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Rods – General Exclusions

Rods – General Exclusions
A. HEALTH BENEFITS
(11GENERAL EXCLUSIONS
· Allergy
     –dust allergy apparatus, 78-178
     –tests/inpatient treatment, 84-467
· Anesthesia services
     –dental procedure,81-09581-24484-36784-460
· Biofeedback therapy,81-22281-64381-674
· Black lung tests,78-31984-05984-284
· Blood glucose monitoring,81-273
· Contact lenses84-282
· Custodial care, 78-24984-09684-28388-039CA-001CA-004CA-011CA-016CA-019
     –covered under unusual circumstances, CA-058 
     –dentures, 84-39688-067
     –extensive surgical procedures, 78-09678-11281-67284-14284-53202-041
     — impacted wisdom teeth,78-02378-03081-03881-13684-17288-30888-764
     –implants, 84-36284-41884-44284-56488-21788-24088-397CA-069
     –oral surgery, 81-25981-388CA-00702-041
     –oral orthopedic appliance,81-54481-59981-65581-67081-67681-68384-07084-07384-31584-38188-08088-15288-355
     –outpatient hospitalization,78-01784-085
     –periodontal disease,78-076187CA-025
     –root canals, 78-10584-594
     –teeth extractions, 84-60388-29888-32302-04107-0006
     –temporomandibular joint dysfunction (TMJ)78-05278-06778-31381-23381-24181-54481-59981-67081-67681-68388-311
· Dyslexia therapy93-06898-003
· Exercise equipment
     –bicycle ergometer and pulsemeter, 81-415
     –exercise bicycle88-148
     –heart rate monitor, CA-020
     —treadmill,88-269
· Experimental medical devices and therapy,78-25478-32081-08281-17381-22281-23081-27381-28781-58181-59181-59281-71184-12384-22288-00888-65611-0136, 16-0015
      –biofeedback therapy,81-64381-674
     –bone marrow transplant,88-364
     –emerging medical procedure, CA-082
     –light box for seasonal affective disorder88-652
     –Lung Volume Reduction Surgery (LVRS), CA-033
     –medication,84-12388-256
     –morphometric analysis, CA-032
     –percutaneous diskectomy,88-036
     –thermography,88-35988-390
     –Interspinous distraction device, 11-0136
    –Medicare LCD reference, 11-0136?
· Eyeglasses/-surgically caused refractive error84-12984-23184-282
     –vision impaired by medical condition,84-514
· Finance charges81-29381-51681-57388-66693-101
· Heart rate monitor, see exercise equipment
· Insulin infusion pump,81-27381-287
· In vitro fertilization88-685
· IontophoresisCA-082 
· Medicare Part A & B,81-04484-49784-516
· Mental deficiencies/ inpatient treatment,81-447
     –prescription drugs, 88-290
     –surgical reduction, 78-17584-24784-43488-11488-619
     –weight loss program, 81-23881-47684-57388-23388-31388-40488-700
     –excess skin, 07-0010
· Obstetrical charges/ excessive fee78-029
· Orthoptic (see heading under Vision Care)
· Physical conditioning88-13588-242
· Podiatrist services, routine care,84-079
· Preexisting conditions,81-63888-326
· Pregnancy,78-018
· Private duty nursing, 84-283
· Private room charges78-16581-30784-34984-53384-54088-16788-208
· Private tutor98-023
· Reversal of sterilization procedures78-24181-01881-07884-150
· Services,
     –furnished by governmental, tax-support or voluntary agency, 93-06898-003
     –not specifically provided, 78-15981-16181-23881-27384-11184-17084-24188-13588-15488-24288-321
· Services rendered after eligibility period ends78-23981-50984-07884-16084-19088-329
· Special education81-161
· Visual therapy (see Vision Care listing)
· Wigs,88-15488-32107-0012
· Workers’ compensation,78-03681-40281-57581-68684-09088-05588-52588-726