LCD ID Number: L36575 Status: A-Approved
LCD Title: Total Knee Arthroplasty
Geographic Jurisdiction: American Samoa, Guam, Hawaii, Northern Mariana Islands 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, §1862 (a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
Title 21, Code of Federal Regulations, Chapter 1, Subchapter H, Part 888 Orthopedic Devices, Section 888.1100 Arthroscope
Title 42, Code of Federal Regulations, §482.24
CMS Manual System, Pub 100-08, Medicare Program Integrity Manual, Chapter 6, §6.5.2
CMS Manual System, Pub 100-08, Medicare Program Integrity Manual, Chapter 3, §18.104.22.168
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03/27/2023 04:52:24 22.214.171.124