Archived LCDs

To view archived Local Coverage Determinations (LCD) on the CMS Medicare Coverage Database This link will take you to an external website. (MCD), follow the instructions below.

  1. Go to CMS Archived Versions of Active LCDs by Contractor Index Criteria This link will take you to an external website. webpage to be directed to search option of MCD archive
    • MCD will open in new window
  2. Select Contractor(s): "Retired - NHIC, Corp. (DME MAC, 16003, Jurisdiction A)"
    • Archived policies are dated prior to July 1, 2016 transition of DME JA contract

      Image displays the Contractor to select within listing. Retired - NHIC, Corp. (DME MAC, 16003, Jurisdiction A)
  3. Click "Submit"
  4. An alphabetical list of all JA DME archived LCDs will open
  5. Click "LMRP/LCD ID" number to open desired LCD
    • User must select "Accept" to view LCD. The link will take a user to last retired LCD version (noted by revision effective date)
      • If looking for an older version, scroll to bottom of LCD and select version based on effective dates listed. Select desired version to open it.

Access the related PA from the "Associated Documents" section located at the bottom of the LCD. See "Related Local Coverage Documents – Article(s)" and select the Article(s) hyperlink to view the PA.

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Title LCD ID
Ankle-Foot/Knee-Ankle-Foot Orthosis L11527
Automatic External Defibrillators L13613
Canes and Crutches L11496
Cervical Traction Devices L15844
Cold Therapy L5038
Commodes L11497
Enteral Nutrition L5041
Epoetin L11463
External Breast Prostheses L5043
External Infusion Pumps L5044
Eye Prostheses L11529
Facial Prostheses L5046
Glucose Monitors L11530
Heating Pads and Heat Lamps L28480
High Frequency Chest Wall Oscillation Devices L12870
Home Dialysis Supplies and Equipment L11498
Hospital Beds And Accessories L5049
Immunosuppressive Drugs L11531
Infrared Heating Pad Systems L12873
Intrapulmonary Percussive Ventilation System L5051
Intravenous Immune Globulin L27260
Knee Orthoses L27263
Lower Limb Prostheses L11464
Manual Wheelchair Bases L11465
Mechanical In-exsufflation Devices L12872
Nebulizers L11499
Negative Pressure Wound Therapy Pumps L11500
Oral Anticancer Drugs L5057
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) L5058
Oral Appliances for Obstructive Sleep Apnea L28603
Orthopedic Footwear L11467
Osteogenesis Stimulators L11501
Ostomy Supplies L11502
Oxygen and Oxygen Equipment L11468
Parenteral Nutrition L5063
Patient Lifts L5064
Pneumatic Compression Devices L11503
DRAFT - Pneumatic Compression Devices L34820
Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea L11528
Power Mobility Devices L21271
Pressure Reducing Support Surfaces - Group 1 L5067
Pressure Reducing Support Surfaces - Group 2 L5068
Pressure Reducing Support Surfaces - Group 3 L5069
Refractive Lenses L11532
Respiratory Assist Devices L11504
Seat Lift Mechanisms L11533
Speech Generating Devices L11534
Spinal Orthoses: TLSO and LSO L11470
Suction Pumps L11505
Surgical Dressings L11471
Therapeutic Shoes for Persons with Diabetes L11535
Tracheostomy Care Supplies L11536
Transcutaneous Electrical Joint Stimulation Devices (TEJSD) L28551
Transcutaneous Electrical Nerve Stimulators (TENS) L11506
Tumor Treatment Field Therapy (TTFT) L34730
Urological Supplies L5080
Vacuum Erection Devices (VED) L34732
Walkers L11472
Wheelchair Options/Accessories L11473
Wheelchair Seating L15845

Last Updated Sep 12, 2017