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Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor Contractor Number: 10211 Contractor Type: MAC A

LCD Information

LCD ID Number: L37642 Status: A-Approved LCD Title: Nerve Blocks and Electrostimulation for Peripheral Neuropathy Geographic Jurisdiction: Georgia Other Jurisdictions Original Determination Effective Date: 01/29/2018 Original Determination Ending Date: Revision Effective Date: 10/03/2024 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 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, §1862(a)(1)(D) and (E) Items and services related to research and experimentation Title XVIII of the Social Security Act, §1862(a)(7) states Medicare will not cover any services or procedures associated with routine physical examinations. CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 1, §30.3 Acupuncture CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 2, §150.6 Vitamin B12 Injections to Strengthen Tendons, Ligaments, etc., of the Foot and §150.7 Prolotherapy, Joint Sclerotherapy, and Ligamentous Injections with Sclerosing Agents Sorry, you need to login or register to view additional sections of this Medicare policy. *