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LCD ID Number: L33619 Status: A-Approved
LCD Title: Nonvascular Extremity Ultrasound
Geographic Jurisdiction: New York - Queens 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):
Title XVIII of the Social Security Act, Section 1862(a)(1)(A).
This section states that no Medicare payment shall be made for items or services that are not reasonable and necessary for the diagnosis or treatment of illness or injury.
Title XVIII of the Social Security Act, Section 1833(e).
This section prohibits Medicare payment for any claim that lacks the necessary information to process the claim.
CMS Publications:
CMS Publication 100-03,Medicare National Coverage Determinations Manual(NCD), Chapter 1:
220.5 Ultrasound Diagnostic Procedures
CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 7:
50 Billing Part B Radiology Services and Other Diagnostic Procedures
CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 12:
70 Payment Conditions for Radiology Services
CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 13:
10.1 Billing Part B Radiology Services and Other Diagnostic Procedures
CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 16:
40.2 Payment Limit for Purchased Services
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06/07/2023 02:40:04 3.235.40.122
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