Find-A-Code Focus Newsletter

NCD's and LCD's - What Are They?

December 16, 2014




What are NCDs and LCDs?

NCD — NATIONAL COVERAGE DETERMINATIONS

Medicare specific coverage on the national level. All Medicare carriers are required to follow the NCDs. The NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for an item or service. NCDs generally outline the conditions for which an item or service is considered to be covered (or not covered). NCDs are usually issued as a program instruction. Once published in a CMS program instruction, an NCD is binding on all Medicare carriers.

LCD — LOCAL COVERAGE DETERMINATIONS

LCDs are always based on medical necessity and created by a carrier whether to cover a particular service. They only apply to the area served by the contractor who made the decision. LCDs determine as to whether the service or item is reasonable or necessary. Medicare contractors develop LCDs when there is no National Coverage Determination (NCD) or when there is a need to further define an NCD.

If an NCD or LCD does not specifically spell out the list of codes, it does not apply to the rule.


share
 

More Items in December 2014


To view more items select a month from our "Items by Month" list.

Or view documentation, coding and billing articles.

 

Poll

What is most unique about Find-A-Code. What makes us better than our competitors?

News Items by Month
February 2022- 1
September 2021- 1
June 2021- 1
February 2021- 1
2020 - View
2019 - View
2018 - View
2017 - View
2016 - View
2015 - View
2014 - View
2013 - View
2012 - View
2011 - View
2010 - View
2009 - View
2008 - View
free demo
request yours today
newsletter
free subscription
pricing
for any budget

Thank you for choosing Find-A-Code, please Sign In to remove ads.