This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV).

Effective Date: February 3, 2022

Summary of Article Changes: Replaced information pertaining to National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services Chapter 4, Section G to current language found in the manual effective 1/1/2022.

Visit the Noridian Medicare Coverage Articles webpage to view the complete listing of coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD.