Common Reasons for Denial

• This is a noncovered item
• Item is not medically necessary for DME

Next Step

• A Redetermination request may be submitted with all relevant supporting documentation. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and documentation checklists prior to submitting request. Noridian encourages Redeterminations be submitted using the Noridian Medicare Portal

How to Avoid Future Denials

• In order for an item to be covered by DME MAC, it must fall within one of ten benefit categories. Some items may not meet definition of a Medicare benefit or may be statutorily excluded