CodeMap® LCD-L39268

Contractor Information

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

Contractor Number: 10111
Contractor Type: MAC A

LCD Information

LCD ID Number: L39268 Status: A-Approved
LCD Title: Bone Mass Measurement
Geographic Jurisdiction: Alabama Other Jurisdictions
Original Determination Effective Date: 09/18/2022
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) 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.

42 Code of Federal Regulations (CFR) §410.32(a) and (b) Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

42 Code of Federal Regulations (CFR) §411.15(k)(1) Particular services excluded from coverage.

CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §80.5 Bone Mass Measurements (BMMs).

CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 2, §150.3 Bone (Mineral) Density Studies.

CMS Internet-Only Manual, Pub.100-04, Medicare Claims Processing Manual, Chapter 13, §140 Bone Mass Measurements (BMMs), §140.2 Denial Messages for Noncovered Bone Mass Measurements, and §140.4 Advance Beneficiary Notices (ABNs).

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