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Medicare Medical Necessity

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Local Coverage Determinations

    CNTEXP Format CPTICD - This data file contains the Medicare Carrier and/or Fiscal Intermediary specific acceptable CPT® code and ICD-9-CM code combinations used to define “medical necessity”.  Data is available by individual Fiscal Intermediary, state or the entire country. Information is available for both Part A and Part B requirements and is updated on a quarterly basis in January, April, July and October.

     

 

National Coverage Determinations

 


 

 

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