LCD ID Number: L36692 Status: A-Approved
LCD Title: Vitamin D Assay Testing
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, 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.
Sorry, you need to login or register to view additional sections of this Medicare policy.
All information on this web site is compiled directly from information obtained from the Center
for Medicare and Medicaid Services (CMS) and from its Contractors.
CodeMap® has made every reasonable effort to ensure the accuracy of the information contained on
this web site. However, the ultimate responsibility for correct coding and claims submission lies with the
provider of services. CodeMap® makes no representation, warranty, or guarantee that this compilation of Medicare information
is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims.
Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.
No part of this web page or data displayed may be redistibuted or used without the express written consent of Wheaton Partners, LLC.
03/27/2023 04:47:14 184.108.40.206