LEEDer Group Inc.
8508 North West 66th St.
Miami, Florida 33166 USA

Phone: 305.436.5030
Fax: 305.436.0086
E-mail Address: info {at] LEEDerGroup [dot] com

2012-07 LCD and Policy Article Revisions - Summary for July 06, 2012

NHIC, Corp.
DME MAC A ListServe For Immediate Release July 06, 2012

LCD and Policy Article Revisions – Summary for July 06, 2012

Outlined below are the principal changes to several DME MAC Local Coverage Determinations (LCDs) and related Policy Articles (PAs) that have been revised and posted. Please review the entire LCD and each related Policy Article for complete information.

  • Ankle-Foot/Knee-Ankle-Foot Orthoses Policy Article Revision Effective Date: 07/01/2012 (July Publication) CODING GUIDELINES: Deleted: Coding verification for codes L1906, L1930, L1932, L1940, L1960, L1970 and L1971
  • Ostomy Supplies LCD Revision History Effective Date: 01/01/2012 (July Publication) INDICATIONS AND LIMITATIONS OF COVERAGE AND MEDICAL NECESSITY: Revised: Order requirements language to specify a “detailed written order” (omitted in error from the last revision) Added: Reference to Policy Article for information about the statutory coverage requirements for ostomy supplies Added: Refill requirements per PIM 5.2.6 (effective 08/02/2011 per CR7452) Added: Reference to information in Tracheostomy Care Supplies LCD Added: POLICY SPECIFIC DOCUMENTATION REQUIREMENTS
  • Oral Appliances for Obstructive Sleep Apnea LCD Revision Effective Date: 07/01/2012 INDICATIONS AND LIMITATIONS OF COVERAGE: Revised: Denial Statement for tongue-retaining devices Clarified: Projection of AHI/RDI calculations based upon less than 2 hours of testing time Added: ACHC as accreditation entity for personnel interpreting sleep testing DOCUMENTATION REQUIREMENTS: (Note: The effective date above is not applicable to this section. These revised and added requirements are existing Medicare requirements which are now included in the LCD for easy reference) Revised: Prescription requirements Added: General medical record information requirements and proof of delivery requirements
  • Policy Article Revision Effective Date: 07/01/2012 NONMEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Section describing the general dental exclusion CODING GUIDELINES Revised: Coding for tongue retaining devices Revised: Coding for E0486

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.