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Last Modified: 8/26/2022 Location: FL, PR, USVI Business: Part B, Part A

Drugs and biologicals

View the following information relating to drugs and biologicals:

Medical documentation checklist

Related policy information

Some LCDs related to drugs and biologicals are listed below. Use the Interactive LCD index to locate additional coverage information.

LCD
Related billing and coding article
Additional related articles:

CMS Internet-only Manual (IOM)

Resources

Social Security Act (Title XVIII) Standard References:
Section 1862(a)(1)(A) states that no Medicare payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury.
Section 1862(a)(7). This section excludes routine physical examinations. 
Section 1833(e) states that no payment shall be made to any provider for any claim that lacks the necessary information to process the claim.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.