Medicare Compliance & Reimbursement - 2015 Issue 12
Reader Question: Consult NCDs and LCDs Both
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Article Overview
This article explains the relationship between Medicare national and local coverage guidance and highlights why providers and billers should review both sources when evaluating coverage for a service. It is a general educational piece for clinicians, coders, compliance staff, and revenue cycle personnel who work with Medicare policy research. The article also points readers to Medicare coverage resources and related policy materials maintained by CMS.
Why This Topic Matters
Medicare coverage policy can be issued at both national and local levels, so understanding where guidance comes from helps organizations verify coverage research, avoid missed policy requirements, and locate the appropriate CMS reference materials.
What You Will Learn
- How Medicare national and local coverage guidance differ at a high level
- Why both national and local policy sources may be relevant for a service
- What types of Medicare coverage resources CMS maintains
- How Medicare policy development may involve local contractors and CMS review processes
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Revenue cycle teams
- Clinicians serving Medicare beneficiaries
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