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Pressure Reducing Support Surfaces - Group 2 - Policy Article
Article A52490 · 9 versions, 2015 to today · last changed 2020-01-01 (R8)
Version 25 of Article A52490: in force by CMS's dates 2020-01-01 to 2019-12-31. The policy text on this page comes from this archived version.
JA · Noridian 16013
JB · CGS 17013
JC · CGS 18003
JD · Noridian 19003
source
CMS's Who are the MACs jurisdiction pages (DME facts as of 2025-09-30) name each contractor and its states; the MCD's Contractor Information table on every DME LCD prints the contract numbers. Both read 2026-10-09. Verzi adds the state lookup only.
Sections in this version: Article Text. Plus 4 sections marked N/A in this version.
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Version history, Article A52490
CMS numbers each version. Each box shows the version's window by CMS's stated dates. Select a version to show it on this page. Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask. Version numbers CMS never published to its archive do not exist as documents.
Revision history, every version
CMS's own change log, quoted, 8 entries. It does not change with the version shown. A revision (R-number) is a change CMS logged. The version (vN) is the snapshot that carries it.
R8 · 2020-01-01 · v27
Revision Effective Date: 01/01/2020 REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217): Removed: “The link will be located here once it is available.” Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list 04/14/2022: 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.
R7 · 2020-01-01 · v25
Revision Effective Date: 01/01/2020 CODING GUIDELINES: Added: “(CVR)” after reference to coding verification review Added: “(PCL)” after reference to “Product Classification List” Revised: Coding verification review information, to include incorrect coding denial language for products billed using HCPCS that require written coding verification review 03/18/2021: At this time 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.
R6 · 2020-01-01 · v22
Revision Effective Date: 01/01/2020 REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217): Added: Section and related information based on Final Rule 1713 ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY: Revised: Section header “ICD-10 Codes that are Covered” updated to “ICD-10 Codes that Support Medical Necessity” ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY: Revised: Section header “ICD-10 Codes that are Not Covered” updated to “ICD-10 Codes that DO NOT Support Medical Necessity” 02/27/2020: At this time 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.
R5 · 2019-01-01 · v20
Revision History Effective Date: 01/01/2019 ICD-10 CODES THAT ARE COVERED: Added: All diagnosis codes formerly listed in the LCD ICD-10 CODES THAT ARE NOT COVERED: Added: Notation excluding all unlisted diagnosis codes from coverage 02/28/2019: At this time 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.
R4 · 2017-05-25 · v16
Revision Effective Date: 05/25/2017 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Added: Modifier requirements RELATED LOCAL COVERAGE DOCUMENTS: Added: LCD-related Standard Documentation Requirements Language Article
R3 · 2016-07-01 · v10
Revision Effective Date: 07/01/2016 Removed: WOPD, this is in the document requirement section
R2 · 2016-07-01 · v7
Effective July 1, 2016 oversight for DME MAC Articles is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the Articles.
R1 · 2015-10-01 · v5
Revision Effective Date: 10/01/2014 CODING GUIDELINES: Revised: E1399 Code Guidelines
Receipts for auditors
Version 25 of Article A52490, shown on this page: in force by CMS's dates 2020-01-01 to 2019-12-31. Archived 2026-10-09. CMS's copy · Our archived file. 5 of 5 sections are proven word-identical to the archived file.
Every archived version of Article A52490 (9 versions, CMS's dates, window by the as-of rule).
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| Article A52490 | version 2 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52490 | version 5 | 2015-10-01 to 2016-06-30 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52490 | version 7 | 2016-07-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52490 | version 10 | 2016-07-01 to 2017-05-24 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52490 | version 16 | 2017-05-25 to 2018-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52490 | version 20 | 2019-01-01 to 2019-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52490 | version 22 | 2020-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A52490 | version 25 shown | 2020-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A52490 | version 27 | 2020-01-01 to today | 2026-09-26 | CMS's copy · Our archived file |
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CMS's live page shows only the current version. To check a passage by eye, open CMS's copy of the same version number. A version's window ends on the earlier of CMS's stated end date and the day before the next version starts.
Every policy word on this page is CMS's, from the archived version named beside it. Verzi adds labels, highlights, citations and links only. Verzi-written summary content on this page: none.