NEW on Find-A-Code: National Coverage Determinations (NCDs)

Medicare limits its coverage of services to those considered reasonable and necessary for the diagnosis and treatment of an injury or illness based on coverage guidelines. National Coverage Determinations (NCDs) are created based on research, evidence-based processes, and public participation, and made available to the public. They provide a guidance related to specific services and identify whether or not they are medically necessary and covered by Medicare. Where an NCD may provide only generalities about a procedure or service, or where one does not exist, Medicare Administrative Contractors (MACs) may create and implement Local Coverage Determinations (LCDs) to provide further detail and guidance.

Although not all codes have an applicable NCD or LCD, Find-A-Code has identified those that exist and has linked them to the CPT and HCPCS codes they apply to so important coding guidance can be quickly identified.

 There are two ways in which to locate NCDs:

1. Using any Find-A-Code search method, look up a CPT or HCPCS code and scroll down to the “Medicare Policies & Guidelines (NCDs, LCDs, Articles).” Click to open the tab, which will identify the number of NCDs (5) or LCDs (2) associated with the code you searched on. Simply click on the NCD link to view the document.
2. Access to  a listing of all NCDs can be done from the home page. Hover over the Info page, under the section “Medicare Manuals and Guides,” and click on “NCDs National Coverage.” A list will appear identifying each NCD by a numerical value, which can be opened and perused at your convenience.

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• Jan 22, 2018
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• Jan 22, 2018
  Should ROM Testing be Reported with Evaluation and Management Services?

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