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Issue Number - Name
0002 - Cataract Removal- Reasonable and Necessary Requirements and Coding Requirements
Review Type
Complex
Claim Type
Outpatient Hospital, Ambulatory Surgical Center
Region and State
RAC 1-4
All States
Date Approved
2017-02-01

Description

Reviewed to determine if Cataract Surgery meets Medicare coverage criteria.

Affected Codes

  • 66830, 66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984

Applicable Policy References

  • CMS NCD, 10.1, Effective 8/31/1992
  • CMS NCD, 80.10 and 80.12, Effective 5/19/1997
  • CGS LCD, L33954, Effective Date 10/01/2015 
  • NGS LCD, L33558, effective date 10/1/2015 
  • Noridian LCD, L34203, Effective Date 10/01/2015
  • Palmetto LCD, L34413, Effective Date 10/01/2015 
  • Palmetto Article, A53047, Effective Date 10/01/2015
  • Novitas LCD, L35091, Effective Date 10/01/2015 
  • First Coast LCD, L33808, Effective Date 10/01/2015
  • Cahaba LCD, L34287, Effective Date 10/01/2015 (PART B ONLY)