National Coverage Determination (NCD) - JE Part A
National Coverage Determination (NCD)
NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for a specific medical service procedure or device. NCDs generally outline the conditions for which a service is considered to be covered (or not covered) and usually issued as a program instruction. In rare instances, if there is contradicting information in the NCD and LCD, the NCD overrides the LCD.
View all NCDs on the CMS website.
Providers may also access the various CMS CRs and associated documents issued as part of the ICD-10 conversion activities related to NCDs from the CMS ICD-10 webpage.
Additional Noridian Coverage Requirement Articles
Access LCD or Article: Select the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD).
Print the LCD or Article: Select the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD).
- Click on the blue download arrow on the right side of page when LCD or Article appears.
- Click the print when PDF opens.
|Topic||Article Number||Brief Description||CPT / HCPCS Codes Referenced|
|Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for Osteoarthritic Knees||A54061||View coverage guidelines for Arthroscopic Lavage and Debridement for Osteoarthritic Knees||29871|
|Billing and Coding: Bariatric Surgery Coverage||A53026||View bariatric surgery procedures defined by NCD as reasonable and necessary under specified conditions for the treatment of complications of morbid obesity.||43644, 43645, 43770, 43845, 43846, 43847, 43775|
|Billing and Coding: Implantable Automatic Defibrillators||A56340||View Coverage and Billing requirements for Billing and Coding: Implantable Automatic Defibrillators coverage.||33202, 33203, 33215, 33216, 33217, 33218, 33220, 33223, 33224, 33225, 33230, 33231, 33240, 33241, 33243, 33244, 33249, 33262, 33263, 33264, 33270, 33271, 33272, 33273, C7537, C7538, C7539, C7540, G0448|
|Billing and Coding: Intravenous Immune Globulin (IVIg) - NCD 250.3||A54641||View NCD 250.3 coverage guidelines for intravenous immune globulin.||N/A|
|Billing and Coding: Positron Emission Tomography Scans Coverage||A54666||View coverage, coding and billing information for Positron Emission Tomography Scans Coverage defined by the SSA, NCD and CMS manuals, including contractor determined coding criteria.||78429, 78430, 78431, 78432, 78433, 78434, 78459, 78491, 78492, 78608, 78609, 78811, 78812, 78813, 78814, 78815, 78816, A4641, A9515, A9526, A9552, A9555, A9580, A9586, A9587, A9588, A9591, A9592, A9593, A9594, A9597, A9598, G0235, Q9982, Q9983|
|Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence||A53359||View coverage of Sacral Nerve Stimulation for Urinary and Fecal Incontinence as defined by the CMS National Coverage Determination (NCD) 230.18.||64561, 64581, 64585, 64590, 64595, A4290, C1767, C1778, C1820, C1883, C1897, L8680|
|Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers - Coding and Billing||A54929||View coverage, coding and billing information for Single Chamber and Dual Chamber Permanent Pacemakers defined by the Social Security Administration (SSA), National Coverage Determination (NCD) and CMS manuals, including contractor determined coding criteria.||33206, 33207, 33208|
|Sterilization||N/A||View coverage and billing requirements for sterilization services to prevent reproduction.||55250, 58600, 58605, 58611, 58615, 58670, 58671|
Last Updated Thu, 02 Nov 2023 11:55:24 +0000