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

2021
2020 (July)

Physician Fee Schedule

2021
2020

OPPS Fee Schedule

2021-April
2021-January

ASC Fee Schedule

2021-April
2021-January

APC Codes

2021-April
2021-January

DRG Codes

2021
2020

ASP Drug Pricing Files

April 2021
January 2021


CMS Transmittals




Next Webinar 06/23/2021:
2021 Regulatory Update: Hospital Outreach Programs

CodeMap® LCD-L33579

 

Printer Friendly Version

L33579
LCD for Transesophageal Echocardiography (TEE) (L33579)
See related Articles:
A52868-Billing and Coding: Transesophageal Echocardiography (TEE)

Contractor Information

Contractor Name: National Government Services, Inc. - Full list of policies of this Medicare Contractor

Contractor Number: 14212

Contractor Type: MAC B

LCD Information

LCD ID Number: L33579 Status: A-Approved

LCD Title: Transesophageal Echocardiography (TEE)

Geographic Jurisdiction: Massachusetts Other Jurisdictions

Original Determination Effective Date: 10/01/2015

Original Determination Ending Date:

Revision Effective Date: 10/01/2019

Revision End Date:

CMS National Coverage Policy:

Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy. NCDs and coverage provisions in interpretive manuals are not subject to the Local Coverage Determination (LCD) Review Process (42 CFR 405.860[b] and 42 CFR 426 [Subpart D]). In addition, an administrative law judge may not review an NCD. See Section 1869(f)(1)(A)(i) of the Social Security Act.

Unless otherwise specified, italicized text represents quotation from one or more of the following CMS sources:

Title XVIII of the Social Security Act (SSA):

Section 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.

Section 1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Section 1862(a)(7) of Title XVIII of the Social Security Act excludes routine physical examination, unless otherwise covered by statute.

Code of Federal Regulations:

42 CFR, Section 410.32, 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) and the results must be used in the management of the patient.

42 CFR, Section 410.33c, describes qualifications required for non-physician practitioners used by an IDTF.

CMS Publications:

CMS Publication 100-02, Medicare Coverage Issues Manual, Chapter 15:

    80 Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests

CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 9:

    100 General Billing Requirements

CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 12:

    30.4 Cardiovascular System (Codes 92950-93799)

CMS Internet-Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 13:

    20 Payment conditions for radiology services

National CCI Manual, version 13.3, Chapter II: CCI editing for anesthesia services; accessible at http://www.cms.hhs.gov/NationalCorrectCodInitEd/


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.

06/22/2021 07:44:32 3.235.184.215


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