CodeMap® 
150 North Wacker Drive
Suite 1870
Chicago, IL 60606
847-381-5465 Phone
847-381-4606 Fax
customerservice@codemap.com
      


User Information

Create New Account

Lost Password

Username:
Password:


Quick Links

LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2022
2021

Physician Fee Schedule

2022
2021

OPPS Fee Schedule

2022-October
2022-July

ASC Fee Schedule

2022-October
2022-July

APC Codes

2022-October
2022-July

DRG Codes

2022
2021

ASP Drug Pricing Files

October 2022
July 2022


CMS Transmittals



CodeMap® LCD-L33467

 

Printer Friendly Version

L33467
LCD for Ophthalmology: Extended Ophthalmoscopy and Fundus Photography (L33467)
See related Articles:
A53060-Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography

Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor

Contractor Number: 11201

Contractor Type: MAC A

LCD Information

LCD ID Number: L33467 Status: A-Approved

LCD Title: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography

Geographic Jurisdiction: South Carolina Other Jurisdictions

Original Determination Effective Date: 10/01/2015

Original Determination Ending Date:

Revision Effective Date: 01/01/2021

Revision End Date:

CMS National Coverage Policy:

Title XVIII of the Social Security Act, §1862(a)(1)(A) excludes expenses incurred for items or services which are not 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)(7) excludes routine physical examinations.

42 CFR §410.32(a) indicates that diagnostic tests may only be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements).

CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 1, §80.6 Intraocular Photography

CMS Manual System, One-Time Notification, Pub 100-20, Transmittal 477, dated April 24, 2009, Change Request 6338


Sorry, you need to login or register to view additional sections of this Medicare policy.

--
*
All information on this web site is compiled directly from information obtained from the Center for Medicare and Medicaid Services (CMS) and from its Contractors.

CodeMap® has made every reasonable effort to ensure the accuracy of the information contained on this web site. However, the ultimate responsibility for correct coding and claims submission lies with the provider of services. CodeMap® makes no representation, warranty, or guarantee that this compilation of Medicare information is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims. Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.

No part of this web page or data displayed may be redistibuted or used without the express written consent of Wheaton Partners, LLC.

12/08/2022 12:22:43 3.225.221.130


CodeMap® is a Registered Trademark of Wheaton Partners, LLC.