LCD ID Number: L34614 Status: A-Approved
LCD Title: Colonoscopy and Sigmoidoscopy-Diagnostic
Geographic Jurisdiction: Michigan Other Jurisdictions
Original Determination Effective Date:
Original Determination Ending Date:
Revision Effective Date:
Revision End Date:
CMS National Coverage Policy:
Social Security Act (Title XVIII)
- Title XVIII of the Social Security Act, § 1862(a)(1)(A) states that no Medicare payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury.
- Title XVIII of the SSA, §1833(e), prohibits Medicare payment for any claim which lacks the necessary information to process the claim.
- Title XVIII of the Social Security Act, § 1862(a)(7). This section excludes routine physical examinations.
CFR, Title 42, Ch. IV, § 410.32, Diagnostic X-Rays, diagnostic laboratory tests, and other diagnostic tests: Conditions. This section describes regulations that apply to performing these tests.
- Pub 100-02, Medicare Benefit Policy Manual, Chapter 15 Covered Medical and Other Health Services:
- Section 80-Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests, Section 280.2 -Colorectal Cancer Screening
- Pub.100-04 Medicare Claims Processing Manual -Chapter 18 Preventive and Screening Services: Section 60 - Colorectal Cancer Screening
CR 10901 Local Coverage Determinations (LCDs) Implementation date January 8, 2019.
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06/03/2023 06:32:10 220.127.116.11