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Billing of Powered L-Coded Items - Correct Coding - Revised
L1690 Prefabricated Bilateral Lumbo-sacral Hip Orthosis - Correct Coding
L1005 - Tension Based Scoliosis Orthosis and Accessory Pads, Includes Fitting and Adjustment - Correct Coding
Retired - Correct Coding - MyoPro (Myomo, Inc.) Assist Device - Revised
Parenteral Nutrition - Correct Coding and Billing
Retired - Correct Coding - Powered Exoskeleton Products
Enteral Nutrition - Correct Coding and Billing
L1686 Prefabricated Hip Abduction Orthosis - Correct Coding
Retired - Correct Coding and Coverage of Ventilators – Revised April 2019
Scoliosis Brace - Correct Coding
Retired - Correct Coding and Coverage - Panzyga® (Immunoglobulin Intravenous (Human), 10%)
Correct Coding - U 500 Insulin for Use in External Insulin Infusion Pumps
HCPCS CODE UPDATE – 2011
Correct Coding – 2019 HCPCS Code Annual Update - Corrected
HCPCS Code Update- 2009
Correct Coding for Items Used to Treat Edema - Revised
Prosthetic Feet and Additions to Lower Limb Extremity Prostheses - Correct Coding and Coding Verification Review Requirement
Continuous Glucose Monitor Supplies - Correct Coding and Billing
KF Modifier Use - Correct Coding
Panzyga® (Immunoglobulin Intravenous (Human), 10%) Correct Coding and Coverage - Revised
2020 HCPCS Code Annual Update - Correct Coding - Revised
Incorrect Use of HCPCS Code A9279 - Correct Coding
Correct Coding - Articulating Digit(s) and Prosthetic Hands - Revised
Partial Hand Prostheses - Correct Coding
New HCPCS Code - Revefenacin (Yupelri®) - J7677
Endoskeletal Prosthetic Knee-Shin Systems - Correct Coding
ENTERAL NUTRITION SUPPLY KITS - B4034-B4036
ULTRASONIC/ELECTRONIC AEROSOL GENERATOR WITH SMALL VOLUME NEBULIZER – CODING VERIFICATION REVIEW REQUIREMENT
HCPCS CODE A9283 – DEVICES USED FOR EDEMA OR ULCER HEALING
ORAL ANTI-CANCER DRUGS – CODING AND BILLING CHANGE
TRANSCUTANEOUS ELECTRICAL NERVE STIMULATORS (TENS) SOLD OVER-THE-COUNTER – CODING GUIDELINES
MANUAL WHEELCHAIR BASES
CODING GUIDELINES FOR THERAPEUTIC SHOES FOR PERSONS WITH DIABETES
HCPCS CODE UPDATE – (2014)
Retired - Correct Coding for Pneumatic Compression Devices
MULTIPLE COPIES OF APPLICATIONS NOT NEEDED
CORRECT CODING AND BILLING OF CANTILEVER TYPE ARMREST
CLARIFICATION OF BILLING SURGICAL DRESSINGS AS COMPONENTS OF KITS
CORRECT CODING – SAFETY EQUIPMENT PACKAGES WITH POWER OPERATED VEHICLES (POVS)
HCPCS CODE E0571 - INVALID
Retired - Ankle-Foot Orthoses – Arizona-Type – Correct Coding
FUNCTIONAL ELECTRICAL STIMULATORS – NEW CODE
PDAC CONTRACT EFFECTIVE AUGUST 18, 2008
HCPCS CODE UPDATE - (2010) - REVISED
HAND FINGER ORTHOSES (L3923) - USE OF CG MODIFIER
TRACHEOSTOMY CARE KIT - CODING GUIDELINES
