Tips to Find Local Coverage Determinations and Billing and Coding Instructions (REVISED 4/6/2022)
We often receive suggestions through our website surveys to make it easier to find LCDs and the associated Billing and Coding articles.
All available LCDs and associated Billing and Coding Articles are accessible from the NGS website, under the Medical Policy Center. The LCD and article indices provide a link for each document to the CMS MCD, where the official versions of these coverage documents are housed.
Please note: There are many procedures for which NGS does not have an LCD/Billing and Coding Article. If your search does not return any coverage documents, then NGS does not have a local coverage statement for that procedure.
This is an example from the index:
|LCD||LCD #||Billing and Coding #||Response to Comments||Related CPT/HCPCS Codes|
|Autonomic Function Testing
Related terms: tilt table, sudomotor
|L36236||A57024||A54403||95921, 95922, 95923, 95924, 95943|
|Biomarker Testing (Prior to Initial Biopsy) for Prostate Cancer Diagnosis
Related terms: N/A
|L37733||A56609||A56742||81539, 84153, 84154, 86316, 81479, 0005U|
To Find an LCD:
- Access the LCD Index
- You may scroll through the list (in alphabetical order by title), or search the list using the title, LCD or article number, or CPT/HCPCS code by doing the following
- Select ‘Ctrl’ and the letter ‘F’ on your keyboard to open a ‘Find on this page’ search box.
- Type in your search term, and ‘enter’
- (Safari [iPhone and iPad] Users instead tap then tab ‘Find on Page,ʼ type your search term and tap )
- Select the applicable link to open the LCD, Billing and Coding Article or Response to Comments from Medicare Coverage Database where the official documents are housed.
- CMS Internet-Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Local Coverage Determinations
- CMS IOM, Publication 100-03, Medicare National Coverage Determinations (NCD) Manual
- MLN Matters® MM10901 Revised: Local Coverage Determinations (LCDs)
- MLN Matters® SE1421 Revised: How to Access Updates to ICD-10 Local Coverage Determinations in the CMS Medicare Coverage Database