Notification of Medical Policy Revisions for August 2023

I. Annual Review:

Medicare Claims Processing Manual Chp 32 sections 68 & 69

Blue Medicare EOC Chp 4 section 3.1

BCBSNC Corporate Medical Policy: Investigational (Experimental) Services

Medicare Managed Manual Chp 4 section 10.7.2 & 90.5

Social Security Exclusions from Coverage

CMS Manual System Pub 100-02 Transmittal 198, change request 8921

MLN Matters MM8921

Medicare Benefit Manual Chp 14 section 20

II. No CMS Updates; Minor Revisions only

I. Annual Review:

Medicare National Coverage Determination Manual Chp 1 section 280.1

LCD L33686

CGS DME MAC; Correct Coding- Definitions Used for Off the Shelf versus Custom Fitted Prefabricated; Orthotics (Braces)

MLN Matters MM8531; CR 8531

Medicare Benefit Policy Manual Chp 15 section 130

II. No CMS Updates. Verbiage added to reflect LCD. Minor Revisions only

I. Annual Review Medicare National Coverage Determination Manual Chp 1 Part 4

LCD L33790

CGS DME MAC; Correct Coding- Definitions Used for Off the Shelf versus Custom Fitted Prefabricated; Orthotics (Braces)

MLN Matters MM8531; CR 8531

LCA A52500

II. No CMS Updates. Minor Revisions only

I. Annual Review

LCD L33797

NCD 240.2

MLN Matters MM6990

Medicare National Coverage Analysis (NCA) Home Use of Oxygen CAG-00296R3

II. CMS Update: Group III, Cluster Headache and OSA/Polysomnography/Home Sleep Tests criteria updated.

I. Annual Review

NCD 160.18

Medicare National Coverage Analysis (NCA) for Vagus Nerve Stimulation for Treatment of Resistant Depression (TRD); (CAG-00313R) Decision Memo

Medicare National Coverage Analysis (NCA) for Vagus Nerve Stimulation (VNS) for Treatment Resistant Depression (TRD) (CAG-00313R2) Decision Memo

II. Annual Review. No CMS Updates. Minor Revisions only—Verbiage added to reflect NCD