Ultrasound, Soft Tissues of Head and Neck

Jurisdiction: J9 MAC Part B. States: Florida, Puerto Rico, US Virgin Islands. Type: Active LCD

Covered Indications Ultrasound of the head and neck will be considered medically reasonable and necessary when used for the following indications: Evaluation of abnormalities in the tissues and/or organs of the head and neck (i.e., palpable masses) Evaluation of abnormalities detected on other imaging examinations (i.e., areas of abnormal uptake seen on radioisotope thyroid examinations) Personal or family history of thyroid malignancies Evaluation of suspected regional nodal metastases in patients with a proven thyroid carcinoma Follow-up of lesion/nodule (i.e., after medical suppression therapy) Localization of thyroid/parathyroid glands or cervical lymph nodes for biopsy, ablation, or other interventional procedures For guidance regarding ordering tests, provider qualifications and supervision of diagnostic testing, please refer to 42 CFR §410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions. Limitations As published in the CMS IOM Publication 100-08, Medicare Program Integrity Manual , Chapter 13, Section 13.5.4, an item or service may be covered by a contractor LCD if it is reasonable and necessary under the Social Security Act Section 1862 (a)(1)(A). Contractors shall determine and describe the circumstances under which the item or service is considered reasonable and necessary.