Eli's Rehab Report
LCDs--Palmetto and Canada Zero In on Dysphagia
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Palmetto GBA and Cahaba GBA are revising their Local Coverage Determinations on dysphagia in home health. Cahaba's general dysphagia LCD (L336) lists documentation requirements for dysphagia treatment including "changes in condition or functional status; history and outcome of previous treatment for the same condition; and other information which justifies the start of care or continued treatment."
And Palmetto says it won't cover home health surface electrical stimulation in the treatment of dysphagia. "There is insufficient scientific or clinical evidence to consider this device as reasonable and necessary for the treatment of dysphagia," the intermediary says in its draft LCD (07HH-004-L). Both LCDs take effect Oct. 1.
Commenters did submit both published and unpublished information supporting use of e-stim for dysphagia, Palmetto says. But the information "did not provide sufficient evidence to amend the proposed non-coverage LCDs," the intermediary concludes.
SLPs are concerned that "use of this intervention has spread ahead of the evidence to support its effectiveness in the various target populations," Palmetto says.
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