LCD ID Number: L33630 Status: A-Approved
LCD Title: Corneal Pachymetry
Geographic Jurisdiction: Illinois 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):
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 1862(a)(7) excludes routine physical examinations, unless otherwise covered by statute.
Section 1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.
CMS Publication Pub. 100-08, Program Integrity Manual, Chapter 13:
13.5.1 Reasonable and Necessary Provisions in LCDs.
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05/16/2022 10:49:13 184.108.40.206