Medicare Coverage Database (MCD) Fu Associates, Ltd. September 2004, Updated July 2006

Fu Associates, Ltd.2 Foreward This slide deck provides an overview of key concepts for the Medicare Coverage Database (MCD).

Fu Associates, Ltd.3 Table of Contents MCD Introduction General MCD Features Coverage Homepage Link Help Link Bread Crumbs AMA/ADA User Agreement MCD Tabs Overview Search Tab – General Features – View Coverage Descriptions – Reset Criteria – Document ID Search – Update Notice – Basket Search Tab – Search Criteria – Keywords – Date Criteria – CPT/HCPCS Codes – ICD-9 Codes

Fu Associates, Ltd.4 Table of Contents (cont.) Search Tab – Search Criteria – Coverage Topics – NCA/CAL Status – Geographic Area or Contractor Search Tab - Search Results Search Tab – Searches – National Coverage Only Search – Local Coverage Only Search – Combination Coverage Search Index Tab – National Coverage Indexes – Local Coverage Indexes – Index Examples Reports Tab – National Coverage Reports – Local Coverage Reports Download Tab Appendix - Full Page Views of Tab Homepages

Fu Associates, Ltd.5 MCD Introduction The Medicare Coverage Database (MCD) houses all National and Local Coverage policies and articles, including draft policies. For National Coverage, the site also includes several types of policy related documents.

Fu Associates, Ltd.6 MCD Introduction – Accessing the MCD There are several ways to access the MCD, but the two most popular ways are: Using the “Coverage Database Search” link on the Medicare Coverage Center page. Using the direct URL:

Fu Associates, Ltd.7 General MCD Features – Coverage Homepage Link On all tabs, a link is available to the Medicare Coverage Center page.

Fu Associates, Ltd.8 General MCD Features – Help Link Page-sensitive help is available on every page.

Fu Associates, Ltd.9 General MCD Features – Basket Users can view the content of their Basket from any MCD tab. The basket functionality is further described in the Search Tab section.

Fu Associates, Ltd.10 General MCD Features – Bread Crumbs Bread Crumbs appear at the top of pages to allow users to see the path that they have taken through the site. Click on a Bread Crumb link to return to that page.

Fu Associates, Ltd.11 General MCD Features – AMA/ADA User Agreement The AMA/ADA User Agreement appears once per internet session when a user first views a document that may contain CPT or CDT codes. Users must accept the agreement to view documents with CPT or CDT codes.

Fu Associates, Ltd.12 MCD Tabs There are four main tabs on the MCD. Each tab provides a unique way to access the data in the MCD. Search - Allows users to search both the National and Local Coverage Databases, using a variety of criteria. Indexes – Provides users with pre-defined lists of National and Local Coverage documents. Reports – Provides users with reports of National and Local Coverage data. Download – Allows users to download complete sets of Local Coverage policies and articles, the complete set of National Coverage Determinations, and the complete set of Public Comments for NCAs/CALs.

The Search Tab

Fu Associates, Ltd.14 Search Tab General Features – View Coverage Descriptions On the Search Tab, users may view definitions of coverage terms used in the MCD by clicking on the “View Coverage Descriptions” link at the top of the page.

Fu Associates, Ltd.15 Search Tab General Features– Reset Criteria At the top of the Search page, there is a “Reset Criteria” link that allows users to clear out previous Search Criteria and start a fresh search.

Fu Associates, Ltd.16 Search Tab General Features - Document ID Search The Document ID Search provides a very quick way to execute a search. However, the Document ID must be known. Document ID formats are as follows – – NCD: 99.1 – NCA/CAL: CAG-00999R – Article: A99999 – LMRP/LCD (final): L99999 – LMRP/LCD (draft): DL99999 Enter the Document ID number into this field

Fu Associates, Ltd.17 Search Tab General Features – Update Notice At the bottom of the Search page, a statement indicates when the MCD data was last refreshed. The note refers primarily to Local Coverage information. National Coverage information is updated “real-time” except for the National Coverage database download, which is weekly.

Fu Associates, Ltd.18 Search Tab General Features - Basket On the Search Results page, users can mark the documents that they would like to view later and save them to the basket. This feature allows users to do multiple searches and then work on reviewing their results separately. To select a document for the basket, check the box in the basket column on the results page and click on the button at the bottom of the page to add the items. The contents of the basket can also be ed to yourself or other people. (See the “ Basket to a Friend” feature.)

