Policy Article Revision – Vacuum Erection Devices (VED)
Joint DME MAC/PDAC Publication
The DME MACs have revised the Coding Guidelines in the related Policy Article for Vacuum Erection Devices (VED). The current Coding Guidelines state:
Vacuum pumps typically draw a vacuum of less than 17 inches of mercury. If the vacuum range of a new device differs by more than ±10% from that specification, manufacturers must conduct studies to establish the clinical safety and efficacy of the vacuum drawn by their device. The manufacturer must perform tests to verify the maximum vacuum level.
All devices coded L7900 for reimbursement by Medicare must include a vacuum limiter such that a maximum vacuum of less than or equal to 17 inches of mercury is obtained unless manufacturers demonstrate via clinical studies establishing the clinical efficacy of the vacuum drawn by their device.
The revised Coding Guidelines state:
Vacuum pumps coded L7900 must demonstrate a capability to generate a negative pressure in the range of greater than 3.9 and less than 17 inches of mercury (100 and 432 mmHg, respectively). All devices coded L7900 for reimbursement by Medicare must include a vacuum limiter such that a maximum vacuum of less than 17 inches of mercury (432 mmHg) is obtained. The manufacturer must perform tests to verify the maximum vacuum level.
The DME MACs will be publishing this revised language in an upcoming revision of the policy.
As a reminder, effective for dates of service on or after 11/01/2014, only products that have been reviewed by the Pricing, Data Analysis and Coding (PDAC) contractor and assigned code L7900 and L7902 are reimbursable by Medicare. Products which have not undergone coding verification review by the PDAC must be coded A9270. The revised Coding Guideline product specifications will be applied to products submitted for review.
For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form.
|12/04/2014||Published on PDAC website|