An LCD is a decision by a Medicare Contractor whether to cover a particular service on a contractor-wide basis in accordance with Section 1862(a)(1)(A) of the Social Security Act (i.e., a determination as to whether the service is reasonable and necessary). For a complete overview of LCDs, please go to the CMS Program Integrity Manual (PUB 100-08), Chapter 13 . LCDs can be accessed from the table below or from the Medicare Coverage Database (MCD) . Retired LCDs will remain on the MCD for 90 days, and superseded versions of active LCDs will remain on the MCD for one year. After these timeframes, these documents can be accessed from the MCD Archive.
An Article is a tool to communicate certain information (e.g. billing, coding, etc.) to providers. Articles may include any newly developed educational materials, coding instructions or clarification of existing medical review related billing or claims policy. For a complete overview of Articles, please go to the CMS Program Integrity Manual (PUB 100-08), Chapter 3, Section 3.3 . Articles can be accessed from the table below or from the MCD . Retired Articles will remain on the MCD for 90 days, and superseded versions of active Articles will remain on the MCD for one year. After these timeframes, these documents can be accessed from the MCD Archive.
Please Note: The following issues have been identified with the MCD .
Currently, when MCD users choose to print an LCD or Article by selecting the ‘Print Record’ button and the ‘Print this Page’ button from within the document, the complete document does not print. The printing issue is specific to those using Internet Explorer as their Browser Type. As an alternative, you can use a different Browser Type (i.e. Firefox) or use the ‘Need a PDF’ function and then print using Internet Explorer.
The archived versions of LCDs and Articles accessed from the link to the ‘MCD Archive Site’ that is located at the bottom of an active document are not displaying correctly. The correct archived documents can be accessed at ‘MCD Archive Site’.
The CMS MCD support team is working towards a resolution to these issues; however, there is no estimated time for a fix. Cahaba GBA does not manage the CMS MCD.
| States | MAC-A Coverage Databases | Previous FI Contractors | |||
|---|---|---|---|---|---|
| AL | LCDs | Status of Draft LCDs |
Articles | Retired LCDs | Retired Articles |
| GA | LCDs | Status of Draft LCDs |
Articles | Retired LCDs | Retired Articles |
| TN | LCDs | Status of Draft LCDs |
Articles | Retired LCDs | Retired Articles |
Draft LCDs
When a new or revised LCD requires comment and notice, Cahaba GBA will provide a minimum comment period of 45 calendar days on the DRAFT LCD. Instructions regarding comment submissions can be found on our LCD Comment and Reconsideration page. Cahaba GBA considers all comments and revises the LCD as needed.
Once finalized, the comments and responses will be compiled into a document which will be accessible within the Final Draft LCD under the “Related Documents” section.
Cahaba GBA shall provide a minimum NOTICE period of 45 calendar days on the Final Draft LCD.
The status of a Draft LCD (denoted by the prefix ‘DL’ in the ID number), can be checked by selecting the appropriate option in the table above.
Medicare’s National Coverage Determinations (NCDs) can be found at National Coverage Database .
For the latest information regarding changes to LCDs please join our list serve and frequent our “Calendar of Events” page where LCD event notices are posted. Also, information regarding revisions or updates to LCDs is posted on Cahaba’s What’s New page.
Page last updated:
December 5, 2011