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Enteral Nutrition - Policy Article
Article A52493 · 9 versions, 2015 to today · last changed 2020-11-12 (R8)
Version 9 of Article A52493: in force by CMS's dates 2017-01-01 to 2018-12-31. The policy text on this page comes from this archived version.
JA · Noridian 16013
JB · CGS 17013
JC · CGS 18003
JD · Noridian 19003
source
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Sections in this version: Article Text · Coding Information. Plus 1 section marked N/A in this version.
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Version history, Article A52493
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 Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask.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 · 2020-11-12 · v21
The DME MACs are retiring the Enteral Nutrition LCD (L33783) and related Policy Article (A52493) effective for claims with dates of service on or after November 12, 2020 due to the evolution of enteral nutrition clinical paradigms. 10/08/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This is not a new LCD nor is it a revision to an LCD, therefore does not require comment and notice.
R7 · 2020-04-30 · v20
Revision Effective Date: 04/30/2020 CODING GUIDELINES: Removed: Statement indicating calorically dense formulas that include characteristics of other HCPCS codes, will be coded based on the calorically dense characteristic 04/30/2020: 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.
R6 · 2020-01-01 · v18
Revision Effective Date: 01/01/2020 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: “attending physician” to “treating practitioner” Revised: Format of HCPCS code references, from code ‘spans’ to individually-listed HCPCS 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 DME INFORMATION FORM (DIF): Revised: “ordering physician” to “treating practitioner” Revised: Format of HCPCS code references, from code ‘spans’ to individually-listed HCPCS CODING GUIDELINES: Revised: Format of HCPCS code references, from code ‘spans’ to individually-listed HCPCS 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” 02/06/2020: 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 · v13
Revision Effective Date: 01/01/2019 CODING GUIDELINES: Revised: 'these supplies' to 'these supply allowances' for enteral feeding supplies Added: In-Line Cartridge Coding Guidelines and billing instructions for Q9994 and B4105 02/14/2019: 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 · 2017-01-01 · v9
Revision Effective Date: 01/01/2017 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Updated: "patient" to "beneficiary CODING GUIDELINES: Revised: Typographical, updated code set to represent a span 04/05/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
R3 · 2017-01-01 · v7
Revision Effective Date: 01/01/2017 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: Supply payment allowance for HCPCS B4034 – B4036 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Added: DIF requirements Updated: Recertification DIF to revised DIF CODING GUIDELINES: Revised: Coding guidelines of items included in the feeding supply allowance Added: Guidelines for blenderized and calorically dense formulations RELATED LOCAL COVERAGE DOCUMENTS: Added: LCD-related Standard Documentation Requirements Language Article
R2 · 2016-07-01 · v4
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 · v3
Revision Effective Date: 10/31/2014 CODING GUIDELINES: Updated: Standard language documentation for PDAC coding verification
Receipts for auditors
Version 9 of Article A52493, shown on this page: in force by CMS's dates 2017-01-01 to 2018-12-31. Archived 2026-09-26. CMS's copy · Our archived file. 3 of 3 sections are proven word-identical to the archived file.
Every archived version of Article A52493 (9 versions, CMS's dates, window by the as-of rule).
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| Article A52493 | version 2 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 3 | 2015-10-01 to 2016-06-30 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 4 | 2016-07-01 to 2016-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 7 | 2017-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 9 shown | 2017-01-01 to 2018-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 13 | 2019-01-01 to 2019-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 18 | 2020-01-01 to 2020-04-29 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 20 | 2020-04-30, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52493 | version 21 | 2020-04-30 to 2020-11-12 | 2026-09-26 | CMS's copy · Our archived file |
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