The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) are seeking public comments regarding their proposed local coverage determination (LCD) for lower limb prostheses.
In a Jan. 18 news announcement jointly published by the DME MACs, the organizations said they’ve written an LCD at the request of the Centers for Medicare & Medicaid Services (CMS).
The DME MACs said they are “proposing modifications to the coverage criteria for microprocessor-controlled prosthetic knees (MPKs), to include coverage for Medicare Functional Classification Level (MFCL) 2 beneficiaries with lower limb amputations who require a prosthetic knee; proposing modifications to the coverage criteria for prosthetic feet in order to allow coverage of a compatible foot when coverage criteria for an MPK are met; proposing addition of GA, GY, GZ, and KX modifiers to the Coding Information section of the LCD.”
As part of the LCD process, the DME MACs are asking for comments from stakeholders, including clinicians, prosthetics manufacturers, suppliers, and other affiliated parties.
“You should be very specific in your comments and, if possible, offer suggestions that may address your concerns,” the announcement said. “You should provide an evidence-based rationale for your comments and attach any full-text references from the published clinical literature (for example, peer-reviewed journals, clinical society guidelines, etc.) that were not included in the bibliography of the proposed LCD. We encourage a written response regardless of your agreement or disagreement with the proposed LCD.”
Comments should be e-mailed to the DME MACs at [email protected] by Sat., March 2.
The DME MACs will host a virtual open meeting on Feb. 22 at 10 a.m. Eastern to take comments from stakeholders.
