CodeMap® LCD-L34425

Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor

Contractor Number: 10211
Contractor Type: MAC A

LCD Information

LCD ID Number: L34425 Status: A-Approved
LCD Title: Magnetic Resonance Imaging of the Orbit, Face, and/or Neck
Geographic Jurisdiction: Georgia Other Jurisdictions
Original Determination Effective Date: 10/01/2015
Original Determination Ending Date:
Revision Effective Date: 09/09/2021
Revision End Date:
CMS National Coverage Policy:
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.

CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 4, §220.2 Magnetic Resonance Imaging (MRI)

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