SCAN Health Plan : LCA DME

ID	Title	Effective Date	Revision Effective Date	End Date	Last Approval / Revision Date
A6307	2003 HCPCS Changes - Added, Deleted and Description Changes	12/12/2002	3/1/2006	N/A	2/19/2008
A6305	2003 HCPCS Updates for Non-Covered Items	12/31/2002	3/1/2006	N/A	2/19/2008
A6294	2003 Healthcare Common Procedure Coding System (HCPCs) Annual Update Reminder	10/2/2002	3/1/2006	N/A	2/19/2008
A16068	2004 Annual Update for Skilled Nursing Facility (SNF) Consolidated Billing for the Common Working File (CWF) and Medicare Carriers	8/28/2003	3/1/2006	N/A	2/19/2008
A135	Abdominal Binders (A4462) vs. Abdominal Supports (L0900-L0960)	7/1/2002	3/1/2006	N/A	2/19/2008
A5253	AC/DC Power Adapters and Backup Batteries	7/1/2001	3/1/2006	N/A	2/19/2008
A11692	Addition of Temporary Codes Q4075, Q4076 and Q4077	8/5/2003	3/1/2006	N/A	2/19/2008
A40681	Advance Determination of Medicare Coverage - Wheelchairs	7/10/2006	N/A	N/A	2/19/2008
A138	Advance Determination of Medicare Coverage (ADMC) - Claim Submission Instructions	4/1/2002	3/1/2006	N/A	2/19/2008
A137	Advance Determination of Medicare Coverage for Wheelchairs	7/1/2001	3/1/2006	N/A	2/19/2008
A18364	Albuterol and Ipratropium – Revised Coding Guidelines	1/10/2004	3/1/2006	N/A	2/19/2008
A45324	Albuterol and Levalbuterol – Coding Changes	7/1/2007	N/A	N/A	2/19/2008
A6322	Amphotericin B - New HCPCS Codes	12/12/2002	3/1/2006	N/A	2/19/2008
A18361	Ankle-Foot Orthoses - Walking Boots – Coverage and Coding Issues	3/1/2004	3/1/2006	N/A	2/19/2008
A19800	Ankle-Foot/Knee-Ankle-Foot Orthosis - Policy Article - Effective July 2007	7/1/2004	7/1/2007	N/A	7/13/2007
A43011	Annual HCPCS Code Update - 2007	1/1/2007	N/A	N/A	2/19/2008
A16069	Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement	10/28/2003	3/1/2006	N/A	2/19/2008
A5871	Appropriate UPIN Usage	12/12/2002	3/1/2006	N/A	2/19/2008
A20689	Are there situations where a beneficiary can simultaneously qualify for a wheelchair and a seat lift mechanism (SLM)?	6/22/2004	6/22/2004	N/A	2/19/2008
A2634	Automatic External Defibrillator And Supplies	6/1/2003	3/1/2006	N/A	2/19/2008
A18356	Automatic External Defibrillators – Correction	3/1/2004	3/1/2006	N/A	2/19/2008
A23892	Automatic External Defibrillators – Policy Article – Effective January 2005	1/1/2005	3/1/2006	N/A	2/19/2008
A5209	Batteries for Power Wheelchairs and POVs	10/1/2000	3/1/2006	N/A	2/19/2008
A5322	Beneficiaries Previously Enrolled In Managed Care Who Return To Traditional Fee-For-Service	6/14/2002	3/1/2006	N/A	2/19/2008
A143	Billing for Glucose Test Strips and Supplies	2/6/2002	3/1/2006	N/A	2/19/2008
A5132	Billing for Implanted Durable Medical Equipment (DME), Prosthetic Devices, Replacement Parts, Accessories and Supplies	8/12/2002	3/1/2006	N/A	2/19/2008
