1. Medicare Coverage Database (MCD)
CMS Website
Last updated January 27, 2011

2. Foreword
This slide deck provides an overview of key concepts for the Medicare Coverage Database (MCD), which is located at
MCD vs. Medicare.gov - The MCD is intended for use by Medicare contractors, providers, and other healthcare industry professionals. People with Medicare, family members, and caregivers should visit the official U.S. Government site for people with Medicare, for the latest information on Medicare enrollment, benefits, and other helpful tools.

3. MCD Introduction – Accessing the MCD
There are several ways to access the MCD, but the two most direct ways are:
Using the direct URL:
Using the “Medicare Coverage Database” link on the Medicare Coverage – General Information page.

4. MCD Introduction – General Information
The Medicare Coverage Database (MCD) is a searchable database.
The MCD contains National and Local Coverage documents.
The MCD offers multiple options to locate the documents.
The MCD provides two types of help. 4

5. MCD Introduction – Document Types in the MCD
The specific document types contained in the database are:
National Coverage Documents
National Coverage Determinations (NCD)
National Coverage Analyses (NCA)
Coding Analyses for Labs (CAL)
Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) Meetings
Technology Assessments (TA)
Claims Processing Instructions (CPI)
Medicare Coverage Documents (e.g. Guidance Documents, Compendia, etc.)
Public comments related to certain NCAs, CALs, and Medicare Coverage Documents.
Local Coverage Documents
Local Coverage Determinations (LCD)
Articles
Note: The CPI document type is not searchable. It can only be viewed via a NCD.

6. MCD Introduction – MCD Functions
The MCD offers multiple ways to locate and view the data:
SEARCH – Allows users to search both National and Local Coverage document sets using a variety of criteria such as geographic area, keywords, effective dates, procedure and diagnosis codes, etc.
INDEXES – Provides users with pre-defined lists of National and Local Coverage Documents
REPORTS - Provide users with reports of National and Local Coverage data.
DOWNLOADS - For National Coverage, users can download the complete set of NCDs, as well as public comments received by CMS for NCAs and CALs. For Local Coverage, complete sets of LCDs and articles are available. The downloads are refreshed weekly.
BASKET – Allows users to save desired documents into a basket they can then to themselves or others for future reference.

7. General MCD Features

8. General MCD Features – Site Navigation
Top Navigation Bar – The top of the page contains a navigation bar that allows users to easily move between different sections within the application. The orange color indicates the active section. In this example, the user would be on the Overview page.
Breadcrumbs – The site includes “breadcrumbs” at the top of each page. These identify the user’s location on the site relative to prior pages.
Keyboard shortcuts – Use “Hot keys" to perform actions using keyboard shortcuts instead of clicking on a button. The actions are performed by holding the "Alt" key, then pressing one additional key.
JavaScript - JavaScript must be turned on while using this site.

9. General MCD Features – Site Navigation
Access Key
MCD website B
Breadcrumb (link) I
Print Selected, Print Record, Print on Help pages and Print on pop-up pages (button) K
Select All (button) N
Submit (button) U
Reset Selection Criteria/reset Form (link) X
Close Window (button)
Keyboard shortcuts – Use “Hot keys" to perform actions using keyboard shortcuts instead of clicking on a button. The actions are performed by holding the "Alt" key, then pressing one additional key, the Access Key.

10. General MCD Features – Help for the MCD
The MCD offers both page sensitive help and contextual help throughout the MCD application. The links are located in the top navigation bar.
Page Help can be used to retrieve page sensitive help that offers information for that particular module by selecting the “Page Help” link in the top navigation bar.
Contextual Help can be turned on by the user in the top navigation bar by selecting the “Contextual Help is Off” link. The name link will change to “Contextual Help is On” indicating the contextual help is on. Help specific to a section on the current page is provided when the user hovers over a section of the page. Contextual help is turned off by selecting the “Contextual Help is On” link in the top navigation bar.

11. General MCD Features – AMA/ADA User Agreement
The AMA/ADA User Agreement appears once per internet session. The first time you view a document that may contain CPT or CDT codes the AMA/ADA User Agreement will appear.
You must accept the agreement to view documents with CPT or CDT codes. 11

12. General MCD Features – Frequency of Updates
All National Coverage documents are updated in “real time” on the site.
Local Coverage data (LCDs and Articles) are updated weekly, usually on Thursdays. Because the database is a snapshot in time, a statement is included on the Overview, Advanced Search, and the Downloads page to indicate when the data was last refreshed.

