How to Search for a Medicare LCD
Medicare Local Coverage Determinations (or Medicare LCD) are categorized by the medical procedures and diagnoses or covered conditions of the patient.
Before you use the Medicare Coverage Database, It is a good idea to know the medical code that is relevant for your search first. The Current Procedural Terminology (or CPT code which is copyright (c) American Medical Association) listings are provided with descriptions from the American Medical Association descriptions. If you are searching for a Durable Medical Equipment (DME) or ambulance service, for example, you will need to know the The Healthcare Common procedure Coding System (HCPCS) medical billing code. LCDs are organized with “L” code unique numbers.
The LCD Title “Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases” has an LCD number which is: LCD ID L37606
You should also be aware of which Medicare Administrative Contractor authored the LCD and what region of the country or jurisdiction it applies to. Furthermore, you should understand the effective date, retired date and whether the Local Coverage Determination is a Draft.
These are now organized as:
Searching for a Medicare Local Coverage Determination Article
Medicare LCDs have been re-organized to some extent, although the work is ongoing. Some of the coverage determination information such as medical coding guidelines and covered conditions may be contained in an LCD associated article which will be delineated with an “A” code.
For example: “Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile NEXT GENERATION SEQUENCING Testing in Cancer” has an Article ID of A54901