Fu Associates, Ltd.19 Search Tab General Features– View Basket & Basket to a Friend The view basket link appears at the top of every page so users can access the basket when necessary. Users may send documents in their basket to themselves or to a friend by using the available link at the bottom of the view Basket page. This is helpful if you would like to save your search results for later and close out your internet session in the interim.

Fu Associates, Ltd.20 Search Tab – Search Criteria A number of different search criteria options are available for both National and Local Coverage.

Fu Associates, Ltd.21 Search Tab – Search Criteria: Keywords The Keyword search allows users to search for National and Local Coverage documents containing a specific word or words. Choose the corresponding radio button if you would like to search for the keyword when it appears just in the title of the document or anywhere in the entire document. The drop down menu allows users to specify how they would like the search to work. An “Exact Phrase” search will return documents that contain only what is entered as the keyword, in the order the words were entered. (e.g., searching for “cardiac pump” will return only documents with “cardiac pump”.) An “All Words” search will return only documents that contain all the words entered, but regardless of the order in which they were entered. (e.g., searching for “cardiac pump” will return only documents that have at least once occurrence of “cardiac” and one occurrence of “pump”.) An “Any Words” search will return documents that contain any of the words entered. (e.g. if the document contains either “cardiac” or “pump” it will be returned.

Fu Associates, Ltd.22 Search Tab – Search Criteria: Keywords The Keyword selection may be optional or required depending on the types of documents being searched. If the search requires a keyword, but a user does not want to include one, they may enter a period in the keyword field to return results when a specific keyword is not chosen. (This works for entire document searches only.) For additional information on using Keyword searches, please see the Help link on the MCD Search tab.

Fu Associates, Ltd.23 Search Tab – Search Criteria: Dates Allows users to search for National and Local Coverage documents effective during a specific time period. The MCD offers three types of date searches. The default is always “currently in effect”. For additional information on using Date searches, please see the Help link on the MCD Search tab.

Fu Associates, Ltd.24 Search Tab – Search Criteria: CPT/HCPCS Codes Allows users to search for Local Coverage documents containing a specific CPT or HCPCS Code.

Fu Associates, Ltd.25 Search Tab – Search Criteria: ICD-9 Codes Allows users to search for Local Coverage documents containing a specific ICD-9 Code. click on the “code lookup” link to search for a specific code by using a keyword search. Select a code from the dropdown box, OR

Fu Associates, Ltd.26 Search Tab – Search Criteria: Coverage Topics Allows users to search for National and Local Coverage documents categorized by a specific Coverage Topic.

Fu Associates, Ltd.27 Search Tab – Search Criteria: NCA/CAL Status the user will be presented with the following search option: If either NCA or CAL is selected,

Fu Associates, Ltd.28 Search Tab - Search Criteria : Geographic Area or Contractor Allows users to search for Local Coverage documents for a specific geographic area or contractor.

Fu Associates, Ltd.29 Search Tab - Search Results The selection criteria is displayed in the header section. Use the sort menu to reorder the results. Click on the ID to view the document. After a user submits their search criteria, the results display on a new page. Select item to add to basket.

Fu Associates, Ltd.30 Search Tab – National Coverage Only Search If only National Coverage is selected, THEN the following OPTIONAL criteria will appear:

Fu Associates, Ltd.31 Search Tab – Local Coverage Only Search If only Local Coverage is selected, the following search criteria will appear: Please note – All search criteria is required if only Local Coverage is selected. THEN

Fu Associates, Ltd.32 Search Tab – Combination Coverage Search If BOTH Local and National Coverage are selected, THEN this search criteria will appear:

The Indexes Tab

Fu Associates, Ltd.34 Indexes Tab The lists will let you drill down to view individual documents. Indexes are available for National Coverage documents, Local Coverage documents and Local Coverage contacts.

Fu Associates, Ltd.35 National Coverage Indexes National Coverage Analyses (NCAs) – Open – Closed – Open for Public Comment – View Public Comments Coding Analyses for Labs (CALs) – Open – Closed – Open for Public Comment – View Public Comments National Coverage Determinations (NCDs) – Alphabetical Listing – List by Chapter/Section – Labs Meetings & Assessments – Medicare Coverage Advisory Committee (MCAC) Meetings – Technology Assessments

Fu Associates, Ltd.36 Local Coverage Indexes List of Articles By Contractor By State Alphabetically List of LMRPs/LCDs By Contractor By State Alphabetically

Fu Associates, Ltd.37 Local Coverage Contacts Indexes List of Medical Director Contacts... For Part A - Fiscal Intermediary (FI) For Part B - Carrier For Rural Home Health Intermediary (RHHI) For Durable Medical Equipment (DME) List of Contractor Websites Note: This information is driven by data in the Helpful Contacts database.

