CodeMap® LCD-L34554

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: L34554 Status: A-Approved
LCD Title: In Vitro Chemosensitivity & Chemoresistance Assays
Geographic Jurisdiction: Alabama Other Jurisdictions
Original Determination Effective Date: 10/01/2015
Original Determination Ending Date:
Revision Effective Date: 07/11/2024
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.

Title XVIII of the Social Security Act, §1862(a)(1)(D) addresses items and services related to research and experimentation.

Title XVIII of the Social Security Act, §1862(a)(7) excludes routine physical examinations.

42 CFR §410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions

CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 3, §190.7 Human Tumor Stem Cell Drug Sensitivity Assays

CMS Internet-Only Manual, Pub 100-08, Medicare Program Integrity Manual, Chapter 3, §3.2.3.7 Special Provisions for Lab Additional Documentation Requests

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