A5326	Billing Of DMEPOS With Chiropractors As Referring Physician	6/14/2002	3/1/2006	N/A	2/19/2008
A2988	Billing Of Home Dialysis Supplies Codes For Non-Dialysis Beneficiaries	6/14/2002	3/1/2006	N/A	2/19/2008
A20457	Billing Reminder - Elevating Leg Rests	6/1/2004	3/1/2006	N/A	2/19/2008
A20458	Billing Reminder for Elevating Legrests	3/10/2004	3/1/2006	N/A	2/19/2008
A5940	Billing Wheelchair Accessories with Miscellaneous HCPCS Code K0108	3/15/2002	3/1/2006	N/A	2/19/2008
A5261	Biofeedback for Urinary Incontinence	10/1/2001	3/1/2006	N/A	2/19/2008
A5628	Blood Gas Testing for Oxygen Qualification by Home Health Agencies	7/1/2001	3/1/2006	N/A	2/19/2008
A18340	Blood Gas Testing for Oxygen Qualification by Home Health Agencies Revisited	3/1/2004	3/1/2006	N/A	2/19/2008
A5874	Breathing Circuits – Billing Instructions	10/1/2000	3/1/2006	N/A	2/19/2008
A23897	Canes and Crutches - Policy Article - Effective May 2005	1/1/2005	3/1/2006	N/A	2/19/2008
A5125	Casts and Splints - Codes A4570, L2102, L2104, L2122, L2124	7/1/2001	3/1/2006	N/A	2/19/2008
A16054	CERT Errors And ICD-9 Codes	12/12/2003	3/1/2006	N/A	2/19/2008
A2677	CERT Program – Reminder	12/3/2002	3/1/2006	N/A	2/19/2008
A34950	CERT Results And Support Surfaces Revisited	4/1/2005	3/1/2006	N/A	2/19/2008
A2631	CERT Revisited	6/1/2003	3/1/2006	N/A	2/19/2008
A20459	CERT Revisited	3/10/2004	3/1/2006	N/A	2/19/2008
A6161	Certificate of Medical Necessity Initial Date	7/1/2000	3/1/2006	N/A	2/19/2008
A11719	Certificates of Medical Necessity – Common Scenarios	9/12/2003	3/1/2006	N/A	2/19/2008
A41106	Certificates of Medical Necessity - Revisions	10/1/2006	N/A	N/A	2/19/2008
A6181	Certificates of Medical Necessity (CMN) – Highlighting	7/1/2000	3/1/2006	N/A	2/19/2008
A6185	Certificates Of Medical Necessity (CMNs) New Instructions For Corrections	4/1/2001	3/1/2006	N/A	2/19/2008
A16055	Cervical Traction Devices – Draft LMRP	12/12/2003	3/1/2006	N/A	2/19/2008
A16851	Cervical Traction Devices - Policy Article - Effective April 2005	7/1/2004	3/1/2006	N/A	2/19/2008
A18341	Cervical Traction Equipment - New Code and Policy	1/16/2004	3/1/2006	N/A	2/19/2008
A5349	Charges Imposed By Family Members Of Patient	12/12/2002	3/1/2006	N/A	2/19/2008
A5296	CIGNA Medicare Selected for Wheelchair Demonstration Project	3/15/2002	3/1/2006	N/A	2/19/2008
A2692	CIGNA Medicare to Process Claims for Medicare Beneficiaries Participating in Federally Sponsored Clinical Trials	9/1/2000	3/1/2006	N/A	2/19/2008
A20460	Clarification – Coding of Night Splints for Plantar Fasciitis	6/1/2004	3/1/2006	N/A	2/19/2008
A2697	Clinical Trials CIM Revision Added	7/1/2001	3/1/2006	N/A	2/19/2008
A2699	Clinical Trials Routine Care Services Diagnosis Coding Instructions	12/6/2001	3/1/2006	N/A	2/19/2008
