Medicare Carrier Links
Medicare Carriers Links to Local Coverage Determinations & Articles
The Public Policy team has developed a state-by-state listing of Local Coverage Determinations (LCD's) and Policy Articles.
LCDs and Policy Articles contain critical information regarding coverage issues that may affect your ability to be reimbursed.
The information includes indications and limitations of coverage and/or medical necessity, ICD-9 Codes that support medical
necessity, documentation requirements, and utilization or frequency guidelines.
LCDs are formal decisions by the carrier or fiscal intermediary regarding whether to cover a particular service or whether
a service is reasonable and necessary for certain diagnoses. Before issuing an LCD, the carrier must provide a notice and
comment period to allow comment on the proposed document. A Policy Article is a less formal document used by the carrier
or fiscal intermediary to communicate information to providers. The carrier is not required to give notice or provide an
opportunity for providers to comment on Articles before being issued. Articles may articulate new coding instructions or
clarify existing claims or billing policies. (Medicare Program Integrity Manual � Chapter 13-Local Coverage Determinations
Rev. 253, 4-25-08).
The amount of guidance provided by carriers through LCDs and Articles varies widely from state to state. For example, while
some carriers have issued several documents relevant to bone density testing, others have issued nothing. LCD and Article topics
include Coding for Bone Mass Measurement, Vertebral Fracture Assessment, Bisphosphonate Drug Therapy, Use of Intravenous
Bisphosphonates, and Vitamin D Assay Testing.
Where we have identified relevant LCD's or Articles, they are listed for your review. The links take you directly to the list
of LCDs and articles for your Medicare carrier. We include the title and number of the corresponding documents as well as
specific prompts to make it easier to locate the relevant resource. If you are interested in reviewing LCDs and articles on
other topics, the link provided will give you the opportunity to view all topics listed by your carrier.
If you have any questions about these resources, contact Donna Fiorentino (dfiorentino@iscd.org).
Choose your State
|
|
