LCD ID Number: L33636 Status: A-Approved
LCD Title: Routine Foot Care and Debridement of Nails
Geographic Jurisdiction: New York - Upstate 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:
Section 1833 (e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.
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) (13)(C) defines the exclusion for payment of routine foot care services.
Code of Federal Regulations: (CFR)
Part 411.15., subpart A addresses general exclusions and exclusion of particular services.
CMS Publication 100-02, Medicare Benefit Policy Manual, Chapter 15:
290 Foot care services which are exceptions to the Medicare coverage exclusion.
CMS Publication 100-03, Medicare National Coverage Determinations (NCD) Manual Part 1:
70.2.1 Services provided for diagnosis and treatment of diabetic peripheral neuropathy.
CMS Publication 100-09, Medicare Contractor Beneficiary and Provider Communications Manual, Chapter 5:
National Correct Coding Initiative.
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