Advisory Articles



3/18/2025
New HCPCS Codes for Wheelchair Accessories – Coding and Billing
3/7/2025
VYALEV® (foscarbidopa and foslevodopa), the VYAFUSER Pump, and Related Infusion Supplies - Correct Coding and Billing - Revised
2/7/2025
New HCPCS Codes for Dynamic Adjustable Joint Stretching Devices – Coding and Billing
1/27/2025
Nebulizers, External Infusion Pumps and Related Drugs
1/24/2025
Concentric Adjustable Torsion Joints – Correct Coding – Revised
Ohtuvayre® (ensifentrine) - Correct Coding and Coverage – Revised
1/3/2025
2025 HCPCS Code Update - January Edition - Correct Coding
11/13/2024
Code Verification Review Requirement for Lower Limb Orthoses (L1832, L1833, and L1851) and Lumbar Sacral Orthoses (L0648 and L0650) – Revised
10/9/2024
Pneumatic Compression Devices - Correct Coding and Billing
9/30/2024
2024 HCPCS Code Update – October Edition – Correct Coding
9/10/2024
Prior Authorization and Code Verification Review Requirement for Lower Limb Orthoses (L1843, L1845, L1951) and Spinal Orthoses (L0631, L0637, L0639)
8/29/2024
Correct Coding of Elbow, Shoulder, Shoulder-Elbow-Wrist-Hand and Shoulder-Elbow-Wrist-Hand-Finger Braces (Orthoses) – Revised
6/13/2024
PDAC Coding Guidelines for Gradient Compression Garments for Lymphedema Treatment
5/16/2024
Code Verification Review Requirement for Multi-Functional Ventilators
Correct Billing and Coding of Ventilators
4/16/2024
2024 HCPCS Code Update - April Edition - Correct Coding
4/1/2024
PureWick Urine Collection System - Coding and Billing Instructions - Revised
3/5/2024
Lymphedema Compression Treatment Items - Correct Coding and Billing - Revised
2/26/2024
External Infusion Pumps and Related Drugs - Revised
2/5/2024
3-D Printed Orthotic Devices – Correct Coding
1/30/2024
Lymphedema Compression Treatment Items Requirement for Registration with the Food and Drug Administration
1/9/2024
2024 HCPCS Code Update - January Edition - Correct Coding
1/4/2024
HCPCS Codes K1018 and K1019 - Correct Coding - Revised
Powered Lower Extremity Exoskeleton - Correct Coding
1/3/2024
Powered Upper Extremity Exoskeleton - Correct Coding
9/29/2023
2023 HCPCS Code Update - October Edition - Correct Coding
9/15/2023
L1681 Prefabricated Bilateral Hip Abduction Orthosis - Correct Coding
6/30/2023
2023 HCPCS Code Update - July Edition - Correct Coding
5/5/2023
2023 HCPCS Code Update - April Edition - Correct Coding
1/25/2023
2023 HCPCS Code Update - January Edition - Correct Coding
10/31/2022
2022 HCPCS Code Update - October Edition - Correct Coding
9/12/2022
Basics of Choosing the Correct HCPCS Code - Correct Coding
7/5/2022
2022 HCPCS Code Update - July Edition - Correct Coding
4/20/2022
2022 HCPCS Code Update - April Edition - Correct Coding - Revised
3/21/2022
Continuous Glucose Monitors - Correct Coding and Billing - Revised
Correct Coding and Billing of Halo Procedure
PDAC Code Verification Reviews for CGM Devices - Coding and Billing
2/14/2022
Irrigation Supply Sleeves - Correct Coding
12/22/2021
2022 HCPCS Code Update - January Edition - Correct Coding
Partial Foot, Shoe Insert (Toe Fillers), and Shoe Inserts for Diabetics - Coding Based on Benefit Category - Correct Coding
11/24/2021
Correct Coding of Finger, Hand, Hand-Finger and Wrist-Hand-Finger Braces (Orthoses) - Revised
11/17/2021
Articulating Digit(s) and Prosthetic Hands - Correct Coding - Revised
11/2/2021
Medicare Coverage for Shoes - Correct Coding - Revised
10/13/2021
2021 HCPCS Code Update - October Edition - Correct Coding
10/5/2021
Insulin Used with Continuous External Insulin Infusion Pumps - Correct Coding - Revised
10/1/2021
Warranty, Reasonable Useful Lifetime (RUL), and the Minimum Lifetime Requirement (MLR) for Durable Medical Equipment - Correct Coding - Revised
9/9/2021
2020 HCPCS Code Update - October Edition - Correct Coding - Revised
2021 HCPCS Code Update - July Edition - Correct Coding - Revised
8/31/2021
L1690 Prefabricated Bilateral Lumbo-sacral Hip Orthosis - Correct Coding - Revised
8/6/2021
