CodeMap® LCD-L36577

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: L36577 Status: A-Approved
LCD Title: Total Knee Arthroplasty
Geographic Jurisdiction: Arizona Other Jurisdictions
Original Determination Effective Date: 09/07/2016
Original Determination Ending Date:
Revision Effective Date: 12/01/2019
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, 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, §3.4.1.3

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10/11/2024 03:40:07 3.237.15.145

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