BILLING FOR CAPECITABINE (XELODA®) 500 MG DOSAGE FORM – EUROPEAN FORMULATION BLISTER PACK
Power Mobility Device Independent Testing Requirements
REVISED – POWER MOBILITY DEVICE INDEPENDENT TESTING REQUIREMENTS
HCPCS CODE UPDATE – 2012
HCPCS CODE UPDATE – 2013
REMINDER - ULTRASONIC/ELECTRONIC AEROSOL GENERATOR WITH SMALL VOLUME NEBULIZER – CODING VERIFICATION REVIEW REQUIREMENT
CORRECT CODING – SURGICAL DRESSINGS CONTAINING MEDICAL HONEY
CORRECT CODING – SUPPLIES USED WITH E0446 – JOINT DME MAC PUBLICATION
Retired - Coverage and Coding – New Oral Antiemetic Drug Varubi™
SPEECH GENERATING DEVICE – INFORMATION REQUIRED FOR CODING VERIFICATION REVIEW
REVISED – POWER MOBILITY DEVICE INDEPENDENT TESTING REQUIREMENTS EFFECTIVE OCTOBER 1, 2015
COVERAGE AND CORRECT CODING OF HYQVIA (IMMUNE GLOBULIN INFUSION (HUMAN) 10%, WITH RECOMBINANT HUMAN HYALURONIDASE) – REVISED JOINT DME MAC PUBLICATION – REVISED
RETIRED – CORRECT CODING – CEFALY®
SPEECH GENERATING DEVICES – CODING VERIFICATION REVIEW REQUIREMENT – UPDATE
Retired - Correct Coding - Lithium Batteries - Updated
BREATHE NIOV™ - CODING REMINDER – REVISED JANUARY 2014
COVERAGE AND CORRECT CODING OF HYQVIA (IMMUNE GLOBULIN INFUSION (HUMAN) 10%, WITH RECOMBINANT HUMAN HYALURONIDASE) – REVISED
NEW OFF-THE-SHELF ORTHOTIC CODES
COVERAGE AND CODING – NEW ORAL ANTIEMETIC DRUG AKYNZEO®
Retired - Coverage and Correct Coding of Continuous Glucose Monitoring (CGM) Devices - Revised
COVERAGE AND CORRECT CODING OF HYQVIA®
CORRECT CODING – DRUGS AND FLUIDS
CORRECT CODING – DIATHERMY AND BIOFEEDBACK DEVICES
MANUAL WHEELCHAIR BASES
Retired - Coverage and Correct Coding of Continuous Glucose Monitoring Devices
CORRECT CODING – SURGICAL DRESSINGS CONTAINING NON-COVERED COMPONENTS
CORRECT CODING – ORAL ANTICANCER DRUGS AND PDAC’S NDC/HCPCS CROSSWALK LISTINGS
CORRECT CODING – 2016 HCPCS CODE ANNUAL UPDATE
COVERAGE REMINDER – SPEECH GENERATING DEVICES
Retired - Correct Coding - Negative Pressure Wound Therapy (NPWT)
CORRECT CODING – IDEO AND EXOSYM ENERGY STORING AFO
Retired - Continuous Glucose Monitors - Frequently Asked Questions
Retired - Correct Coding – NOC Codes for Enteral (B9998) and Parenteral (B9999) Nutrition
CORRECT CODING – HYGIENIC CLEANSERS, DIAPERS, AND UNDER-PADS
COVERAGE AND CORRECT CODING OF CUVITRU™
Retired - Coding and Coverage - Therapeutic Continuous Glucose Monitors (CGM)
Retired - Speech Generating Devices – Coding Verification Review Requirement
CORRECT CODING – HCPCS CODING RECOMMENDATIONS FROM NON-MEDICARE SOURCES
Retired – Correct Coding – Eclipse™ Vaginal Insert System (Pelvalon, Inc) - Revised
CORRECT CODING OF CUVITRU™ REVISED
Retired - Correct Coding - inFlow™ Intraurethral Valve-Pump (Vesiflo, Inc.)
