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Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor Contractor Number: 11502 Contractor Type: MAC B

LCD Information

LCD ID Number: L33417 Status: A-Approved LCD Title: Allergy Skin Testing Geographic Jurisdiction: North Carolina Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 04/15/2021 Revision End Date: CMS National Coverage Policy: Title XVIII of the Social Security Act, §1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Title XVIII of the Social Security Act, §1862(a)(1)(D) Investigational or Experimental Title XVIII of the Social Security Act, §1862(a)(6) Personal Comfort Items Title XVIII of the Social Security Act, §1862(a)(7) excludes routine physical examinations 42 Code of Federal Regulations §410.20 Physicians' Services CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §50.2 Determining Self-Administration of Drug or Biological and §50.4.4.1 Antigens CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 2, §110.9 Antigens Prepared for Sublingual Administration, §110.11 Food Allergy Testing and Treatment, §110.12 Challenge Ingestion Food Testing and §110.13 Cytotoxic Food Tests Sorry, you need to login or register to view additional sections of this Medicare policy. *