CodeMap® LCD-L38441

Contractor Information

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

Contractor Number: 08202
Contractor Type: MAC B

LCD Information

LCD ID Number: L38441 Status: A-Approved
LCD Title: MolDX: Blood Product Molecular Antigen Typing
Geographic Jurisdiction: Michigan Other Jurisdictions
Original Determination Effective Date: 10/25/2020
Original Determination Ending Date:
Revision Effective Date: 11/07/2024
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act, §1862(a)(1)(A) states that no Medicare payment shall be made for items or services that are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

42 CFR 410.32. Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

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

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04/17/2025 04:45:44 18.97.14.83

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