CORRECT CODING AND COVERAGE – BRACES CONSTRUCTED PRIMARILY OF ELASTIC OR OTHER FABRIC MATERIALS – REVISED
CORRECT CODING – DIAPERS AND UNDERPADS
Retired - Correct Coding - Manual Wheelchairs Constructed of Titanium
Retired - Correct Coding and Coverage of Ventilators – Revised May 2016
CORRECT CODING – 2017 HCPCS CODE ANNUAL UPDATE
Retired - Coverage and Coding – New Oral Antiemetic Drug Varubi® – Revised – Effective Date July 1, 2016
Retired - Correct Coding - 2019 HCPCS Code Annual Update
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Battery Charger
Correct Coding - Warranty, Reasonable Useful Lifetime (RUL), and the Minimum Lifetime Requirement (MLR) for Durable Medical Equipment
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Wheelchair Tray
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for an Actuator
Retired - Correct Coding - Q9994 (IN-LINE CARTRIDGE CONTAINING DIGESTIVE ENZYME(S) FOR ENTERAL FEEDING, EACH) Coverage Indicator Changed
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Anti-Tip Devices for Manual Wheelchairs
Retired - Correct Coding - Inserts Used with Therapeutic Shoes for Persons with Diabetes (A5512, A5513, K0903)
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for a Wheel Lock Brake Extension for Manual Wheelchairs
Correct Coding – Incorrect Use of HCPCS Code K0108 To Bill for a Wheelchair Headrest
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Labor Charges
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Transit System and Associated Bracket
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Front Riggings: Shoe Holder or Shoe Holder Replacement Straps
Continuous Glucose Monitors - Use of Smart Devices
Topical Oxygen Therapy Used For Wound Care - An Update
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Battery Replacement
Correct Coding - Custom Fabricated Wheelchair Seat and Back Cushions
Correct Coding – Replacement Cecostomy Tube
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Replacement of Wheelchair Seat and Back Upholstery
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Front Riggings: Calf Pad or Calf Support
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for a Privacy Flap
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Wheelchair Ventilator Tray
Correct Coding - A9286 - Hygienic Item or Device, Disposable or Non-disposable, Any Type, Each
Retired - 2020 HCPCS Code Annual Update - Correct Coding
PDAC Coding Guidelines for Off-the-Shelf Diabetic Shoes (A5500)
CORRECT CODING – INSULIN USED WITH CONTINUOUS EXTERNAL INSULIN INFUSION PUMPS
Retired - Correct Coding and Coverage of Ventilators - Revised January 2019
HCPCS CODE L0430 - INVALID
RETIRED – CORRECT CODING – MARTIN BIONICS SOCKET-LESS SOCKET – REVISED
Retired - Correct Coding – “No-Touch” Catheters
REVISED – COLLAGEN SURGICAL DRESSINGS – CODING VERIFICATION REVIEW REQUIREMENT
K0009 MANUAL WHEELCHAIR – CODING VERIFICATION REVIEW REQUIREMENT
Retired - Correct Coding Reminder - Duopa® (AbbVie)
CORRECT CODING – WEIGHTLESS WALKER
COVERAGE AND CORRECT CODING OF YONDELIS®
Retired - Correct Coding – Center Mounted Elevating Leg Rest
CORRECTION – NEW MODIFIER CS – EFFECTIVE DATE APRIL 20, 2010
CORRECT CODING – INTEGRATED RESPIRATORY PRODUCTS
Retired - Correct Coding – Eclipse™ Vaginal Insert System (Pelvalon, Inc.)
CORRECT CODING – BUZZY®
Retired - Correct Coding - Not Otherwise Classified (NOC) HCPCS Codes Used for Drugs
Retired - Correct Coding and Coverage of Ventilators
Retired - Correct Coding and Coverage – Peristeen® Transanal Irrigation (PAI) System
WALKER UNBUNDLING BILLING FOR BRAKES
CORRECT CODING – VIBRATION THERAPY DEVICES
CORRECT CODING – NEW ORAL ANTIEMETIC DRUG AKYNZEO® - JOINT DME MAC PUBLICATION REVISED
