Self Service Tips

Locating Local Coverage Determinations


Locating Local Coverage Determinations

All ICD-9 and ICD-10 Local Coverage Determinations (LCDs) are now available in table format within the Medical Policy Center section on our website (Medical Policy & Review > Medical Policy Center). Once you are in the applicable LCD table, you can search by a key term, LCD Number (L number), Healthcare Common Procedure Coding System (HCPCS) codes, or current procedural terminology (CPT) codes by using the CTRL+F function!  In addition, all links to LCDs now provide direct access to the actual LCD from the Centers for Medicare & Medicaid Services (CMS) Medicare Coverage Database. This will ensure that you always have access to the current version of the LCD!
Make the Most of Your Call

To make the most of your call be sure you have all of your information together when calling. Required information includes National Provider Identifier (NPI), Provider Transaction Access Number (PTAN), the last five digits if the Tax ID Number (TIN). If your call is claim- specific you will also need the patient’s Health Insurance Claim (HIC) number, their first name (or initial) and last name, date of birth, date of service, and denial reason.

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