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CodeMap® LCD-L36692

 

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L36692
LCD for Vitamin D Assay Testing (L36692)
See related Articles:
A55372-Response to Comments: Vitamin D Assay Testing
A57718-Billing and Coding: Vitamin D Assay Testing

Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor

Contractor Number: 01182

Contractor Type: MAC B

LCD Information

LCD ID Number: L36692 Status: A-Approved

LCD Title: Vitamin D Assay Testing

Geographic Jurisdiction: California - Southern Other Jurisdictions

Original Determination Effective Date: 02/03/2017

Original Determination Ending Date:

Revision Effective Date: 12/01/2019

Revision End Date:

CMS National Coverage Policy:

Title XVIII of the Social Security Act, Section 1862(a)(1)(A) states that no Medicare payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury.

Title XVIII of the Social Security Act, Section 1862(a)(7). This section excludes routine physical examinations.

Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider for any claim that lacks the necessary information to process the claim.

42CFR410.32(a) requires a clinical diagnostic test be ordered by the physician who is treating the patient for a specific medical problem and uses the results in the management of the beneficiary’s specific problem.

MBPM Internet Only Manual(IOM 100-02), chap. 6, §20.4.3 applies 42CFR410.32 to hospitals.


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02/08/2023 07:24:42 44.211.239.1


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