LCD ID Number: L34413 Status: A-Approved
LCD Title: Cataract Surgery
Geographic Jurisdiction: Alabama Other Jurisdictions
Original Determination Effective Date:
10/01/2015
Original Determination Ending Date:
Revision Effective Date:
11/21/2024
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act §1862(a)(7) excludes routine physical examinations.
Title XVIII of the Social Security Act, §1862 (a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
42 CFR §411.15 (b)(2) and (o)(1)&(2) Particular services excluded from coverage.
42 CFR §416.65 Covered surgical procedures.
CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 1, §80.10, Phaco-Emulsification Procedure-Cataract Extraction.
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