The Center for Medicare and Medicaid Services (CMS) has different methods of sharing and publishing its policies and guidelines.  Two of those methods are National Coverage Determinations (NCD), and Local Coverage Determinations(LCD).  The Medicare Carrier system is divided into geographical areas in which different carriers are contracted to adjudicate claims for Medicare Part A and B patients.  NCD’s are National Coverage Determinations that give direction on billing and coding for certain procedures that apply to all providers in any geographical area.  There is also a spreadsheet which for each NCD that describes the payable ICD-10-CM codes for the procedures in the policy, if applicable, along with other information needed for correct claims submission.  In the absence of an NCD, a Local Coverage Determination, or LCD, may be created by a particular Medicare carrier for Part A or B benefits on a particular or group of procedures and/or services.  The NCD would only apply to those states that are listed on the NCD, and cannot be applied claims for other jurisdictions.  This can complicate things as one state may cover a service or procedure for a particular reason, but the next state may not.  This webinar will show attendees how to locate the appropriate NCD’s and LCD’s for their area, and give direction on how to use the information in the policies.

Areas Covered in the Session:-

• Locating NCD’s on the Center for Medicare and Medicaid Services (CMS) website
• Utilize the information on the NCD spreadsheet to determine coverage for medical necessity
• Learn how to receive information when policies are updated
• Look up LCD’s for your state
• Dissect an LCD explaining the different pieces of information
• Discovering LCD articles that give further detailed instructions on the application of an LCD

Who Will Benefit?

• Medical offices
• Billing companies
• Insurance companies
• Consulting firms
• Consultants
• Auditors
• Compliance officer
• Physician
• PA
• Nurse
• Biller
• Coder
• Collector
• Claims representative
• Claims adjuster
• Claims processor
• Manager
• Supervisor
• Administrator
• Medical assistants
• Office staff
• Medicare specialist