2021 HCPCS Code Update - April Edition - Correct Coding
7/7/2021
Incorrect Use of HCPCS Code A9279 - Correct Coding - Revised
6/15/2021
Code Verification Review Requirement for Articulating Digit(s) and Prosthetic Hands - Revised
5/18/2021
Custom Fabricated Wheelchair Seat and Back Cushions - Correct Coding - Revised
3/12/2021
Custom Fitted Orthotic HCPCS Codes Without a Corresponding Off-the-Shelf Code - Correct Coding
Definitions Used for Off-the-Shelf versus Custom Fitted Prefabricated Orthotics (Braces) - Correct Coding - Revised
2/3/2021
MyoPro® (Myomo, Inc.) Assist Device - Correct Coding - Revised
1/14/2021
Correct use of Not Otherwise Specified L-codes for Orthoses and Prostheses - Billing Reminder
12/9/2020
PDAC Coding Guidelines for Off-the-Shelf Diabetic Shoes (A5500)
11/19/2020
Billing of Powered L-Coded Items - Correct Coding - Revised
L1005 - Tension Based Scoliosis Orthosis and Accessory Pads, Includes Fitting and Adjustment - Correct Coding
10/27/2020
Ankle-Foot Orthoses - Arizona-Type - Correct Coding - Revised
9/21/2020
L1686 Prefabricated Hip Abduction Orthosis - Correct Coding
7/28/2020
Scoliosis Brace - Correct Coding
7/21/2020
Insulin Infusion Pumps with Integrated Continuous Glucose Sensing Capabilities and Related Accessories/Supplies – Codes E0787 and A4226 - Correct Coding
6/26/2020
Prosthetic Feet and Additions to Lower Limb Extremity Prostheses - Correct Coding and Coding Verification Review Requirement
3/24/2020
L3960 - Coding Verification Review Requirement
2/25/2020
2020 HCPCS Code Annual Update - Correct Coding - Revised
10/28/2019
Continuous Glucose Monitor Supplies - Correct Coding and Billing
10/21/2019
KF Modifier Use - Correct Coding
New HCPCS Code - Revefenacin (Yupelri®) - J7677
Partial Hand Prostheses - Correct Coding
9/5/2019
Functional Electrical Stimulation (FES) - Coverage and HCPCS Coding - Revised
1/24/2019
Correct Coding – 2019 HCPCS Code Annual Update - Corrected
12/21/2018
Correct Coding - U 500 Insulin for Use in External Insulin Infusion Pumps
Correct Coding for Items Used to Treat Edema - Revised
10/18/2018
Topical Oxygen Therapy Used For Wound Care - An Update
8/20/2018
Correct Coding - A9286 - Hygienic Item or Device, Disposable or Non-disposable, Any Type, Each
Correct Coding - Porta-Lung Negative Pressure Ventilator - Revised
7/18/2018
Continuous Glucose Monitors - Use of Smart Devices
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Battery Charger
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Battery Replacement
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Replacement of Wheelchair Seat and Back Upholstery
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Wheelchair Tray
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Wheelchair Ventilator Tray
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for a Drive Wheel Gear Box
Correct Coding – Incorrect Use of HCPCS Code K0108 To Bill for a Wheelchair Headrest
Correct Coding – Replacement Cecostomy Tube
3/27/2018
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Anti-Tip Devices for Manual Wheelchairs
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Front Riggings: Calf Pad or Calf Support
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Front Riggings: Shoe Holder or Shoe Holder Replacement Straps
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Labor Charges
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for Transit System and Associated Bracket
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for a Privacy Flap
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for a Wheel Lock Brake Extension for Manual Wheelchairs
Correct Coding - Incorrect Use of HCPCS Code K0108 To Bill for an Actuator
12/12/2017
Correct Coding of CUVITRU™ - Revised
11/29/2017
Correct Coding – 2018 HCPCS Code Annual Update
Correct Coding – Full Length Rocker Soles Added to Therapeutic Shoes
Correct Coding – Hygienic Cleansers, Diapers, and Under-Pads
Correct Coding – Hygienic Items, Wash Cloths, and Cleansing Wipes