A1392	Coding Instructions – Otto Bock C-Leg®	6/1/2003	3/1/2006	N/A	2/19/2008
A19826	Cold Therapy - Policy Article - Effective July 2007	6/1/2004	7/1/2007	N/A	2/19/2008
A34906	Commodes – Coverage and Coding Clarification	7/1/2005	3/1/2006	N/A	2/19/2008
A23899	Commodes - Policy Article - Effective January 2007	4/1/2005	1/1/2007	N/A	2/19/2008
A2675	Comprehensive Error Rate Testing (CERT) Information	10/1/2000	3/1/2006	N/A	2/19/2008
A5835	Compression Bandage Systems	3/15/2002	3/1/2006	N/A	2/19/2008
A2613	Continuous Passive Motion (CPM) Devices	6/1/2003	3/1/2006	N/A	2/19/2008
A2703	Continuous Positive Airway Pressure (CPAP) - LMRP Revision	3/15/2002	3/1/2006	N/A	2/19/2008
A2701	Continuous Positive Airway Pressure CIM Revision	3/15/2002	3/1/2006	N/A	2/19/2008
A19827	Continuous Positive Airway Pressure System (CPAP) - Policy Article - Effective July 2007	7/1/2004	7/1/2007	N/A	7/12/2007
A5139	Correct Billing Of Vision Codes	12/12/2002	3/1/2006	N/A	2/19/2008
A5372	Correct Use Of RT And LT Modifiers	6/14/2002	3/1/2006	N/A	2/19/2008
A18359	Correction to January 2004 Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement	1/23/2004	3/1/2006	N/A	2/19/2008
A16072	Correction to Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing	9/9/2003	3/1/2006	N/A	2/19/2008
A3169	Coverage of Breast Prostheses for Partial Mastectomy or Lumpectomy	1/1/2001	3/1/2006	N/A	2/19/2008
A11620	Coverage of Compression Garments in the Treatment of Venous Stasis Ulcers	7/15/2003	3/1/2006	N/A	2/19/2008
A34952	CPAP And Documentation	4/1/2005	3/1/2006	N/A	2/19/2008
A24381	CPAP And RAD – Clarification Of Apnea-Hypopnea Index	1/1/2005	3/1/2006	N/A	2/19/2008
A34907	CPAP and RAD – Nasal Interfaces	7/1/2005	3/1/2006	N/A	2/19/2008
A12530	CPAP and Respiratory Assist Devices – Apnea/Hypopnea Index	3/17/2003	3/1/2006	N/A	2/19/2008
A2708	CPAP Documentation And KX Modifier Usage	9/6/2002	3/1/2006	N/A	2/19/2008
A2707	CPAP Policy	5/1/2002	3/1/2006	N/A	2/19/2008
A6207	Crosswalked HCPCS Codes for Year 2000	1/1/2000	3/1/2006	N/A	2/19/2008
A5868	Deceased Physicians’ UPINs on DMERC Claims	3/15/2002	3/1/2006	N/A	2/19/2008
A6246	Deleted and Crosswalk Codes	1/1/2001	3/1/2006	N/A	2/19/2008
A6276	Deleted and Crosswalk HCPCS Codes	11/9/2001	3/1/2006	N/A	2/19/2008
A6277	Deleted and Crosswalk HCPCS Codes	12/6/2001	3/1/2006	N/A	2/19/2008
A5232	Delivery of Orthoses or Other DMEPOS Items and Hospitalization	1/1/2001	3/1/2006	N/A	2/19/2008
A5350	Deported Medicare Beneficiaries	12/12/2002	3/1/2006	N/A	2/19/2008
A5367	Description of GK Modifier	4/8/2002	3/1/2006	N/A	2/19/2008
A39376	Dexamethasone Documentation Requirement for Oral Antiemetic Drugs LCD	1/1/2006	N/A	N/A	2/19/2008
A5865	Diabetic Shoe Insert A5510 Noncovered	3/15/2002	3/1/2006	N/A	2/19/2008
