CodeMap® LCD-L39780

Contractor Information

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

Contractor Number: 11202
Contractor Type: MAC B

LCD Information

LCD ID Number: L39780 Status: A-Approved
LCD Title: Lower Esophageal Magnetic Sphincter Augmentation
Geographic Jurisdiction: South Carolina Other Jurisdictions
Original Determination Effective Date: 07/14/2024
Original Determination Ending Date:
Revision Effective Date:
Revision End Date:
CMS National Coverage Policy:
Title XVIII of the Social Security Act (SSA), §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.

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05/13/2025 08:11:32 18.97.9.173

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