Correct Coding – Urinary Drainage Tube Adapter
10/9/2017
Correct Coding - Lithium Batteries - Revised
Correct Coding – HCPCS Coding of Surgical Dressings – Components to Report on the PDAC HCPCS Code Verification Application
9/12/2017
Correct Coding – SpeediCath® Flex Coudé Catheter (Coloplast)
4/5/2017
Correct Coding and Coverage – Braces Constructed Primarily of Elastic or Other Fabric Materials – Revised
Correct Coding – Interferential Current (IFC) Therapy Devices
12/20/2016
Correct Coding – Diapers and Underpads
Correct Coding – Oral Appliances Not Used for the Treatment of Obstructive Sleep Apnea
12/1/2016
Correct Coding - 2017 HCPCS Code Annual Update
9/27/2016
Correct Coding – Argus® II Retinal Prosthesis System
8/5/2016
Cantilever Type Armrest – Correct Coding
8/3/2016
Correct Coding and Coverage – Oral Suspensions Used in the Treatment of Oral Mucosal Injuries
4/27/2016
Manual Wheelchair Bases - Correct Coding - Revised
2/16/2016
Correct Coding – IDEO and ExoSym Energy Storing AFO
2/11/2016
Coverage and Correct Coding of YONDELIS®
1/12/2016
Coverage and Correct Coding of HYQVIA (Immune Globulin Infusion (Human) 10%, with Recombinant Human Hyaluronidase) – Revised
12/29/2015
Correct Coding – New Oral Antiemetic Drug Akynzeo® - Revised
11/30/2015
Correct Coding – Buzzy®
Correct Coding – Tracheostomy Tubes
11/24/2015
Correct Coding – 2016 HCPCS Code Annual Update
10/29/2015
Correct Coding – Diathermy and Biofeedback Devices
Correct Coding – P-stim® Device
Correct Coding – TOBI® Podhaler™
8/12/2015
Correct Coding and Coverage – E0740 Non-Implantable Pelvic Floor Electrical Stimulator
5/19/2015
Correct Coding – Weightless Walker
3/9/2015
Power Mobility Device Independent Testing Requirements Effective October 1, 2015 - Revised
1/27/2015
Rescinded - Correct Coding – Surgical Dressings Containing Non-Covered Components
1/21/2015
Correct Coding - Cast Covers
12/29/2014
Correct Coding – Fitness Monitoring Technologies
Correct Coding – Integrated Respiratory Products
12/19/2014
HCPCS Code Update - 2015
12/4/2014
Policy Article Revision – Vacuum Erection Devices (VED)
11/13/2014
Correct Coding – Oral Anticancer Drugs and PDAC’S NDC/HCPCS Crosswalk Listings
9/4/2014
Correct Coding – Vibration Therapy Devices
3/11/2014
Correct Coding of Continuous Passive Motion Devices
2/25/2014
Correct Coding - ApniCure Winx® Sleep Therapy System
1/27/2014
Coding Guideline – K0900 (Custom Durable Medical Equipment, Other Than Wheelchairs)
1/17/2014
Breathe NIOV™ - Coding Reminder – Revised January 2014
1/3/2014
HCPCS Code Update - 2014
12/16/2013
Correct Coding – Supplies Used With E0446 – Joint DME MAC Publication
10/1/2013
Correct Coding and Billing of Cantilever Type Armrest
7/23/2013
Transcutaneous Electrical Nerve Stimulators (TENS) Sold Over-the-Counter – Coding Guidelines
4/10/2013
Oral Anti-Cancer Drugs – Coding and Billing Change
1/11/2013
HCPCS Code L0430 - Invalid
12/17/2012
HCPCS Code Update - 2013
7/12/2012
Correct Coding for Oral Appliances for the Treatment of Obstructive Sleep Apnea (E0486)
12/7/2011
Correct Coding – Safety Equipment Packages with Power Operated Vehicles (POVs)
12/2/2011
HCPCS Code Update – 2012
6/6/2011
Correct Coding – L0174 Coding Review
5/23/2011
E0486 – Custom Fabricated Oral Appliance for OSA – Coding and Utilization Guidelines
4/28/2011
Billing for Capecitabine (Xeloda®) 500 MG Dosage Form – European Formulation Blister Pack
1/24/2011
Correction – New Modifier CS – Effective Date April 20, 2010
12/17/2010
HCPCS Code Update – 2011
5/25/2010
Requirements for Coding Review of Custom Fabricated Spinal Orthoses
5/18/2010
Coding Guidelines for Therapeutic Shoes for Persons with Diabetes
3/3/2010
HCPCS Code Update - 2010 - Revised
7/30/2009
Exercise Equipment - Correct Coding
7/22/2009
HCPCS Code A9283 - Devices Used for Edema or Ulcer Healing
12/16/2008
HCPCS Code Update - 2009
9/4/2008
What is the Difference Between the PDAC and the DME MACS?
8/7/2008
Multiple Copies of Applications Not Needed