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Issue Number - Name
0113-Radiologic Examination of the Chest
Review Type
Automated
Claim Type
Physician/Non-Physician Practitioner
Region and State
Noridian (JE, JF)
Date Approved
09/11/2018

Description

Claims submitted with chest x-rays (CPT codes 71045, 71046, 71047, 71048) billed without a covered ICD-10 code as specified in the applicable LCDs will be denied as not medically necessary.

Affected code(s)

71045, 71046, 71047, 71048

Applicable Policy References

42 Code of Federal Regulations, Section 410.32 

CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 13, Section 100 and 100.1   

CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 80.6.1

LCD L34317, Radiologic Examination, Chest, Retired 06/21/2018 (Noridian JE) 

LCD L34097, Chest X-Ray Policy, Revised 01/01/2018, Retired 6/21/2018 (Noridian JF)