A140	Diabetic Supplies and Correct Units of Service	4/1/2000	3/1/2006	N/A	2/19/2008
A3850	Diagnosis Codes	4/1/2003	3/1/2006	N/A	2/19/2008
A11624	Dialysis LMRP – Modifier KX Change	9/12/2003	3/1/2006	N/A	2/19/2008
A43024	Dispensing DMEPOS Items – Quantity Limits	12/6/2006	N/A	N/A	2/19/2008
A45190	Dispensing DMEPOS Items: Quantity Limits - Updated June 2007	6/1/2007	N/A	N/A	2/19/2008
A26231	Dispensing Fees - Nebulizer Drugs	4/1/2005	3/1/2006	N/A	2/19/2008
A40072	DME PSC Article for Glucose Monitors - June 2006	6/1/2006	N/A	N/A	2/19/2008
A44214	DME Upgrades, ABNs and Claims Modifiers	4/1/2007	4/1/2007	N/A	2/19/2008
A5278	DMEPOS Billing Procedures	3/15/2002	3/1/2006	N/A	2/19/2008
A5705	DMERC Coverage Of Treprostinil (Remodulin®)	10/1/2002	3/1/2006	N/A	2/19/2008
A2954	DMERC Place of Service (POS) Code Update	6/12/2003	3/1/2006	N/A	2/19/2008
A11705	DMERC Place of Service (POS) Code Update	6/12/2003	3/1/2006	N/A	2/19/2008
A5205	DMERCs -- Pre-Discharge Delivery of DMEPOS for Fitting and Training	4/1/2000	3/1/2006	N/A	2/19/2008
A2680	Documentation Errors	12/3/2002	3/1/2006	N/A	2/19/2008
A18360	Documentation Requirements – Signature Stamps	12/9/2003	3/1/2006	N/A	2/19/2008
A5649	Documentation Requirements For Power Operated Vehicles (POVs) - Region D Change	6/14/2002	3/1/2006	N/A	2/19/2008
A38173	Documentation Tips Blood Glucose Monitors And Supplies	1/1/2006	3/1/2006	N/A	2/19/2008
A1394	Dual Oxygen Concentrators	6/1/2003	3/1/2006	N/A	2/19/2008
A34908	DuoNeb and Budesonide – Coding Clarification	7/1/2005	3/1/2006	N/A	2/19/2008
A5869	Durable Medical Equipment Ordered With Surrogate Unique Physician Identification Numbers (UPIN)	10/1/2002	3/1/2006	N/A	2/19/2008
A11723	Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Claims During an Inpatient Stay	8/11/2003	3/1/2006	N/A	2/19/2008
A11739	Early Delivery of Immunosuppressive Drugs	7/15/2003	3/1/2006	N/A	2/19/2008
A45540	Electrical Joint Stimulation Devices – E0762 – Coding Guidelines	7/1/2007	N/A	N/A	2/19/2008
A5351	Electrical Stimulation For The Treatment Of Wounds CIM Revision	12/12/2002	3/1/2006	N/A	2/19/2008
A5331	Electrical Stimulation for Wound Healing - New National Coverage Decision	11/27/2002	3/1/2006	N/A	2/19/2008
A24382	Enteral Nutrition – Code Changes	1/1/2005	3/1/2006	N/A	2/19/2008
A1396	Enteral Nutrition – Coverage Reminder	6/1/2003	3/1/2006	N/A	2/19/2008
A25361	Enteral Nutrition - Policy Article - Effective April 2005	4/1/2005	3/1/2006	N/A	3/1/2006
A3540	Enteral Nutrition in Nursing Facilities	7/1/2000	3/1/2006	N/A	2/19/2008
A35424	Epoetin - Policy Article - Effective January 2007	10/1/2005	1/1/2007	N/A	2/19/2008
A18365	Epoetin and Darbepoetin – New Codes	1/20/2004	3/1/2006	N/A	2/19/2008
A3173	Epoprostenol (Flolan®) – HCPCS Code J1325	10/1/2000	3/1/2006	N/A	2/19/2008
A11743	ESRD Claim Processing Procedures	7/17/2003	3/1/2006	N/A	2/19/2008
A6205	Estimated Length Of Need: Correct Entries On Certificates Of Medical Necessity (CMNs)	10/1/2002	3/1/2006	N/A	2/19/2008
A5262	Expanded Coverage of Diabetes Outpatient Self-Management Training	10/1/2001	3/1/2006	N/A	2/19/2008
A19833	External Breast Prostheses - Policy Article - Effective July 2004	6/1/2004	3/1/2006	N/A	2/19/2008
A5237	External Cardiac Defibrillators	1/1/2001	3/1/2006	N/A	2/19/2008
A3182	External Infusion Pump Policy - HCPCS Coding Changes	2/17/2003	3/1/2006	N/A	2/19/2008
A3171	External Infusion Pump Policy Update	4/1/2000	3/1/2006	N/A	2/19/2008
A20461	External Infusion Pumps – Coverage for Gallium Nitrate Added	6/1/2004	3/1/2006	N/A	2/19/2008
A19834	External Infusion Pumps - Policy Article - Effective January 2007	7/1/2004	1/1/2007	N/A	2/19/2008
A3175	External Infusion Pumps - Policy Revision	1/1/2001	3/1/2006	N/A	2/19/2008
A2628	EY Modifier Use – Clarification	6/1/2003	3/1/2006	N/A	2/19/2008
A33672	Eye Prostheses - Policy Article - Effective July 2005	7/1/2005	3/1/2006	N/A	2/19/2008
A16075	Face Down Positioning Devices	12/12/2003	3/1/2006	N/A	2/19/2008
A25364	Facial Prostheses - Policy Article - Effective July 2007	4/1/2005	7/1/2007	N/A	2/19/2008
A45667	FAQs – Power Mobility Devices	7/25/2007	N/A	N/A	2/19/2008
A5359	Forgotten ZX Modifiers	7/1/2000	3/1/2006	N/A	2/19/2008
A21658	Frequently Asked Questions - Comprehensive Error Rate Testing (CERT)	1/31/2004	3/1/2006	N/A	2/19/2008
A36586	Frequently Asked Questions - Mobility Assistive Equipment (MAE)	6/9/2005	3/1/2006	N/A	2/19/2008
A21660	Frequently Asked Questions - Mobility DME	1/31/2004	3/1/2006	N/A	2/19/2008
A21661	Frequently Asked Questions - Oxygen	1/31/2004	3/1/2006	N/A	2/19/2008
A21663	Frequently Asked Questions - Power Mobility	1/31/2004	3/1/2006	N/A	2/19/2008
A21667	Frequently Asked Questions - Respiratory Assist Devices	1/31/2004	3/1/2006	N/A	2/19/2008
A21668	Frequently Asked Questions - Support Surfaces	1/31/2004	3/1/2006	N/A	2/19/2008
A36605	Frequently Asked Questions (FAQs) - Fall 2005 Miscellaneous Topics	9/19/2005	3/1/2006	N/A	2/19/2008
A5355	Functional Electrical Stimulation (FES) - New Coverage and Coding	2/17/2003	3/1/2006	N/A	2/19/2008
A16063	Gait Trainers – Coding Guidelines	12/12/2003	3/1/2006	N/A	2/19/2008
A5264	Gastric Suction Pump - New HCPCS Code	12/6/2001	3/1/2006	N/A	2/19/2008
A3649	Gastrostomy Tubes - New HCPCS Code	12/6/2001	3/1/2006	N/A	2/19/2008
A18354	Glucose Monitor Supplies - Medical Review	1/16/2004	3/1/2006	N/A	2/19/2008
A41105	Glucose Monitors - Documentation Requirements	9/7/2006	N/A	N/A	2/19/2008
A33673	Glucose Monitors - Policy Article - Effective January 2007	7/1/2005	1/1/2007	N/A	2/19/2008
