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Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor Contractor Number: 03102 Contractor Type: MAC B

LCD Information

LCD ID Number: L35457 Status: A-Approved LCD Title: Nerve Blockade for Treatment of Chronic Pain and Neuropathy Geographic Jurisdiction: Arizona Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 09/04/2022 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- Chapter 1 Section: 30.3 – Acupuncture 150.6 - Vitamin B12 Injections to Strengthen Tendons, Ligaments, etc of the Foot 150.7 - Prolotherapy, Joint Sclerotherapy, and Ligamentous Injections with Sclerosing Agents Sorry, you need to login or register to view additional sections of this Medicare policy. *