Negative Pressure Wound Therapy Pumps - Policy Article

Revision Effective Date: 08/15/2021
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.

Revision Effective Date: 08/15/2021
CODING GUIDELINES:
Added: A9272 coding guideline information, to clarify all-inclusive and supplies are not separately billable
Removed: Direction for billing miscellaneous A9900


07/08/2021: 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.

Revision Effective Date: 01/01/2020
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Revised: “an” to “a” before NPWT
MODIFIERS:
Revised: "an” to “a” before NPWT


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.

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

POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
 Revised: “physician” to “practitioner”
 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”


02/13/2020: 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.

02/07/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This is an article and not a local coverage determination.

Revision History Effective Date: 05/25/2017
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: WOPD requirement
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Removed: WOPD requirement

Revision History Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Billing Information, Written Order Prior to Delivery and Modifiers requirements
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements Language Article

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.

Revision Effective Date:  10/01/2015
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Added: HCPCS Code A9272 (code effective 01/01/2012) to statement regarding denial of disposable wound suction pumps and related supplies
CODING GUIDELINES:
Added: Instructions for billing disposable wound suction system
Revised: Instructions for billing supplies used with disposable wound suction systems