ACU-Serve’s Role in ensuring that Medicare policies remain up to date with the latest ICD-10-CM codes
ACU-Serve has played an integral role in ensuring that Medicare policies, particularly those that are diagnosis-specific, remain up to date with the latest ICD-10-CM codes that meet the clinical indications of these policies. Through ongoing collaboration with DME MACs and industry stakeholders, ACU-Serve has successfully initiated the addition of the following ICD-10-CM codes to the respective Medicare policies:
- ICD-10-CM G72.41 (Inclusion body myositis) added to the Wheelchair Seating Policy Article effective October 17, 2024
- ICD-10-CM G70.00 (Myasthenia Gravis without acute exacerbation) and ICD-10-CM G70.01 (Myasthenia Gravis with acute exacerbation added to the Wheelchair Seating Policy Article effective August 29, 2024
- ICD-10-CM Z87.2 (Person history of disease of the skin and subcutaneous tissue) added to the Wheelchair Seating Policy Article effective December 20 ,2023
- ICD-10-CM G61.0 (Guillain-Barré syndrome) and ICD-10-CM G71.11(myotonic muscular dystrophy) added to the Wheelchair Seating Policy Article effective August 1, 2019
- ICD-10-CM G80.0 (Spastic Quadriplegic Cerebral Palsy) added to the High Frequency Chest Wall Oscillation Device Policy Article effective May 04, 2023
- ICD-10-CM G72.41 (Inclusion body myositis) added to the High Frequency Chest Wall Oscillation Device Policy Article effective August 08, 2024
- ICD-10-CM G80.0 (Spastic Quadriplegic Cerebral Palsy) added to the Mechanical In-exsufflation Device Policy Article effective May 25, 2023
- The following ICD-10-CM codes were added to the Mechanical In-exsufflation Device Policy Article effective August 08, 2024:
- G71.12 (Myotonia congenita)
- G71.13 (Myotonic chondrodystrophy)
- G71.14 (Drug induced myotonia)
- G71.19 (Other specified myotonic disorders)
- G71.3 (Mitochondrial myopathy, not elsewhere classified)
- G71.8 (Other primary disorders of muscles)
- G72.0 (Drug-induced myopathy)
- G72.1 (Alcoholic myopathy)
- G72.2 (Myopathy due to other toxic agents)
- G72.89 (Other specified myopathies)
- G73.7 (Myopathy in diseases classified elsewhere)
- J98.6 (Disorders of diaphragm)
- M33.02 (Juvenile dermatomyositis with myopathy)
- M33.12 (Other dermatomyositis with myopathy)
- M33.22 (Polymyositis with myopathy)
- M33.92 (Dermatopolymyositis, unspecified with myopathy)
- M34.82 (Systemic sclerosis with myopathy)
- M35.03 (Sjogren syndrome with myopathy)
ACU-Serve’s team of clinical and non-clinical auditors remains dedicated to analyzing each policy as new diagnoses arise that meet the clinical indications of Medicare’s guidelines. Noel proactively communicates these codes to the DME MAC for consideration, aiming to extend Medicare coverage to a wider range of patients. By simply adding these codes to Medicare policy articles, we benefit not only Medicare beneficiaries but also Medicare Advantage plans and other payers who rely on Medicare guidelines for coverage.
The inclusion of these codes opens up Medicare coverage to thousands, if not hundreds of thousands, of patients nationwide, providing access to essential items and devices. ACU-Serve remains steadfast in its mission to add value to the HME industry, ensuring patients receive the care they deserve.