Fu Associates, Ltd.38 Index Example – National Coverage: NCAs Open for Public Comment This index lists NCAs that are currently open for comment. Users are able to submit comments directly from the index. To submit a public comment, access the “Open for Public Comment” Indexes.

Fu Associates, Ltd.39 Index Example – National Coverage: Alphabetical List of NCDs Users may click on the NCD title to view the document.

Fu Associates, Ltd.40 Index Example – National Coverage: Submitting Public Comments To Submit a Public Comment from the “Open for Public Comment Index” click on the COMMENT button.

Fu Associates, Ltd.41 Index Example – National Coverage: Submitting Public Comments Enter identification information and your comment…

Fu Associates, Ltd.42 Index Example – National Coverage: Submitting Public Comments …and additional information. Click when all information is completed.

Fu Associates, Ltd.43 Index Example - Local Coverage: List of Articles By Contractor Contractors are listed alphabetically. Select a contractor’s name to access its list of policies or articles. Links to jurisdiction definitions and state abbreviations are also available.

Fu Associates, Ltd.44 Index Example - Local Coverage: List of Articles By Contractor The index displayed by default shows a list of currently in effect documents. Links are provided to access separate indexes of retired articles, articles with future effective dates, key articles, SAD Exclusion articles, and FAQ articles for that contractor.

Fu Associates, Ltd.45 Index Example - Local Coverage: List of Articles By Contractor The top of the contractor’s index will provide a total number of documents on the index. The alpha links provide a quick way to navigate to documents beginning with that letter. Users can click on an Article ID number to view the document. The index can be sorted by any column.

Fu Associates, Ltd.46 Index Example - Local Coverage: List of Articles By Contractor Key articles will be identified in the index by a key icon.

Fu Associates, Ltd.47 Index Example - Local Coverage: List of Draft LCDs by Contractor The index displayed by default shows only a list of currently in effect documents. Links are provided to access separate indexes of retired policies, policies with future effective dates, and draft policies for that contractor. To see draft policies, click the draft link.

Fu Associates, Ltd.48 Index Example - Local Coverage: List of Draft LCDs by Contractor To return to the list of currently in effect policies, click the Active Documents link.

The Reports Tab

Fu Associates, Ltd.50 Reports Tab Various reports are available for National and Local Coverage.

Fu Associates, Ltd.51 National Coverage Reports What’s New List of NCA, CAL, MCAC, TA, NCD, and Medicare Coverage Document postings for the last 90 days. Annual Reports List of NCDs, NCAs and/or CALs by year.

Fu Associates, Ltd.52 Local Coverage Reports LMRP/LCD Status Report – Use this report to view the statuses of a contractor's LMRPs/LCDs. Draft LCD Status Report – Use this report to view the statuses of a contractor's Draft LCDs. LMRP/LCD Service Indication Report – Use this report to find LMRPs/LCDs that allow a particular service for a particular diagnosis. Articles Status Report – Use this report to view the statuses of a contractor's Articles. SAD Exclusion List Report – List of drugs determined by the contractor to be usually self-administered and, therefore, excluded from Medicare coverage by law. What's New Report – Use this report to view all Local Coverage documents that were changed for a specified database update.

The Downloads Tab

Fu Associates, Ltd.54 Downloads Tab Articles, LMRPs/LCDs, NCDs, and Public Comments for NCAs/CALs can be downloaded. A Microsoft Access 2000 database file is what will be downloaded. The download is not intended for casual users of the MCD. It is intended for heavy users such as health policy researchers. Select a database and click the download button.

Appendix

Fu Associates, Ltd.56 Appendix – Full Page Views of Tab Homepages MCD Search Tab Homepage MCD Indexes Tab Homepage MCD Reports Tab Homepage MCD Download Tab Homepage

Fu Associates, Ltd.57 MCD “Search” Tab Homepage

Fu Associates, Ltd.58 MCD “Indexes” Tab Homepage

Fu Associates, Ltd.59 MCD “Reports” Tab Homepage

Fu Associates, Ltd.60 MCD “Downloads” Tab Homepage