes
Local Coverage Determinations
Revision Effective Date:
- 09/01/2009
Indications And Limitations Of Coverage AND/OR Medical Necessity:
- Removed: Reference to DMERC
HCPCS Codes And Modifiers::
- Added: GA and GZ modifiers
- Revised: KX modifier
Documentation Requirements:
- Added: Instructions for the use of GA, GY and GZ modifiers.
Policy Article
Revision Effective Date:
- 09/01/2009
Coding Guidelines:
- Changed: SADMERC to PDAC
Enteral Nutrition
Policy Article
Revision Effective Date:
- 07/01/2009
Non-Medical Necessity Coverage and Payment Rules:
- Added: Instructions for delivery of supplies
- Changed: DMERC to DME MAC
Coding Guidelines:
- Clarified: Definition for supply kit codes B4034-B4036.
- Changed: SADMERC to PDAC
Epoetin
Local Coverage Determination
- Revision Effective Date: 09/01/2009
- CMS NATIONAL COVERAGE POLICY:
- Added: CMS Pub. 100-2, Medicare Benefit Policy Manual, Chapter 15, Section 50.5.2
HCPCS CODES AND MODIFIERS:
- Added: GY modifier
- Revised: KX modifier
- DOCUMENTATION REQUIREMENTS:
- Added: Instructions for use of GY modifier
Policy Article
- Revision Effective Date: 09/01/2009
- CODING GUIDELINES:
- Changed: SADMERC to PDAC
Eye Prostheses
Policy Article
- Revision Effective Date: 07/01/2009
CODING GUIDELINES:
- Revised: RT/LT instructions.
Changed: SADMERC to PDAC
Facial Prostheses
Policy Article
- Revision Effective Date: 07/01/2009
CODING GUIDELINES:
- Revised: RT/LT modifier instructions
- Changed: SADMERC to PDAC
Home Dialysis Supplies and Equipment
Local Coverage Determination
- Revision Effective Date: 09/01/2009
HCPCS CODES AND MODIFIERS:
- Added: GY modifier
- Revised: KX modifier
DOCUMENTATION REQUIREMENTS:
- Added: Instructions for use of GY modifier.
Policy Article
- Revision Effective Date: 09/01/2009
CODING GUIDELINES:
- Changed: SADMERC to PDAC
Positive Airway Pressure ( PAP ) Devices for Obstructive Sleep Apnea
Local Coverage Determination
- Revision Effective Date: 09/01/2009
HCPCS CODES AND MODIFIERS
- Added : GA and GZ modifiers
- Revised: KX Modifier
DOCUMENTATION:
- Added: Information about the required use of GA, GZ or KX on claim lines for PAP devices and/or accessories.
Respiratory Assist Devices ( RAD )
Local Coverage Determinatio
- Revision Effective Date: 09/01/2009
HCPCS CODES AND MODIFIERS:
- Added: GA and GZ modifiers
- Revised: KX modifier
DOCUMENTATION REQUIREMENTS:
- Added: Instructions for the use of GA and GZ modifiers
Policy Article
- Revision Effective Date: 09/01/2009
CODING GUIDELINES:
- Changed: SADMERC to PDAC
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 Policy Article.
