Every policy word on this page is CMS's own. Verzi adds pins, receipts, and links only.
Walkers
LCD L33791 · CMS's HCPCS descriptor for A9270: Non-covered item or service.
CMS lists A9270 in 15 LCDs in the Verzi KB: LCD L33318 LCD L33611 LCD L33733 LCD L33735 LCD L33790 LCD L33791 LCD L33792 LCD L33794 LCD L33803 LCD L33826 LCD L33828 LCD L33830 LCD L33831 LCD L36267 LCD L38955
Not on CMS's Required Prior Authorization List for DMEPOS on 2026-10-13. source
LCD L33791 · 6 versions, 2015 to today · last changed 2026-10-01 (R5)
Version 3 of LCD L33791: in force by CMS's dates 2015-10-01 to 2016-06-30. The policy text on this page comes from this archived version. On its start date, 2015-10-01, the companion Article in force was Article A52503 version 3.
JA · Noridian 16013
JB · CGS 17013
JC · CGS 18003
JD · Noridian 19003
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.
Sections in this version: CMS National Coverage Policy · Coverage Indications, Limitations, and/or Medical Necessity · Coding Information · Associated Information. Plus 4 sections marked N/A in this version.
Full verbatim text serves to customers · Customer? Log in
Version history, LCD L33791
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 Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask.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, 5 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.
R5 · 2026-10-01 · v18
Revision Effective Date: 10/01/2026 CMS NATIONAL COVERAGE POLICY: Added: “280.1,” as clarification HCPCS CODES: Added: E0150 to Group 1 Codes 10/01/2026: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because the revisions are non-discretionary updates per CMS HCPCS coding determinations.
R4 · 2020-01-01 · v15
Revision Effective Date: 01/01/2020 COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY: Revised: Order information as a result of Final Rule 1713 CODING INFORMATION: Removed: Field titled “Bill Type” Removed: Field titled “Revenue Codes” Removed: Field titled “ICD-10 Codes that Support Medical Necessity” Removed: Field titled “ICD-10 Codes that DO NOT Support Medical Necessity” Removed: Field titled “Additional ICD-10 Information” DOCUMENTATION REQUIREMENTS: Revised: “physician’s” to “treating practitioner’s” GENERAL DOCUENTATION REQUIREMENTS: Revised: Prescriptions (orders) to SWO 02/20/2020: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due to non-discretionary coverage updates reflective of CMS FR-1713.
R3 · 2017-01-01 · v8
Revision Effective Date: 01/01/2017 COVERAGE INDICATIONS, INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY: Removed: Standard Documentation Language Added: New reference language and directions to Standard Documentation Requirements Added: General Requirements DOCUMENTATION REQUIREMENTS: Removed: Standard Documentation Language Added: General Documentation Requirements Added: New reference language and directions to Standard Documentation Requirements POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Removed: Standard Documentation Language Added: Direction to Standard Documentation Requirements Removed: Supplier Manual reference from Miscellaneous Removed: PIM reference from Appendices RELATED LOCAL COVERAGE DOCUMENTS: Added: LCD-related Standard Documentation Requirements article
R2 · 2016-07-01 · v5
Effective July 1, 2016 oversight for DME MAC LCDs 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 LCDs.
R1 · 2015-10-01 · v3
Revision Effective Date: 10/31/14 COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY: Revised: Standard Documentation Language to add covered prior to a beneficiary’s Medicare eligibility DOCUMENTATION REQUIREMENTS: Revised: Standard Documentation Language to add who can enter date of delivery date on the POD Added: Instructions for equipment retained from a prior payer Revised: Repair to beneficiary-owned DMEPOS
Receipts for auditors
Version 3 of LCD L33791, shown on this page: in force by CMS's dates 2015-10-01 to 2016-06-30. Archived 2026-09-26. CMS's copy · Our archived file. 8 of 8 sections are proven word-identical to the archived file.
Every archived version of LCD L33791 (6 versions, CMS's dates, window by the as-of rule).
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| LCD L33791 | version 2 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| LCD L33791 | version 3 shown | 2015-10-01 to 2016-06-30 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L33791 | version 5 | 2016-07-01 to 2016-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L33791 | version 8 | 2017-01-01 to 2019-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L33791 | version 15 | 2020-01-01 to 2026-09-30 | 2026-09-26 | CMS's copy · Our archived file |
| LCD L33791 | version 18 | 2026-10-01 to today | 2026-10-02 | CMS's copy · Our archived file |
The related Articles each have their own receipts: Article A55426 · Article A52503.
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.
Governing policies, as CMS lists them:
- LCD L33318 · Knee Orthoses
CMS lists A9270 in group 1 of version 63. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A52465 · Article A55426 · Article A60371 - LCD L33611 · Oral Appliances for Obstructive Sleep Apnea
CMS lists A9270 in group 1 of version 25. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A52512 · Article A55426 · Article A58823 - LCD L33733 · Canes and Crutches
CMS lists A9270 in group 1 of version 19. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52459 - LCD L33735 · Cold Therapy
CMS lists A9270 in group 1 of version 19. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52460 - LCD L33790 · Spinal Orthoses: TLSO and LSO
CMS lists A9270 in group 1 of version 20. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52500 - LCD L33791 · Walkers
CMS lists A9270 in group 1 of version 18. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52503 - LCD L33792 · Wheelchair Options/Accessories
CMS lists A9270 in group 9 of version 43. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52504 - LCD L33794 · External Infusion Pumps
CMS lists A9270 in group 2 of version 176. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A52507 · Article A60373 · Article A55426 - LCD L33803 · Urological Supplies
CMS lists A9270 in group 1 of version 61. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A52521 · Article A55426 · Article A60353 - LCD L33826 · Oral Anticancer Drugs
CMS lists A9270 in group 1 of version 22. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52479 - LCD L33828 · Ostomy Supplies
CMS lists A9270 in group 1 of version 27. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52487 - LCD L33830 · Pressure Reducing Support Surfaces - Group 1
CMS lists A9270 in group 1 of version 22. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A52489 - LCD L33831 · Surgical Dressings
CMS lists A9270 in group 1 of version 48. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A54563 · Article A55426 - LCD L36267 · Bowel Management Devices
CMS lists A9270 in group 1 of version 44. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A54516 · Article A55426 - LCD L38955 · Enteral Nutrition
CMS lists A9270 in group 1 of version 24. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
Related Articles, as CMS lists them: Article A55426 · Article A58833 · Article A59397 - LCD L39936 (on CMS's site; not in the Verzi KB yet)
CMS lists A9270 in group 1 of version 14. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”. - LCD L40247 (on CMS's site; not in the Verzi KB yet)
CMS lists A9270 in group 2 of version 8. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”. - LCD L40270 (on CMS's site; not in the Verzi KB yet)
CMS lists A9270 in group 1 of version 19. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”. - LCD L40345 (on CMS's site; not in the Verzi KB yet)
CMS lists A9270 in group 9 of version 10. CMS's description, quoted: “NON-COVERED ITEM OR SERVICE”.
From CMS's LCD code table. HCPCS Level II codes only.
source
CMS's LCD code table in the Medicare Coverage Database download, archived 2026-10-09: Our archived file.
Watch A9270
One email when any policy cited for A9270 changes or gains a future effective date. Nothing else, ever.