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LCD & Policy Article Revisions for March 11, 2010 |
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LCD and Policy Article RevisionsSummary for March 11, 2010 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. External
Breast Prostheses LCDRevision Effective Date: 01/01/2010INDICATIONS AND
LIMITATIONS OF COVERAGE AND/OR MEDICAL NECESSITY:Added: Coverage information
specific to mastectomy bras (L8000)Added: Coverage information specific to
breast prostheses, silicone or equal, with integral adhesive (L8031)Added:
Coverage information on quantity dispensed at a timeHCPCS CODES AND
MODIFIERS:Added: L8031, L8032Revised: L8030 Policy ArticleRevision Effective
Date: 01/01/2010NON-MEDICAL NECESSITY AND COVERAGE AND PAYMENT RULES:Added:
Nipple prostheses have a 3 month reasonable lifetime expectancyCODING
GUIDELINES:Added: Description for L8000Revised: RT/LT modifier
instructionsChanged: SADMERC to PDAC Positive Airway Pressure (PAP) Devices for
the Treatment of Obstructive Sleep Apnea LCDRevision Effective Date: 04/01/2010
(February 2010 Revision)INDICATIONS AND LIMITATIONS OF COVERAGE:Added: Program
Integrity Manual instructions on refills of accessoriesAdded: Replacement
instructions for beneficiaries already in MedicareRevised: Types of sleep
testsRevised: Coverage of replacement devices and/or accessoriesRevised:
Beneficiaries entering Medicare instructionsDOCUMENTATION REQUIREMENTS:Added:
Replacement instructions for beneficiaries already in MedicareRevised:
Documentation of replacement devices and/or accessoriesRevised: Beneficiaries
entering Medicare instructions Policy ArticleRevision Effective Date:
04/01/2010CODING GUIDELINES:Revised: Use of RAD termRevised: Definition of
E0470 and E0471 Spinal Orthoses: TLSO and LSOPolicy ArticleRevision Effective
Date: 07/01/2010CODING GUIDELINES:Revised: Requirement for coding verification
review by the 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.
Registration and playback for the "On Demand" Medicare University 2009 Virtual
Convention has been extended by popular demand to March 31, 2010.
National Government Services has extended the availability for registration and
playback of the 2009 Medicare University Virtual Convention "On Demand" courses
through March 31, 2010. For the low cost of $150, you have access to over 60
unique on-demand courses, not offered through Medicare University, at a time
that is convenient for you. Plus, you can earn as many as 57 continuing
education units!
Visit the Course page on the
Medicare University 2009 Virtual Convention Web site to view a list of all the
on-demand courses. After March 31, 2010 there is no turning back, so register
today at www.NGSMEDICARECONVENTION.com
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