Local Coverage Determination · DME MAC
L36267
Bowel Management Devices
Version 44. CMS effective date 04/01/2026. CMS updated 04/08/2026. Read from the CMS Coverage API on 2026-10-13. Contractors on the report: CGS Administrators (DME MAC) and Noridian Healthcare Solutions (DME MAC).
CMS coverage policy citation. CMS Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Sections 230.15 and 280.1
Coverage indication
Benefit Category and other statutory requirements are discussed in the related Policy Article NONMEDICAL NECESSITY AND COVERAGE RULES section. Refer to the Policy article for information on these criteria. In addition to the “reasonable and necessary” criteria contained in this LCD there are other payment rules, which are discussed in the following documents, that must also be met prior to Medicare reimbursement: The LCD-related Standard Documentation Requirements Article, located at the bottom of this policy under the Related Local Coverage Documents section. The LCD-related Policy Article, located at the bottom of this policy under the Related Local Coverage Documents section. Refer to the Supplier Manual for additional information on documentation requirements. Refer to the DME MAC web sites for additional bulletin articles and other publications related to this LCD. For the items addressed in this LCD, the "reasonable and necessary" criteria, based on Social Security Act §1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity. Bed Pans (E0275, E0276) are covered for beneficiaries who are bed-confined (see NCD 280.1 in the “Related National Coverage Documents” section of this LCD). Rectal inserts and related accessories (A4337) will be denied as not reasonable and necessary because they do not meet the medical evidence requirements outlined in the CMS Pub. 100-08, Medicare Program Integrity Manual (PIM), Chapter 13.
Excerpt from the LCD indication. Full text on CMS.
Documentation requirements
Items covered in this LCD have additional policy-specific requirements that must be met prior to Medicare reimbursement. Refer to the LCD-related Policy article, located at the bottom of this policy under the Related Local Coverage Documents section for additional information.
Related articles
- A54516 · Bowel Management Devices - Policy Article
- A55426 · Standard Documentation Requirements for All Claims Submitted to DME MACs
Related NCDs
- NCD 230.15 · Electrical Continence Aid (version 1)
- NCD 280.1 · Durable Medical Equipment Reference List (version 4)
HCPCS codes on this LCD
11 other Level II codes are on the LCD and are not given a page in this set: A4335, A4337, A4453, A4458, A4459, A4479, A4520, A4553, A4554, E0350, E0352.
Questions
What does LCD L36267 cover?
L36267 is Bowel Management Devices. It is a current final DME MAC local coverage determination, version 44.
Where is the CMS source for L36267?
The Medicare Coverage Database page for LCD L36267 version 44.
Get the signed answer via API
The signed answer is the receipt for this code on a date of service: the rule that was in force, with a hash you can replay. The call needs an API key. The source archive and as-of resolution are public.
curl -H "X-API-Key: $VERZI_API_KEY" \
"https://api.verzi.health/v1/rules/warrant?hcpcs=A9270&as_of=2024-01-15&npi=1234567890&state=UT"