Printer Friendly Version

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: L34433 Status: A-Approved LCD Title: Somatosensory Testing Geographic Jurisdiction: Georgia Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 09/12/2024 Revision End Date: CMS National Coverage Policy: Title XVIII of the Social Security Act, §1861(r) states the term "physician" used in connection with the performance of any function or action means, a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he performs such function or action Title XVIII of the Social Security Act, §1861(s)(2)(K)(i) addresses services furnished under the supervision of a physician Title XVIII of the Social Security Act, §1861(s)(3) states the term "medical and other health services" means diagnostic X-ray tests (including tests under the supervision of a physician, furnished in a place of residence used as the patient's home) 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 Title XVIII of the Social Security Act, §1862(a)(14) excludes payment for services, which are other than physicians' services, certified nurse-midwife services, qualified psychologist services, and services of a certified registered nurse anesthetist, and which are furnished to an individual who is a patient of a hospital or critical access hospital by an entity other than the hospital or critical access hospital, unless the services are furnished under arrangements with the entity made by the hospital or critical access hospital 42 CFR §410.32 indicates 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 (NCD) Manual, Chapter 1, Part 2, §160.23 Sensory Nerve Conduction Threshold Tests (sNCTs) Sorry, you need to login or register to view additional sections of this Medicare policy. *