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.

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).

  1. Click on the blue download arrow on the right side of page when LCD or Article appears.
  2. Click the print when PDF opens.
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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: Artificial Hearts and Percutaneous Endovascular Cardiac Assist Procedures and Devices A52966 View coverage, coding and billing information for Billing and Coding: Percutaneous Endovascular Cardiac Assist Procedures and Devices defined by the SSA. 33990, 33991, 33995, 33997
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, 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
Outpatient Cardiac Rehabilitation A54068 View coverage, coding and billing information for Outpatient Cardiac Rehabilitation defined by the SSA, NCD and CMS manuals, including contractor determined coding criteria. 93797, 93798
Sterilization N/A View coverage and billing requirements for sterilization services to prevent reproduction. 55250, 58600, 58605, 58611, 58615, 58670, 58671

 

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Last Updated Thu, 14 Oct 2021 16:23:03 +0000