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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: L33444 Status: A-Approved LCD Title: Pulmonary Stress Testing Geographic Jurisdiction: North Carolina Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 12/07/2023 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) indicates no payment can be made for services that are research and/or experimental. Title 42 CFR §410.32(a) indicates that diagnostic tests may be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements). Title 42 CFR §410.32(d)(iii) describes who may furnish covered Medicare Part B diagnostic laboratory tests. CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §231 Pulmonary Rehabilitation (PR) Program Services Furnished On or After January 1, 2010 CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 4, §240.7 Postural Drainage Procedures and Pulmonary Exercises Sorry, you need to login or register to view additional sections of this Medicare policy. *