LCD ID Number: L34526 Status: A-Approved
LCD Title: Surgical Treatment of Obstructive Sleep Apnea (OSA)
Geographic Jurisdiction: Iowa Other Jurisdictions
Original Determination Effective Date:
Original Determination Ending Date:
Revision Effective Date:
Revision End Date:
CMS National Coverage Policy:
CMS Pub. 100-02 Medicare Benefit Policy Manual Chapter 15 §70- Sleep Disorder Clinics;
Chapter 16 §140 Dental Services Exclusion
CMS Pub. 100-03 Medicare National Coverage Determinations Manual:
Chapter 1, Part 4 §240.4 Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA)
Social Security Act 1862 (a)(1)(A) Medically Reasonable & Necessary.
Social Security Act 1862 (a)(1)(D) Investigational or Experimental.
CMS Transmittal No, 857, effective date October 3, 2018 Change Request 10901 Local Coverage Determinations (LCDs) Implementation date January 8, 2019.
Sorry, you need to login or register to view additional sections of this Medicare policy.
All information on this web site is compiled directly from information obtained from the Center
for Medicare and Medicaid Services (CMS) and from its Contractors.
CodeMap® has made every reasonable effort to ensure the accuracy of the information contained on
this web site. However, the ultimate responsibility for correct coding and claims submission lies with the
provider of services. CodeMap® makes no representation, warranty, or guarantee that this compilation of Medicare information
is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims.
Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.
No part of this web page or data displayed may be redistibuted or used without the express written consent of Wheaton Partners, LLC.
12/08/2022 12:24:48 188.8.131.52