LCD ID Number: L37848 Status: A-Approved
LCD Title: Lumbar Spinal Fusion
Geographic Jurisdiction: North Carolina Other Jurisdictions
Original Determination Effective Date:
05/06/2019
Original Determination Ending Date:
Revision Effective Date:
09/12/2024
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) in the case of clinical care items and services provided with respect to research and experimentation
CMS Internet-Only Manual, Pub. 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.1 General Requirements (states that "reasonable and necessary" services must be ordered and/or furnished by qualified personnel)
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