Local Coverage Determination (LCD)

An LCD is a determination by a Medicare Administrative Contractor (MAC) whether to cover a particular service on a MAC-wide, basis. Coverage criteria is defined within each LCD, including: lists of HCPCs codes, ICD-10 codes for which the service is covered or considered not reasonable and necessary. View published Active LCDs on our website and access others located within the CMS Medicare Coverage Database (MCD).

Access the below related information from this page.

LCD Review and Revision

Noridian shall review and appropriately revise the affected LCD within 90 days of the publication of program instruction (e.g., Program Memorandum, manual change) containing:

  • A new or revised National Coverage Determination (NCD)
  • A new or revised coverage provision in an interpretive manual; or
  • A change to national payment policy.

The MCD will notify contractors of each LCD that is affected by HCPCS or diagnosis code updates. Noridian shall review and approve and/or appropriately revise affected LCDs within 120 days of the date of notification. If there are major changes, Noridian shall revise the effective date, revision number and revision history.

Noridian shall annually review and revise all LCDs to ensure they remain accurate and up-to-date at all times based upon the CMS NCDs, coverage provisions in interpretive manuals, national payment policies, and national coding policies.

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Last Updated Feb 01, 2018