CodeMap® LCD-L37779

Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor

Contractor Number: 10111
Contractor Type: MAC A

LCD Information

LCD ID Number: L37779 Status: A-Approved
LCD Title: Intraoperative Radiation Therapy
Geographic Jurisdiction: Alabama Other Jurisdictions
Original Determination Effective Date: 09/24/2018
Original Determination Ending Date:
Revision Effective Date: 07/29/2021
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) in the case of clinical care items and services provided with respect to research and experimentation.

CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §90 X-Ray, Radium, and Radioactive Isotope Therapy

CMS Internet-Only Manual, Pub. 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.1 General Requirements

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