LCD ID Number: L34588 Status: A-Approved
LCD Title: Trigger Points, Local Injections
Geographic Jurisdiction: Kansas Other Jurisdictions
Original Determination Effective Date:
Original Determination Ending Date:
Revision Effective Date:
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act, section 1862(a)(1)(A). This section allows coverage and payment for only those services that are considered to be medically reasonable and necessary.
Title XVIII of the Social Security Act, section 1833(e). This section prohibits Medicare payment for any claim which lacks the necessary information to process the claim.
Title XVIII of the Social Security Act, section 1862 (a)(7) excludes routine physical evaluations.
PUB 100-03 Medicare National Coverage Determinations (NCD) Manual-
Part 1 Section 30.3 – Acupuncture, 30.3.1 Acupuncture for Fibromyalgia, 30.3.2 Acupuncture for Osteoarthritis.
Part 2 Section 150.7 - Prolotherapy, Joint Sclerotherapy, and Ligamentous Injections with Sclerosing Agents.
Change Request 10901, Local Coverage Determinations (LCDs)
CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13.5.4 - Reasonable and Necessary Provisions in an LCD.
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