Parenteral Nutrition - Policy Article

The DME MACs are retiring the Parenteral Nutrition LCD (L33798) and related Policy Article (A52515) 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.

Revision Effective Date: 01/01/2020
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES
:
 Revised: “attending physician” to “treating practitioner”
 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 “treating practitioner”
 Revised: Format of HCPCS code references, from ‘code spans’ to individually-listed HCPCS
 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


02/20/2020: 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.

Revision Effective Date: 01/01/2020
 CODING GUIDELINES:
 Added: B4187 to guidance
 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”


12/19/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article and not a local coverage determination.

Revision Effective Date: 01/01/2019
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: HCPCS codes needing a revised DIF when changes in calories prescribed


03/28/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article and not a local coverage determination.

Revision Effective Date: 01/01/2019
 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Removed: Method of administration from revised DIF requirements
 Revised: Change in route of administration from revised DIF requirements


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

Revision Effective Date: 01/01/2017
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09/20/2018: 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.

Revision Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Billing Instructions and DIF 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.

Removed: Effective Date from Policy Article title