Use the carrier advisory committee process to update LMRPs

Article Overview

This piece discusses a provider-led approach to working with a Medicare carrier advisory committee and related local policy processes when repeated denials appear inconsistent with appeal outcomes. It is relevant to coders, compliance staff, and physician practices that track local medical review policies, appeal trends, and evidence used to support coverage updates. The article focuses on the general process of building a case, presenting supporting documentation, and pursuing changes to local policy guidance.