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CodeMap® LCD-L37873


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LCD for Topical Oxygen Therapy (L37873)
See related Articles:
A56392-Response to Comments: Topical Oxygen Therapy
A56431-Billing and Coding: Topical Oxygen Therapy

Contractor Information

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

Contractor Number: 11501

Contractor Type: MAC A

LCD Information

LCD ID Number: L37873 Status: A-Approved

LCD Title: Topical Oxygen Therapy

Geographic Jurisdiction: North Carolina Other Jurisdictions

Original Determination Effective Date: 05/06/2019

Original Determination Ending Date:

Revision Effective Date: 04/08/2021

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) no payment may be made for any expenses incurred for items or services in the case of clinical care items and services provided with respect to research and experimentation.

42 CFR §410.26(a)(2) defines direct supervision.

42 CFR §410.74(b)(3) Physician assistants' services

42 CFR §410.75(c)(1) Nurse practitioners' services

42 CFR §410.76(b)(1) Clinical nurse specialists' services

CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 6, §20.5.2 coverage of Outpatient Therapeutic Services Incident to a Physician's Service Furnished on January 2, 2010 through December 31, 2019

CMS Internet- Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 1, §20.29 Hyperbaric Oxygen Treatment

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05/10/2021 11:11:04

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