I Published the information, about Policy Article A52507 in reference to CMS billing, codes, payment criteria, and general information of Infusion related DMEs and medication on 12/28/16. Since, Policy Article A52507, has been superseded with Revised Policy Article L33794, revisions begin implementation 01/01/17.
Since last posting , CMS reports that the External INFUSION PUMPS – Policy Article (A52507) has been superseded. Reviewing the policy article from A52507, may give the reader a comparison to the implementation of the revised Policy Article L33794.
Policy Article “Local Coverage Determination (LCD) External Infusion Pumps”(L33794) Revisions seem to supersede Policy Article A52507. Of note, Revisions; JW Modifier instructions, Denial verbiage for JW Modifiers when coverage criteria is not met, and more.
I would encourage any patient, or any person, to check the changes and decide if the changes will affect your current medical situation.
My perspective, the #cures has moved forward. How this will affect DME needed for SCIG infusions, is not yet clear. However, as educated and concerned patients we certainly need to keep aware of what is occurring with the DME exclusions. As well, continue to check any strategic movement that may, or may not, affect the PID community.
Link To .pdf:
Link to docs.com with Both CMS Coverage Articles available:
Sources and Attribution:
Over 700 Groups Stand Behind #Cures2015: https://energycommerce.house.gov/news/press-release/over-700-groups-stand-behind-cures2015/