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LCD ID Number: L33449 Status: A-Approved
LCD Title: Swallowing Studies for Dysphagia
Geographic Jurisdiction: South Carolina Other Jurisdictions
Original Determination Effective Date:
10/01/2015
Original Determination Ending Date:
Revision Effective Date:
11/14/2019
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
42 Code of Federal Regulations §410.32(a) Diagnostic tests must be ordered by the physician treating the beneficiary for a specific medical problem and who uses the results in the management of the beneficiary's specific problem.
42 Code of Federal Regulations §411.15(k)(1) Services that are not reasonable necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member are excluded from coverage.
CMS Internet-Only Manual, Pub 100-02, Medicare Benefit Policy Manual, Chapter 6, §20.4.1 Diagnostic Services Defined
CMS Internet-Only Manual, Pub 100-02, Medicare Benefit Policy Manual, Chapter 15, §§220-220.4 Coverage of Outpatient Rehabilitation Therapy Services (Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services) Under Medical Insurance
CMS Internet-Only Manual, Pub 100-02, Medicare Benefit Policy Manual, Chapter 15, §230.3 Practice of Speech-Language Pathology
CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 3, §170.3 Speech-Language Pathology Services for the Treatment of Dysphagia
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