CodeMap® LCD-L38667

Contractor Information

Contractor Name: National Government Services, Inc. - Full list of policies of this Medicare Contractor

Contractor Number: 14412
Contractor Type: MAC B

LCD Information

LCD ID Number: L38667 Status: A-Approved
LCD Title: Computed Tomography Cerebral Perfusion Analysis (CTP)
Geographic Jurisdiction: Rhode Island Other Jurisdictions
Original Determination Effective Date: 11/01/2020
Original Determination Ending Date:
Revision Effective Date:
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act (SSA):

Section 1862(a)(1)(A) excludes expenses incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Section 1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Section 1862 (a)(7) excludes routine physical examinations.

CMS Publications:

CMS Publication 100-3, National Coverage Determination Manual, Chapter 1
220.1 Computerized Tomography

CMS Publication 100-4, Medicare Claims Processing Manual, Chapter 13
20 Payment Conditions for Radiology Services

CMS Publication 100-9, Contractor Beneficiary and Provider Communication Manual, Chapter 5
20 Correct Coding Initiative

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10/05/2024 09:03:21 3.237.15.145

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