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Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor Contractor Number: 11202 Contractor Type: MAC B

LCD Information

LCD ID Number: L33458 Status: A-Approved LCD Title: Chemodenervation Geographic Jurisdiction: South Carolina Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 05/27/2021 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) states no payment can be made for services that are for research or experimentation. CMS Internet-Only Manual, Pub 100-02, Medicare Benefit Policy Manual, Chapter 15, §50.4.1 Approved Use of Drug CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 2, §160.1 Induced Lesions of Nerve Tracts   Sorry, you need to login or register to view additional sections of this Medicare policy. *