Common Reasons for Denial

• Equipment is the same or similar to equipment already being used.
• There is a date span overlap or overutilization based on related LCD.

Next Step

• A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. 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

• Prior to providing equipment, an Advance Beneficiary Notice of Noncoverage (ABN) may be obtained for items a supplier knows a beneficiary does not qualify for
• To verify if beneficiary has/has not had a same or similar item in the past, suppliers may use the Noridian Medicare Portal or Noridian Interactive Voice Response (IVR) System @ 866-419-9458