LCDs are created by the MAC assigned by CMS to each jurisdiction. National Government Services is the MAC for Jurisdiction 6 – Illinois, Minnesota and Wisconsin, and Jurisdiction K – Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut and New York. The MACs LCDs are applicable only in the states they support, therefore it is imperative to research LCDs through your assigned MAC website as they can differ from one jurisdiction to another. NCDs are created by CMS and apply nationally, to all jurisdictions. If CMS has created an NCD, the MAC will not create an LCD on the same topic.
CMS MCD houses the official versions of LCDs. However, you can easily (and quickly) access them via the Medical Policies/LCDs page on our website. This page offers all of the LCDs NGS has created, in alphabetic order by medical procedure. You may also search for a specific CPT/HCPCS code to see if an LCD applies to that code, or if you know the actual LCD number, you may search for it by entering it in the search function located on every page of our website.
You can search for LCDs, as well as billing and coding articles by entering the CPT/HCPCS code in the search bar on our website. The search results will display a list of everything housed on the website pertaining to that specific code, as well as relevant LCDs, if applicable. Not every service includes an LCD, however it is always a good idea to check if one exists before rendering/billing the service.
The most efficient way to remain informed is to subscribe to our email updates. Any time an LCD has changed, we will notify you via email. If you are not currently receiving our email updates, visit Subscribe for Email Updates. Another way to find out is to scroll to the bottom of each LCD, which will reflect the revision history.
Yes you may – everyone has a voice when it comes to the LCD creation/revision process. CMS' MCD offers Medical Policy Article (A52842) covering the reconsideration process for existing LCDs. This article will walk you through the process for submitting a change request.
CMS offers a search function on proposed LCDs by MAC on the MCD. You simply search for Local Coverage Proposed LCDs by contractor, in your case if you fall under J6 or JK, National Government Services. You will see a list of LCDs that we are soliciting feedback. You will also find status information, comment period dates, and release dates of proposed LCDs. Additionally, if you Subscribe for Email Updates, you will be notified when an LCD is in draft form and NGS is soliciting feedback.
Yes. All you have to do is select Medical Policies/LCDs on our website. From there, you can view all active LCDs, and related Billing and Coding articles for applicable related CPT/HCPCS codes. Also available are direct links to CMS' MCD Draft Policies, Future Effective LCDs, Future Effective Billing and Coding Articles and NCDs.
Medical Policy Articles, otherwise known as “Billing and Coding articles” coincide with LCDs. They provide additional information such as CPT/HCPCS coding, utilization guidelines, documentation requirements, diagnosis coding, and more. We strongly urge you to review both the LCD and article to ensure you are billing correctly the first time thus avoiding the appeals process.