Pressure Reducing Support Surfaces - Group 2

Revision Effective Date: 05/01/2021
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Spelling error from ‘appropriatge’ to ‘appropriate’
Revised: Roman to Arabic numerals in staging scheme
APPENDICES:
Revised: National Pressure Ulcer Advisory Panel to National Pressure Injury Advisory Panel and 2019 guidelines (unchanged from 2016 guidelines)


03/18/2021: Pursuant to the 21st Century Cures Act, these revisions do not require notice and comment because they are due grammatical or non-substantive changes.

Revision Effective Date: 01/01/2020

COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
 Revised: Statement to refer to ICD-10 code list in the LCD-related Policy Article
 Revised: “physician” to “treating practitioner”
 GENERAL:
 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”
 GENERAL DOCUMENTATION REQUIREMENTS:
 Revised: “Prescriptions (orders)” to “SWO”


02/27/2020: 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.

Revision Effective Date: 01/01/2019

COVERAGE INDICATIONS, LIMITATIONS, AND/OR MEDICAL NECESSITY:
 Removed: Statement to refer to diagnosis code section below
 Added: Refer to Covered ICD-10 Codes in the LCD-related Policy Article
 ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
 Moved: All diagnosis codes to the LCD-related Policy Article diagnosis code section per CMS instruction
 ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
 Moved: Statement about noncovered diagnosis codes moved to LCD-related Policy Article noncovered diagnosis code section per CMS instruction

Revision Effective Date: 05/25/2017
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 section
Removed: PIM reference under Appendices section
Revised: Pressure ulcer staging criteria per NPUAP 2016 Staging Consensus Conference
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements article

Revision Effective Date: 01/01/2016
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Removed: WOPD instructions added erroneously
DOCUMENTATION REQUIREMENTS:
Revised: Standard Documentation language to add Dispensing orders, New order, and Correct coding requirements; revised Detailed written orders, WOPD, Proof of delivery  (Effective 04/28/16)

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.

Revision Effective Date: 10/01/2015
COVERAGE INDICATIONS, LIMITATIONS AND/OR MEDICAL NECESSITY:
Revised: Standard Documentation Language to add covered prior to a beneficiary’s Medicare eligibility
Removed: ICD-9 references
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
Added: Repair and Replacement section
Removed: Sources of Information and Basis for Decision, inadvertently not removed for prior update