CORRECT CODING INSTRUCTIONS – A4358 URINARY COLLECTION BAG
CORRECT CODING – BEMER PHYSICAL VASCULAR THERAPY DEVICES
MANUAL WHEELCHAIR BASES - CORRECT CODING - REVISED
POLICY ARTICLE REVISION – VACUUM ERECTION DEVICES (VED)
CORRECT CODING – FITNESS MONITORING TECHNOLOGIES
Retired - MyoPro™ - Coding Reminder
CORRECT CODING OF CONTINUOUS PASSIVE MOTION DEVICES
Retired - Coverage and Correct Coding of Blincyto™
COVERAGE AND CORRECT CODING OF DUOPA® (LEVODOPA-CARBIDOPA ENTERAL SUSPENSION) JOINT DME MAC PUBLICATION – REVISED
CORRECT CODING - A5513 CUSTOM MOLDING REQUIREMENTS
E0486 – CUSTOM FABRICATED ORAL APPLIANCE FOR OSA – CODING AND UTILIZATION GUIDELINES
HCPCS CODE UPDATE – (2015)
Retired - Correct Coding - Center Mount Elevating Leg Rest - Revised
Correct Coding - Lithium Batteries - Revised
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for a Drive Wheel Gear Box
COVERAGE AND CODING – NEW ORAL ANTIEMETIC DRUG AKYNZEO – REVISED
CORRECT CODING AND COVERAGE – E0740 NON-IMPLANTABLE PELVIC FLOOR ELECTRICAL STIMULATOR
L3960 - Coding Verification Review Requirement
CORRECT CODING – LINERS USED WITH POSITIVE AIRWAY PRESSURE (PAP) MASK
COVERAGE AND CORRECT CODING OF DUOPA® (LEVODOPA-CARBIDOPA ENTERAL SUSPENSION)
CORRECT CODING REMINDER - MONITORING TECHNOLOGY USED WITH POSITIVE AIRWAY PRESSURE DEVICES (PAP) AND RESPIRATORY ASSIST DEVICES (RAD)
Retired - Coverage and Correct Coding of Blincyto™ – Revised
UROLOGICAL SUPPLIES – A4353 CORRECT CODING CLARIFICATION POLICY REVISION
Xembify® - Correct Coding
Correct Coding - PROSE ® Device
CORRECT CODING – TOBI® PODHALER™
Retired - Correct Coding and Coverage - RELiZORB (Alcresta Therapeutics) In-Line Cartridge
CORRECT CODING – ARGUS® II RETINAL PROSTHESIS SYSTEM
RETIRED - CORRECT CODING – PRO-FLEX® PROSTHETIC FOOT (ÖSSUR)
K0009 MANUAL WHEELCHAIR – CODING VERIFICATION REVIEW REQUIREMENT – UPDATE
CORRECT CODING – L0174 CODING REVIEW
CORRECT CODING – CAST COVERS
CORRECT CODING AND COVERAGE – BRACES CONSTRUCTED PRIMARILY OF ELASTIC OR OTHER FABRIC MATERIALS
CORRECT CODING – ORAL APPLIANCES NOT USED FOR THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA
CORRECT CODING AND COVERAGE – ORAL SUSPENSIONS USED IN THE TREATMENT OF ORAL MUCOSAL INJURIES
CORRECT CODING – INTERFERENTIAL CURRENT (IFC) THERAPY DEVICES
Retired - Correct Coding - Lithium Batteries
CORRECT CODING – 2018 HCPCS CODE ANNUAL UPDATE
K0009 MANUAL WHEELCHAIR – CODING VERIFICATION REVIEW REQUIREMENT – DEADLINE EXTENDED
RESPIRATORY ASSIST DEVICES – E0472
Retired - Correct Coding – Pneumatic Compression Devices and Related Appliances – Revised
Retired - Correct Coding - Otto Bock C-Leg Coding - Revised
Retired - Correct Coding – Billing of Powered L-Coded Items
Retired - Glucose Monitors LCD and Related Policy Article - Revised
CORRECT CODING – FULL LENGTH ROCKER SOLES ADDED TO THERAPEUTIC SHOES
CORRECT CODING – TRACHEOSTOMY TUBES
CANTILEVER TYPE ARMREST – CORRECT CODING
CODING GUIDELINE – K0900 (CUSTOM DURABLE MEDICAL EQUIPMENT, OTHER THAN WHEELCHAIRS)
HAND-FINGER ORTHOSES – USE OF CG MODIFIER – REVISED
CORRECT CODING FOR ORAL APPLIANCES FOR THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA (E0486)
ANKLE-FOOT ORTHOSES – ARIZONA-TYPE – CORRECT CODING – REVISED
CORRECT CODING – P-STIM® DEVICE
Retired - Correct Coding and Coverage of Ventilators – Revised Effective January 1, 2016
COLLAGEN SURGICAL DRESSINGS – CODING VERIFICATION REVIEW REQUIREMENT
CORRECT CODING – ANKLE ORTHOSES, WITH OR WITHOUT JOINTS, PREFABRICATED OR CUSTOM FABRICATED CODING VERIFICATION REVIEW
REVISED – K0009 MANUAL WHEELCHAIR – CODING VERIFICATION REVIEW REQUIREMENT
CONCENTRIC ADJUSTABLE TORSION JOINTS – CORRECT CODING
WHAT IS THE DIFFERENCE BETWEEN THE PDAC AND THE DME MACS?
