New Local Coverage Determination Request Process
Noridian receives inquiries for new LCDs which include supporting evidence. Noridian will consider all new LCD requests from beneficiaries residing or receiving care in Jurisdiction E and any other interested party doing business Jurisdiction E.
Noridian will only accept requests for new LCDs. New LCD requests will not be accepted for other documents including:
- National Coverage Determinations (NCDs)
- Coverage provisions in interpretive manuals
- Noridian Part B draft LCDs
- Retired Part B LCDs
- Individual claim determinations
- Bulletins, articles, training materials
If a new LCD would conflict with an NCD, the request would not be valid.
Submitting Requests for New LCD Creation
Requests for new LCDs must include justification supported by complete copies of published evidence. Abstracts are not acceptable for this purpose. The level of evidence required for new LCD development is described in the CMS Internet Only Manuals (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 13..7.1 .
Any request for new LCD that, in the judgment of the contractor, does not meet these criteria is invalid. Noridian may consolidate valid requests if similar requests are received.
Requests for Noridian to develop a new LCD can be submitted in writing with supporting documentation using either mail, fax, or email.
| Noridian JE Part B |
Attn: New LCD Request
PO Box 6781
Fargo ND 58108-6781
Noridian JE Part B
Information regarding requests to modify, or request an LCD Reconsiderations for an existing, active LCD is available on the LCD Reconsideration webpage.
Last Updated May 15, 2017