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CMS-1403-FC PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT 16. The authority citation for part 411 continues to read as follows: Authority: Secs. 1102, 1860D–1 through 1860D–42, 1871, and 1877 of the Social Security Act (42 U.S.C. 1302, 1395w–101 through 1395w–152, 1395hh, and 1395nn). Subpart A-- General Exclusions and Exclusion of Particular Services 17. Section 411.15 is amended by-- A. Revising paragraphs (a)(1) and (b). B. Adding new paragraph (k)(15). C. Redesignating paragraphs (p)(2)(xii), (xiii), (xiv), and (xv) as (p)(2)(xiii), (xiv), (xv), and (xvi) respectively. D. Adding new paragraph (p)(2)(xii). The revision and additions read as follows: §411.15 Particular services excluded from coverage * * * * * (a) * * * (1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening tests, screening pelvic exams, 1108
CMS-1403-FC prostate cancer screening tests, glaucoma screening exams, ultrasound screening for abdominal aortic aneurysms (AAA), cardiovascular disease screening tests, diabetes screening tests, a screening electrocardiogram, initial preventive physical examinations that meet the criteria specified in paragraphs (k)(6) through (k)(15) of this section, or additional preventive services that meet the criteria in §410.64 of this chapter. * * * * * (b) Low vision aid exclusion. (1) Scope. The scope of the eyeglass exclusion encompasses all devices irrespective of their size, form, or technological features that use one or more lens to aid vision or provide magnification of images for impaired vision. (2) Exceptions. (i) Post-surgical prosthetic lenses customarily used during convalescence for eye surgery in which the lens of the eye was removed (for example, cataract surgery). (ii) Prosthetic intraocular lenses and one pair of conventional eyeglasses or contact lenses furnished subsequent to each cataract surgery with insertion of an intraocular lens. 1109
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<strong>CMS</strong>-1403-FC<br />
prostate cancer screening tests, glaucoma screening exams,<br />
ultrasound screening for abdominal aortic aneurysms (AAA),<br />
cardiovascular disease screening tests, diabetes screening<br />
tests, a screening electrocardiogram, initial preventive<br />
physical examinations that meet the criteria specified in<br />
paragraphs (k)(6) through (k)(15) of this section, or<br />
additional preventive services that meet the criteria in<br />
§410.64 of this chapter.<br />
* * * * *<br />
(b) Low vision aid exclusion.<br />
(1) Scope. The scope of the eyeglass exclusion<br />
encompasses all devices irrespective of their size, form,<br />
or technological features that use one or more lens to aid<br />
vision or provide magnification of images for impaired<br />
vision.<br />
(2) Exceptions.<br />
(i) Post-surgical prosthetic lenses customarily used<br />
during convalescence for eye surgery in which the lens of<br />
the eye was removed (for example, cataract surgery).<br />
(ii) Prosthetic intraocular lenses and one pair of<br />
conventional eyeglasses or contact lenses furnished<br />
subsequent to each cataract surgery with insertion of an<br />
intraocular lens.<br />
1109