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Notification of Medical Policy Reviews January 2023
Medical PolicyRevision
Respiratory Assist Devices for Obstructive Sleep Apnea and Breathing Related Sleep Disorders

Annual Review

LCD L3380

NCD 240.4

Corporate Policy: Sleep Apnea Diagnosis and Medical Management

No CMS Updates; Minor Revisions only

Electrical Stimulators-TENS

Updated to mirror LCD;

LCD L33802

NCD 160.27

No CMS Updates; Added statement: ” TENS therapy for Chronic Low Back Pain (CLBP) will be denied as not reasonable and necessary” to the section When Coverage will not be Approved to mirror LCD

Refractive Surgical Services

Annual Review

NCD 80.7

Refractive Errors Preferred Practice Pattern

External Physician Consult

No CMS Updates; External Physician Review: did not recommend any changes; Minor Revisions only; Removed 65765 epikeratophakia under applicable codes; Updated reference #2 to reflect updated link

External Infusion Pumps

CMS Update

LCD L33794

NCD 280.14

LCD was revised to replace CGM HCPCs code K0554 with a new CGM HCPCs code E2103; K0554 removed and E2103 added; Reference #4 updated to reflect updated link