LCD Local coverage determination - PowerPoint PPT Presentation

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LCD Local coverage determination

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  1. LCD Local coverage determination

  2. LCD or Medical Policy

  3. The rules by which a chart is judged during a Medicare audit

  4. LCDs Medicare Part B, Active Google: “(carrier name) Part B LCDs”

  5. Download: Current, Retired, & Articles Print, keep in binder Download NCDs too

  6. Nordian:(active Sep 2013) NonCovered Service Gonioscopy (ret.) Botulinum Blepharoplasty (ret.) YAG for 2°Cataract (ret.) EO & Fundus Photo (ret.) Skin Lesion Topography (ret.) Ophthal. Services (ret.) Scanning Image (OCT) (ret.) Pachymetry(ret.) VF (ret.)

  7. CGS:(active Sep 2013) Blepharoplasty Punctum Dilate-Probe Botulinum Photo, External YAG for 2°Cataract Biometry for IOL Cataract Surgery EO & Fundus Photo Category 3 CPTs Skin Lesion Topography Scanning Image (OCT) Pachymetry VF

  8. WPS:(active Sep 2013) Blepharoplasty Low Vision Botulinum VF Implant Telescope (ret.) Biometry for IOL (ret.) Cataract Surgery(ret.) EO & Fundus Photo (ret.) Category 3 CPTs Skin Lesion Topography (ret.) Scanning Image (OCT) Pachymetry(ret.)

  9. Novitas:(active Sep 2013) Blepharoplasty A & B Scan CoManage Surgery VF E/M in SNF Vision Rehab Cataract Surgery EO Biometry for IOL Skin Lesion Not Reasnble & Necssry Scanning Image (OCT) Fundus Photo

  10. Palmetto:(active Sep 2013) Blepharoplasty Category 3 CPTs Cataract Surgery EO & Fundus Photo Skin Lesion Pachymetry

  11. DME:(active Sep 2013) Refractive Lenses Google: “(carrier name) DME LCD refractive lenses”

  12. Provides Limitations on frequency, Indications - medical conditions that are covered,

  13. Provides Documentation Requirements - what must be in chart notes, ICDs which will show medical necessity

  14. Not necessarily good Can change or retire any time

  15. Retired policies can be useful if no other guide can be found

  16. NCDs Medicare National Coverage Determinations Google “Medicare NCDs”

  17. GLAUCOMA file://localhost/Users/alanhomestead/Documents/My Documents B 3-8-13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Topic Modules/Glaucoma/Glc Aug 13.ppt