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Enteral Nutrition - Policy Article

Article A58833 · 5 versions, 2021 to today · last changed 2023-10-01 (R4)

Version 3 of Article A58833: in force by CMS's dates 2021-09-05 to 2021-09-04. 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You are viewing version 3 (2021-09-05, superseded same day). Version 17 is in force today.

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

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Version history, Article A58833

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 Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask.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, 4 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.

R4 · 2023-10-01 · v17
Revision Effective Date: 10/01/2023
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Added: “B4148” to supply allowance codes
CODING GUIDELINES:
Added: “B4148” to supply allowance codes
11/09/2023: 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.
R3 · 2023-07-02 · v15
Revision Effective Date: 07/02/2023
MODIFIERS:
Added: Section header
Added: BA, BO, GA, GY, GZ, and KX modifier instructions
Added: “As of January 1, 2023, suppliers must calculate the units of service (UOS) for each enteral product billed to Medicare, based on the treating practitioner’s order.”
Added: “Claim lines billed with codes without a KX, GA, GY or GZ modifier will be rejected as missing information” for claims with dates of service on or after July 2, 2023
CODING GUIDELINES:
Removed: “As of January 1, 2023, suppliers must calculate the units of service (UOS) for each enteral product billed to Medicare, based on the treating practitioner’s order.”
Removed: BA and BO modifier instructions


05/18/2023: 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.
R2 · 2023-01-01 · v11
Revision Effective Date: 01/01/2023
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Billing information relevant to DIFs, for DOS affected by the DIF elimination
CODING GUIDELINES:
Added: Information pertaining to the need for calculation of UOS based on the treating practitioner’s order


11/17/2022: 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.
R1 · 2021-09-05 · v7
Revision Effective Date: 09/05/2021
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 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.
Receipts for auditors

Version 3 of Article A58833, shown on this page: in force by CMS's dates 2021-09-05 to 2021-09-04. 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 A58833 (5 versions, CMS's dates, window by the as-of rule).

DocumentVersionIn forceArchived onVerify
Article A58833version 3 shown2021-09-05, superseded same day2026-09-26CMS's copy · Our archived file
Article A58833version 72021-09-05 to 2022-12-312026-09-26CMS's copy · Our archived file
Article A58833version 112023-01-01 to 2023-07-012026-09-26CMS's copy · Our archived file
Article A58833version 152023-07-02 to 2023-09-302026-09-26CMS's copy · Our archived file
Article A58833version 172023-10-01 to today2026-09-26CMS's copy · Our archived file

Each archived file's page gives its sha256 fingerprint. A copy of the file hashes to the same value, byte for byte.

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.