CodeMap® LCD-L34659

Contractor Information

Contractor Name: Wisconsin Physicians Service Insurance Corporation - Full list of policies of this Medicare Contractor

Contractor Number: 05201
Contractor Type: MAC A

LCD Information

LCD ID Number: L34659 Status: A-Approved
LCD Title: Endoscopic Treatment of GERD
Geographic Jurisdiction: Kansas Other Jurisdictions
Original Determination Effective Date: 10/01/2015
Original Determination Ending Date:
Revision Effective Date: 08/29/2024
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.

Title XVIII of the Social Security Act, § 1833(e). This section prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Change Request 10901 Local Coverage Determinations (LCDs) Implementation date January 8, 2019.

IOM 100-08 Medicare Program Integrity Manual, Chapter 13-Local Coverage Determinations

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06/30/2025 05:39:32 216.73.216.44

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