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Parenteral Nutrition - Policy Article

Article A52515 · 10 versions, 2015 to today · last changed 2020-11-12 (R9)

Version 24 of Article A52515: in force by CMS's dates 2019-01-01 to 2019-12-31. The policy text on this page comes from this archived version.

DME MAC jurisdictions
JA · Noridian 16013
CT, DE, DC, ME, MD, MA, NH, NJ, NY, PA, RI, VT
JB · CGS 17013
IL, IN, KY, MI, MN, OH, WI
JC · CGS 18003
AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, VI, VA, WV
JD · Noridian 19003
AK, AS, AZ, CA, GU, HI, ID, IA, KS, MO, MT, NE, NV, ND, MP, OR, SD, UT, WA, WY
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.

You are viewing version 24 (2019-01-01 to 2019-12-31). No version of Article A52515 is in force today.

Sections in this version: Article Text · Coding Information. Plus 1 section marked N/A in this version.

Full verbatim text serves to customers · Customer? Log in

Version history, Article A52515

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 Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask.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, 9 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.

R9 · 2020-11-12 · v31
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.
R8 · 2020-01-01 · v30
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.
R7 · 2020-01-01 · v27
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.
R6 · 2019-01-01 · v24
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.
R5 · 2019-01-01 · v22
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.
R4 · 2017-01-01 · v18
Revision Effective Date: 01/01/2017
Formatted bullets


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.
R3 · 2017-01-01 · v9
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
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 · v6
Removed: Effective Date from Policy Article title
Receipts for auditors

Version 24 of Article A52515, shown on this page: in force by CMS's dates 2019-01-01 to 2019-12-31. 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 A52515 (10 versions, CMS's dates, window by the as-of rule).

DocumentVersionIn forceArchived onVerify
Article A52515version 22015-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52515version 62015-10-01 to 2016-06-302026-09-26CMS's copy · Our archived file
Article A52515version 72016-07-01 to 2016-12-312026-09-26CMS's copy · Our archived file
Article A52515version 92017-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52515version 182017-01-01 to 2018-12-312026-09-26CMS's copy · Our archived file
Article A52515version 222019-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52515version 24 shown2019-01-01 to 2019-12-312026-09-26CMS's copy · Our archived file
Article A52515version 272020-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52515version 302020-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52515version 312020-01-01 to 2020-11-122026-09-26CMS's copy · Our archived file

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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.