Consolidation of Part A and Part B Local Coverage Determinations (LCDs)
Cahaba is in the process of consolidating Part A (Fiscal Intermediary) and Part B (Carrier) LCDs that are currently in common. This consolidation will include:
- Standardizing titles into categories (i.e. Drugs and Biologicals, Pathology and Laboratory, Medicine, Radiology, Surgery);
- Clarifying and numbering the bullet points under the ‘Indications and Limitations’ and ‘Documentation Requirements’ sections;
- Clarifying and revising the ‘Utilization Guidelines’ section; and
- Expanding the list of ‘ICD-9 Codes that Support Medical Necessity’
In most cases, coverage will be either liberalized or unchanged as a result
of the consolidation. In these circumstances, the LCD will not require
a comment and notice period. In cases where coverage will be restricted,
the LCD will be presented in an Intermediary Advisory Committee (IAC)
meeting and will undergo a comment and notice process.
Part A and Part B LCDs which are not in common will also be converted to
the same standardized title format
Cahaba will provide updated information to providers as the consolidation process continues.
Page last updated: April 29, 2008
