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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 F, providers doing business in the Noridian jurisdiction and any other interested party doing business Jurisdiction F.

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
  • Template 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 This link will take you to an external website..

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.

Mail Noridian JF Part B
Attn: New LCD Request
PO Box 6781
Fargo ND 58108-6781
Fax

Noridian JF Part B
Attn: New LCD Request 

701-277-5160

Email partb_mpreconsider@noridian.com

 

Information regarding requests to modify, or request an LCD Reconsiderations for an existing, active LCD is available on the LCD Reconsideration webpage.

Last Updated Mar 07, 2016