CodeMap® LCD-L38743

Contractor Information

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

Contractor Number: 11502
Contractor Type: MAC B

LCD Information

LCD ID Number: L38743 Status: A-Approved
LCD Title: Implantable Continuous Glucose Monitors (I-CGM)
Geographic Jurisdiction: North Carolina Other Jurisdictions
Original Determination Effective Date: 04/18/2021
Original Determination Ending Date:
Revision Effective Date: 07/25/2024
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act, §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.

Title XVIII of the Social Security Act, §1862(a)(7) excludes routine physical examinations.

CMS Internet-Only Manual, Pub. 100-08, Medicare Program Integrity Manual, Chapter 13, §13.5.4 Reasonable and Necessary Provision in an LCD

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