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CodeMap® LCD-L37027

 

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L37027
LCD for Cataract Surgery in Adults (L37027)
See related Articles:
A55689-Response to Comments: Cataract Surgery in Adults
A57196-Billing and Coding: Cataract Surgery in Adults

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: L37027 Status: A-Approved

LCD Title: Cataract Surgery in Adults

Geographic Jurisdiction: Alaska Other Jurisdictions

Original Determination Effective Date: 10/10/2017

Original Determination Ending Date:

Revision Effective Date: 10/01/2019

Revision End Date:

CMS National Coverage Policy:

Title XVIII of the Social Security Act §1862(a)(7) excludes routine physical examinations.

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 XVIII of the Social Security Act, §1833(e) prohibits Medicare Payment for any claim which lacks the necessary information to process the claim.

Code of Federal Regulations 42 CFR CH.IV [411.15(b)(2)&(3)and(o)(1)&(2)] Services excluded from coverage

Code of Federal Regulations 42 CFR CH. IV [416.65] Covered surgical procedures

CMS Manual System, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 1, §80.10, Phaco-Emulsification Procedure-Cataract Extraction

CMS Manual System, Pub 100-04, Medicare Claims Processing Manual Chapter 12, §§40.6, 40.7, Claims for Multiple Surgeries, Claims for Bilateral Surgeries


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04/12/2021 02:07:53 18.206.177.17


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