Retired - Correct Coding - Articulating Digit(s) and Prosthetic Hands
CORRECT CODING – SPEEDICATH® FLEX COUDÉ CATHETER (COLOPLAST)
EXERCISE EQUIPMENT - CORRECT CODING
REQUIREMENTS FOR CODING REVIEW OF CUSTOM FABRICATED SPINAL ORTHOSES
Correct Coding - Porta-Lung Negative Pressure Ventilator - Revised
CORRECT CODING INSTRUCTIONS – PORTA-LUNG® NEGATIVE PRESSURE VENTILATOR
HEATING PADS AND HEAT LAMPS – DRAFT MEDICAL POLICY FINALIZED
CORRECT CODING - APNICURE WINX® SLEEP THERAPY SYSTEM
CORRECT CODING – HCPCS CODING OF SURGICAL DRESSINGS – COMPONENTS TO REPORT ON THE PDAC HCPCS CODE VERIFICATION APPLICATION
HEIGHT STANDARDS FOR CODING LSO AND TLSO - REVISED
CORRECT CODING – URINARY DRAINAGE TUBE ADAPTER
CORRECT CODING – A5513 PRODUCT CODING REDETERMINATION PROJECT
CORRECT CODING – HYGIENIC ITEMS, WASH CLOTHS, AND CLEANSING WIPES
Retired - Spinal Orthosis – Coding Verification Review Requirement
Retired - Charcot Restraint Orthotic Walker - Crow Boot - Coding
Retired - Charcot Restraint Orthotic Walker – Crow Boot – Coding Update
Retired - Coding Instructions - Microprocessor Controlled Knee Prostheses
Retired - Elastic Garments – Noncovered
Retired - Correct Coding – LIM Innovations Infinite Socket™
Retired - Pneumatic Knee Splint – Coding Verification Review Requirement
Retired - LIM Innovation Infinite Socket - Correct Coding - Revised
Retired - Correct Coding – LIM Innovation Below Knee Socket
Retired - Correct Coding – LIM Innovations Infinite Socket™ – Revised
Retired - Coding Guidelines for Ankle Foot Orthoses
Retired - Revised - Coding Guidelines for Ankle-Foot Orthoses
Retired - Correct Coding – Submitting Diabetic Shoe Inserts for HCPCS Coding – PDAC Coding Application Instruction
Retired - Submitting Diabetic Shoe Inserts for Coding
Retired - Correct Coding Instructions – Endolite Echelon® Prosthetic Foot
Correct use of Not Otherwise Specified L-codes for Orthoses and Prostheses - Billing Reminder
Retired - Correct Coding - MyoPro® (Myomo, Inc.) Assist Device
MyoPro® (Myomo, Inc.) Assist Device - Correct Coding - Revised
Retired - Correct Coding - Definitions Used for Off-the-Shelf versus Custom Fitted Prefabricated Orthotics (Braces) - Revised
Retired - Correct Coding – Definitions Used for Off–the–Shelf Versus Custom Fitted Prefabricated Orthotics (Braces) – Revised
Retired - Correct Coding and Billing for Microprocessor-Controlled Knee Systems
Retired - Correct Coding – Braces (Orthoses) Attached to Wheelchairs
Retired - Appropriate Coding and Billing of Lower Limb Prosthetic Covers and Covering Systems
Definitions Used for Off-the-Shelf versus Custom Fitted Prefabricated Orthotics (Braces) - Correct Coding - Revised
Retired - Correct Coding - Definitions Used for Off-the-Shelf versus Custom Fitted Prefabricated Orthotics (Braces) - Revised
Insulin Infusion Pumps with Integrated Continuous Glucose Sensing Capabilities and Related Accessories/Supplies – Codes E0787 and A4226 - Correct Coding
Correct Coding and Coverage of Ventilators - Revised July 2020
Custom Fitted Orthotic HCPCS Codes Without a Corresponding Off-the-Shelf Code - Correct Coding
Retired - MyoPro® (Myomo, Inc.) Assist Device - Correct Coding - Revised
Retired - Incorrect Use of HCPCS Codes for Custom Fit Orthotics
Retired - Vacuum Erection Device – Coding Verification Review Requirement
Ankle-Foot Orthoses - Arizona-Type - Correct Coding - Revised
Retired - Correct Coding – Whill Model A Powered Personal Mobility Device
Retired - Correct Coding – Billing of HCPCS Code E0986
Retired - Correct Coding – Bariatric Pressure Reducing Support Surfaces
Retired - Correct Coding – Whill Powered Personal Mobility Devices – Revised
Last Updated:
12/20/2018