13. Overview

14. Overview – General Information
The Overview page provides general information about the application, including a description of the available data and the various methods of accessing the data, and information on the following topics:
Quick Search
MCD vs. Medicare.gov
Frequency of MCD data updates
MCD Archive
Related Links

15. Overview – Quick Search
Quick Search – The Quick Search allows the user to locate document(s) currently in effect by providing the Document ID or by selecting the Document Type and other criteria . Matching results are displayed in a list format; click on individual document titles to view the full document. Additionally, documents can be added to the basket to be viewed later in the session or sent by .

16. Overview – Search by Document ID
If the user knows the ID number of the document they want to retrieve, they can use the ID Search box that appears at the top of the Quick Search and the Advanced Search. When performing an ID Search, the entire ID must be specified, including any letters or dashes. The following are examples of IDs for each type of document:
Search by Document from the Quick Search on the Overview Page
NCD: 99.1
NCA or CAL: CAG-00999R
LCD (final): L99999
Draft LCD: DL99999
Article: A99999
Search by Document from the Quick Search on the Overview Page
Note – MEDCACs, Technology Assessments, and Medicare Coverage Documents, cannot be searched via the ID Search, they can only be searched using the other two methods. 16

17. Overview – Quick Search by Document Type
The Quick Search allows the user to locate document(s) currently in effect by selecting the Document Type and other criteria .
Document Type - The user can select to search for both National and Local Coverage documents, or to search for National only, or Local only. Users check the radio buttons for the type of documents they are interested in.
Geographic Area/Region - If the Type of Document includes “Local Coverage”, users must indicate the Geographic Area to search within. This select list includes “All States”, or the user can select one or multiple individual states/territories to search. Additionally, the CMS Regions can be selected.
Keyword (s)- The Quick Search allows users to search document titles for a specific word or words. This is required unless users choose to search for a CPT/HCPCS code instead. Keyword searches are NOT case sensitive. Users can enter the keyword search using upper case, lower case, or mixed case and it will retrieve matching keywords ignoring the case.
CPT/HCPCS Code - If the search includes Local Coverage, the user can search by CPT/HCPCS code. If the user selects a National and Local Coverage search, only the Local Coverage documents will be checked for matching CPT/HCPCS codes. CPT/HCPCS code will not be allowed for National Coverage Only searches.

18. Overview – MCD Archive
MCD Archive – The Overview page includes a link to the MCD Archive. The MCD Archive includes Local Coverage documents, or document versions, that have been retired for greater than 2 years (i.e., an Ending Date or Revision Ending Date older than 2 years.) The Archive site includes LMRPs, LCDs, Draft LCDs, and Articles.

19. Overview – Related Links
Related Links – The Overview page includes helpful links to sites with Medicare Coverage information.

20. Advanced Search

21. Advanced Search – General Information
The Advanced Search function provides a variety of selection criteria beyond the Quick Search for searching the database for specific content. The Advanced Search function is divided into several steps. The steps can vary depending on the criteria selected. Note that when multiple criteria are entered, only records meeting ALL criteria are returned. Matching results are displayed in a list format; click on individual document titles to view the full document. Additionally, documents can be added to the basket to be viewed later in the session or sent by .
There are two search types that can be performed: Document ID search and Advanced search.
Please be aware, in some cases users may find the MCD Indexes or the MCD Reports as a quicker or better way to locate documents of interest. Both of these functions are discussed elsewhere in this presentation.

22. Advanced Search – Document Type Search
Users can run advanced searches for National Coverage only, Local Coverage only, or both National and Local Coverage documents. Users check the radio buttons for the type of documents they are interested in.
Note – The document types selected in this step will cause variations in the selection criteria that appear to complete the search.

23. Advanced Search – Document Type
Once National Coverage, Local Coverage, or both is indicated there will be options for specific types of documents. Users can check the boxes for any specific document types they want included in the search. An empty checkbox means the system will NOT return results for that document type. The document types selected in this step will cause variations in the selection criteria that appear to complete the search. Draft LCDs are not selected by default. However, they may be added to the search criteria by selecting the corresponding checkbox.
Note – Clicking on “View Coverage Descriptions” will provide information on coverage descriptions for the National and Local Coverage documents.

