The Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for Region C has released an updated Local Coverage Determination (LCD) policy for external breast prostheses. The LCD determines Medicare coverage and reimbursement policy as defined by code and benefit. According to the Centers for Medicare and Medicaid Services (CMS) website, the new policy is effective as of March 5, 2010. This LCD was updated to include reimbursement policy for new 2010 breast prosthesis codes and clarifications for current codes and code language.
To view the LCD, click here.
