Name	Value
CODE	N115
STATUS EFFECTIVE DATE	2003-06-01 00:00:00 STATUS: ACTIVE FEE USE: NOT APPLICABLE
DESCRIPTION EFFECTIVE DATE	DESCRIPTION: This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered. A copy of this policy is available at www.cms.gov/mcd, or if you do not have web access, you may contact the contractor to request a copy of the LCD.

Name

Value

CODE

N115

STATUS EFFECTIVE DATE

2003-06-01 00:00:00

STATUS: ACTIVE

FEE USE: NOT APPLICABLE

DESCRIPTION EFFECTIVE DATE

DESCRIPTION:

This decision was based on a Local Coverage Determination (LCD). An LCD 
provides a guide to assist in determining whether a particular item or 
service is covered. A copy of this policy is available at 
www.cms.gov/mcd, or if you do not have web access, you may contact the 
contractor to request a copy of the LCD.

N115 (311) REMITTANCE REMARK (161.93)