CodeMap® LCD-L39396

LCD for Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin (L39396)

Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor

Contractor Number: 01311
Contractor Type: MAC A

LCD Information

LCD ID Number: L39396 Status: A-Approved
LCD Title: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin
Geographic Jurisdiction: Nevada Other Jurisdictions
Original Determination Effective Date: 03/05/2023
Original Determination Ending Date:
Revision Effective Date:
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 and treatment of illness or injury or to improve the functioning of a malformed body member.

CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 2, §110.23 Stem Cell Transplantation

CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 4, §310.1 Routine Costs in Clinical Trials

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing Manual, Chapter 3, §90.3 Stem Cell Transplantation

CMS Internet-Only Manual, Pub. 100-04, Medicare Claims Processing, Chapter 32, §90 Stem Cell Transplantation and §90.1 General

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12/08/2023 03:22:19 3.239.2.192

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