CodeMap® LCD-L34431

Contractor Information

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

Contractor Number: 10111
Contractor Type: MAC A

LCD Information

LCD ID Number: L34431 Status: A-Approved
LCD Title: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
Geographic Jurisdiction: Alabama Other Jurisdictions
Original Determination Effective Date: 10/01/2015
Original Determination Ending Date:
Revision Effective Date: 08/12/2021
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act, §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.

42 CFR §410.32(a) indicates that diagnostic tests may only be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements).

CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 1, §80.6 Intraocular Photography and §80.9 Computer Enhanced Perimetry Part 2, §140.5 Laser Procedures

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12/10/2024 06:14:52 18.97.14.84

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