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

July 31, 2019 2:08 PM | Anonymous

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. These changes were communicated in CMS Transmittal 863, issued on 2/12/2019.

Please ensure your staff is aware of the LCD revisions and transition of all coding to related articles. There has been no change in coverage associated with this update.

  • 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.


Screen Clipping


Related Content

  • More details on this update are available in MLN Matters® Article MM10901.
  • For a complete listing of all LCDs, visit the Medical Policy Center

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