A26229	Group 2 Support Surfaces And ICD-9 Codes	4/1/2005	4/1/2005	N/A	2/19/2008
A5200	HCFA Provides Clarification on Implementation of Mandatory Assignment for Drug Claims	8/2/2001	3/1/2006	N/A	2/19/2008
A16077	HCPCS Code Changes & Modifier AX Requirement on New Codes	12/12/2003	3/1/2006	N/A	2/19/2008
A6301	HCPCS Updates	12/18/2002	3/1/2006	N/A	2/19/2008
A6287	Heating Pad - New HCPCS Code	12/6/2001	3/1/2006	N/A	2/19/2008
A25365	High Frequency Chest Wall Oscillation Devices - Policy Article - Effective April 2005	4/1/2005	3/1/2006	N/A	2/19/2008
A2651	Home Blood Glucose Monitor Supply Claims And Spanned Dates	6/14/2002	3/1/2006	N/A	2/19/2008
A2664	Home Blood Glucose Monitors – Policy Revision	6/14/2002	3/1/2006	N/A	2/19/2008
A2641	Home Blood Glucose Monitors and Hypoglycemia	3/15/2002	3/1/2006	N/A	2/19/2008
A144	Home Blood Glucose Monitors and Supplies – New Codes	2/6/2002	3/1/2006	N/A	2/19/2008
A141	Home Blood Glucose Supplies	1/1/2002	3/1/2006	N/A	2/19/2008
A2616	Home Dialysis – New HCPCS Codes	6/1/2003	3/1/2006	N/A	2/19/2008
A3167	Home Dialysis Emergency Supplies	6/14/2002	3/1/2006	N/A	2/19/2008
A3168	Home Dialysis Supplies & Equipment - Code Changes	12/3/2002	3/1/2006	N/A	2/19/2008
A2958	Home Dialysis Supplies and Equipment - New HCPCS Codes	12/6/2001	3/1/2006	N/A	2/19/2008
A33674	Home Dialysis Supplies and Equipment - Policy Article - Effective January 2006	7/1/2005	3/1/2006	N/A	3/1/2006
A5265	Home Prothrombin Time (INR) Monitors - Coverage Change	12/6/2001	3/1/2006	N/A	2/19/2008
A37079	Hospital Beds And Accessories - Policy Article - Effective January 2007	1/1/2006	1/1/2007	N/A	2/19/2008
A3660	Hospital Beds Policy Revised	10/1/2001	3/1/2006	N/A	2/19/2008
A20462	Humidifiers – HCPCS Codes E0550, E0555, E0560, E0561, and E0562	6/1/2004	3/1/2006	N/A	2/19/2008
A3843	ICD-9 Codes Will Be Date of Service Driven	8/28/2002	3/1/2006	N/A	2/19/2008
A3847	ICD-9 Diagnosis Codes Must Be Valid (Revised Article)	12/16/2002	3/1/2006	N/A	2/19/2008
A3665	ICD-9-CM Coding Update	10/1/2002	3/1/2006	N/A	2/19/2008
A11746	ICD-9-CM Coding Update	7/2/2003	3/1/2006	N/A	2/19/2008
A5113	Immunosuppressive Drug Policy Update	4/1/2000	3/1/2006	N/A	2/19/2008
A34957	Immunosuppressive Drugs – DIF Reinstated; Supply Fee Revised	7/1/2005	3/1/2006	N/A	2/19/2008
A5116	Immunosuppressive Drugs – DMERC Information Form	10/1/2000	3/1/2006	N/A	2/19/2008
A5111	Immunosuppressive Drugs - New Codes	1/1/2000	3/1/2006	N/A	2/19/2008
A25366	Immunosuppressive Drugs - Policy Article - Effective January 2007	7/1/2005	1/1/2007	N/A	2/19/2008
A34954	Immunosuppressive Drugs DIF Eliminated	4/1/2005	3/1/2006	N/A	2/19/2008
A5117	Immunosuppressive Drugs Following Intestinal Transplantation Coverage and DMERC Information Form (DIF)	4/1/2001	3/1/2006	N/A	2/19/2008
A5119