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Contractor Information

Contractor Name: National Government Services, Inc. - Full list of policies of this Medicare Contractor Contractor Number: 14412 Contractor Type: MAC B

LCD Information

LCD ID Number: L36236 Status: A-Approved LCD Title: Autonomic Function Testing Geographic Jurisdiction: Rhode Island Other Jurisdictions Original Determination Effective Date: 10/01/2015 Original Determination Ending Date: Revision Effective Date: 09/12/2019 Revision End Date: CMS National Coverage Policy: Title XVIII of the Social Security Act, Section 1833 (e). This section states that no payment shall be made to any provider for any claims that lack necessary information to process the claim. Title XVIII of the Social Security Act section 1862 (a)(1)(A). This section allows coverage and payment of those services that are considered to be medically reasonable and necessary. Title XVIII of the Social Security Act section 1862 (a)(7). This section excludes routine physical examinations and services. CMS Manual System, Pub 100-08, Medicare Program Integrity Manual, Chapter 3, Part 3.2.3 Requesting Addition Documentation During Prepayment and Post-payment review. 42 CFR Section 410.32(a) indicates diagnostic tests are payable only when the physician who is treating the beneficiary for a specific medical problem uses the results in such treatment. Sorry, you need to login or register to view additional sections of this Medicare policy. *