Policies (LCDs and NCDs)
A Local Coverage Determination (LCD) is a decision by a Medicare Administrative Contractor (MAC) whether to cover a particular service on a MAC-wide, basis. The LCDs are located on the CMS website in a Medicare Coverage Database (MCD).
National Coverage Determinations (NCDs) are developed by CMS to describe the circumstances for Medicare coverage nationwide for a specific medical service procedure or device.
An LCD is a decision by a Medicare Administrative Contractor (MAC) whether to cover a particular service on a MAC-wide, basis. The LCDs are located on the CMS website in a Medicare Coverage Database (MCD).
|MolDX||View coverage and reimbursement information for molecular diagnostic tests.|
View additional Noridian coverage requirement articles.
An NCD is a national policy granting, limiting or excluding Medicare coverage for a specific medical item or service. These are developed and published by CMS and apply to all states. NCDs are made through an evidence-based process, with opportunities for public participation. In rare instances, if there is contradicting information in the NCD and LCD, the NCD overrides the LCD.
Medicare contractors post articles into the Medicare Coverage Database (MCD). Articles address local coverage, coding or medical review related billing and claims considerations, and may include any newly developed educational materials, coding instructions or clarification of existing medical review related billing or claims policy.
View coverage details on topics found outside NCDs and LCDs.
View information on how you are able to determine which drugs are usually self-administered by the patient and see the SAD exclusion list.
Last Updated Oct 04, 2015
CPT and ADA End User License Agreement for Providers
NOTE: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the files unless you read, agree to, and abide by the provisions of the copyright statement. Read the copyright statement now and you will be linked back to here.
CPT codes, descriptors and other data only are copyright 2015 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.
Last Updated Jul 31, 2015