LCD ID Number: L33619 Status: A-Approved
LCD Title: Nonvascular Extremity Ultrasound
Geographic Jurisdiction: Rhode Island Other Jurisdictions
Original Determination Effective Date:
Original Determination Ending Date:
Revision Effective Date:
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 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
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.
06/26/2022 03:07:51 22.214.171.124