CodeMap® LCD-L39400

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: L39400 Status: A-Approved
LCD Title: Magnesium
Geographic Jurisdiction: Alabama Other Jurisdictions
Original Determination Effective Date: 01/22/2023
Original Determination Ending Date:
Revision Effective Date: 09/12/2024
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

Title XVIII of the Social Security Act, §1862(a)(7) states Medicare will not cover any services or procedures associated with routine physical checkups

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

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12/10/2024 05:23:37 18.97.14.84

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