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New Look and Process for CMS Local Coverage Determination (LCDs)

Wed, July 31, 2019 1:59 PM | Babette Grey (Administrator)

Changes to National Government Services Local Coverage Determination Process

In accordance with Section 4009 of H.R. 34-21st Century Cures Act (Public Law No: 114-255), CMS is updating the “Medicare Program Integrity Manual” with detailed changes to the LCD process.

  • All coding information, will be removed from the LCDs and placed in a related billing and coding article, including national coverage provisions, and associated information (documentation requirements, utilization guidelines).
  • The article name will begin with “Billing and Coding,” followed by the title of the associated LCD.
  • Bill types, revenue codes, CPT/HCPCS codes, ICD-10 codes, as well as any coding guidance or mention of codes in the LCD will now be found in the associated billing and coding article.
  • Several LCDs will be revised for 8/1/2019 publication. The remaining LCDs will be revised in the coming months, with all completed by 1/1/2020.
  • Billing and coding articles will be listed on the Medical Policy Center page alongside the related LCD.


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