CodeMap® LCD-L37216

Contractor Information

Contractor Name: Wisconsin Physicians Service Insurance Corporation - Full list of policies of this Medicare Contractor

Contractor Number: 05401
Contractor Type: MAC A

LCD Information

LCD ID Number: L37216 Status: A-Approved
LCD Title: BDX-XL2
Geographic Jurisdiction: Nebraska Other Jurisdictions
Original Determination Effective Date: 09/16/2017
Original Determination Ending Date:
Revision Effective Date: 03/30/2023
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act (the “Act”), Section 1862(a)(1)(A). This section limits coverage and payment to those items and services that are reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

42 FR 410.32 (a) Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions

CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §80 Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests and §80.1.1 Certification Changes

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10/11/2024 04:01:32 3.237.15.145

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