CodeMap® LCD-L38994

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: L38994 Status: A-Approved
LCD Title: Epidural Steroid Injections for Pain Management
Geographic Jurisdiction: North Carolina Other Jurisdictions
Original Determination Effective Date: 12/05/2021
Original Determination Ending Date:
Revision Effective Date: 11/16/2023
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 Provisions in LCDs

42 CFR §410.74 defines Physician assistants' services, §410.75 defines Nurse practitioners' services and §410.76 defines Clinical nurse specialists' services.

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12/10/2024 05:48:42 18.97.14.84

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