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CodeMap® LCD-L39297

 

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L39297
LCD for Off-label Use of Rituximab and Rituximab Biosimilars (L39297)
See related Articles:
A59101-Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars
A59213-Response to Comments: Off-label Use of Rituximab and Rituximab Biosimilars

Contractor Information

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

Contractor Number: 06301

Contractor Type: MAC A

LCD Information

LCD ID Number: L39297 Status: A-Approved

LCD Title: Off-label Use of Rituximab and Rituximab Biosimilars

Geographic Jurisdiction: Wisconsin Other Jurisdictions

Original Determination Effective Date: 11/01/2022

Original Determination Ending Date:

Revision Effective Date:

Revision End Date:

CMS National Coverage Policy:

Title XVIII of the Social Security Act, Section 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.

Title XVIII of the Social Security Act, Section 1861(t)(2)(B) Drugs and Biologicals

Title XVIII of the Social Security Act, Section 1862(a)(1)(D) Investigational or Experimental

CMS Publications

CMS Publication Pub 100-02, Medicare Benefit Policy Manual, Chapter 15:
50 - Drugs and Biologicals

50.4.5 - Off-Label Use of Drugs and Biologicals in an Anti-Cancer Chemotherapeutic Regimen

CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 17:
10 - Payment Rules for Drugs and Biologicals


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02/08/2023 08:52:17 44.211.239.1


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