Have you heard about LCDs and NCDs? Well, if you order or provide services to Medicare patients, you do need to know what they are and how to find them LCDs or Local Coverage Determinations (formerly known as local medical review policies) govern coverage, coding and documentation guidelines for certain services rendered only in a certain geographic area covered by a Part B Carrier - such as Empire Medicare Services in New Jersey and New York .
There is a distinct process to create new LCDs or to modify existing ones That process primarily involves the Carrier Advisory Committee (or CAC) as a formal mechanism for physicians to be informed of, and participate in, the development of local policy in an advisory capacity.
New and revised LCDs are first presented in draft form for comment, then in a notice period to the community before they become final It's also possible to ask for a reconsideration of an existing LCD through a formal reconsideration process All LCDs, in their various stages, are easily found on Empire Medicare Services web site by clicking onto Part B New Jersey or New York and then onto Local Coverage Determinations (Empire Local Policies).
You'll be able to search for an LCD by CPT code or by the category of service and you will find final policies, draft policies, archived or retired policies as well as those currently in the notice period. You will also find the reconsideration process and will be offered the opportunity to subscribe to our electronic mailing list so changes in final LCDs or new LCDs are automatically sent to you by e-mail Finally, you'll be able to click onto NCDs on this page of our site.
NCDs are National Coverage Determinations which apply to Medicare Part B in ANY geographic location in the country and are determined by the Centers for Medicare and Medicaid Services or CMS When you click onto NCDs or National Coverage Topics on our site, you will be automatically linked to the CMS site for the full text of the national policy.
So remember, it's really imperative to see if there is an LCD or NCD for any service you perform or order for a Medicare patient And, it's also important to keep up with any revisions or changes to those LCDs or NCDs Even if you don't have Internet access, you may obtain our final LCDs by fax by using our Fax-on-Demand telephone number.
Thank you for your interest in the Medicare Program and in Empire Medicare Services and watch for future video clips introducing other topics!