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Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor Contractor Number: 02102 Contractor Type: MAC B

LCD Information

LCD ID Number: L37020 Status: A-Approved LCD Title: Plastic Surgery Geographic Jurisdiction: Alaska Other Jurisdictions Original Determination Effective Date: 10/10/2017 Original Determination Ending Date: Revision Effective Date: 02/14/2025 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 medically reasonable and necessary. Title XVIII of the Social Security Act, §1833(e). Prohibits Medicare payment for any claim, which lacks the necessary information to process the claim. Title XVIII of the Social Security Act, §1862(a)(10). Coverage of cosmetic surgery is discussed. Medicare On-Line Manual System, Publication 100-02, Medicare Benefit Policy Manual, Chapter 16, §§10, 120, and 180. Medicare On-Line Manual System, Publication 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 2, §§140.2 and 140.4. Sorry, you need to login or register to view additional sections of this Medicare policy. *