24. Advanced Search – Geographic Area and Contractor Criteria
An Advanced Search including Local Coverage Documents requires the user to select a Geographic Area and/or specific contractor information, either Contractor Type or Contractor Name. If both Geographic Area and Contractor Type or Name are selected, the system will only return results that match both criteria.

25. Advanced Search – Geographic Area and Contractor Criteria
The user can select “All States” from the list or single or multiple states/territories. To select multiple locations the user can hold down the “Ctrl” key and select locations with the mouse or the user can hold down the “Shift” and select locations with the down arrow on the keyboard.
When selecting a state that has been split into multiple regions (such as California, Missouri, and New York), click the “View county listing for split states” link to see the counties that make up each region to determine which region is applicable.

26. Advanced Search – Geographic Area and Contractor
Contractor selections
Select the radio button for Contractor Type or Contractor Name to determine which criteria will be searched.
Contractor Type: To select multiple Contractor Types, the user can hold down the “Ctrl” key and select types with the mouse or the user can hold down the “Shift” and select locations with the down arrow on the keyboard.
Contractor Name: To select multiple Contractor Names, the user can hold down the “Ctrl” key and select names with the mouse or the user can hold down the “Shift” and select locations with the down arrow on the keyboard.

27. Advanced Search – Keywords
Use the Keyword search option on the Advanced Search page to search for National and Local Coverage documents containing a specific word or words. Most, but not all, fields in a document are searched in an entire document search. To see which fields are excluded, please look at the MCD Page Help link on the Advanced Search page.
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, 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.

28. Advanced Search – CPT/HCPCS Codes
Search for Local Coverage documents containing a specific CPT/HCPCS code or code range.
Select the checkbox for CPT/HCPCS. The system will display more options.
Select the bullet for a single code or code range.
For the single code enter a code in the box and for the code range enter beginning and end codes to search for a code range.

29. Advanced Search – ICD-9 Codes
Search for Local Coverage documents containing a specific ICD-9 code or code range.
Select the checkbox for ICD-9. The system will display more options.
Select the bullet for a single code or code range.
For the single code enter a code in the box and for the code range enter beginning and end codes to search for a code range.
If the code is unknown, you may click on the “Code Lookup” link to search for a specific code by using a keyword search.

30. Advanced Search – Benefit Category
Search for National Coverage documents categorized by a specific Benefit Category.
Select the checkbox for Benefit Category. The system will display more options.
Select the category from the dropdown list.

31. Advanced Search – NCA/CAL Status
If either NCA or CAL is selected, you will be presented with the following optional search criteria:

32. Advanced Search – Dates
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 MCD Page Help link on the MCD Search.

33. Search Results
After the search criteria is submitted, the results display on a new page.
The selection criteria is displayed above the search results.

34. Search Results
Use the Expand All, Collapse All, to expand or collapse the results. Use the “+” or “-” to expand or collapse the results for each document type.
Use the pagination
features to change the
number of items viewed per
page and to navigate
through the results.
Use the sorting
triangles to reorder
the results for a section.
Select item to add to the basket or to print
Click on the title to view the document.

35. Advanced Search – National Coverage Only Search
If only National Coverage is selected,
then
the following optional criteria will appear:

36. Advanced Search – Local Coverage Only Search
If only Local
Coverage is
selected,
then
the following
search criteria
will appear:

37. Advanced Search – Combination Coverage Search
If both Local and National Coverage are selected,
then
this search
Criteria
will appear:

38. Advanced Search – Execute Another Search
Use one of the following to execute another search by returning to the Advanced Search:
Click the “Back to Advanced Search” link from the breadcrumbs at the top of the page. The selection criteria from the previous search will be retained.
Click the “Modify Your Search” link. The selection criteria from the previous search will be retained.
Click the “New Search” link. The selection criteria from the previous search will not be retained.

39. Indexes

40. Indexes – General Information
The MCD Index page provides users with pre-defined lists of National Coverage documents, Local Coverage documents, and Local Coverage contacts.
The National Coverage indexes provide pre-defined lists of NCDs, NCAs, CALs, MEDCACs, Technology Assessments, and Medicare Coverage Documents.
The Local Coverage indexes are organized as follows:
LCDs By Contractor, By State and Alphabetically
Articles By Contractor, By State and Alphabetically
Contacts: Contractor websites and Medical Directors Contacts for Part A MACs, Part A FIs (Fiscal Intermediaries), Part B MACs, Part B Carriers, DME MACs (Durable Medical Equipment MAC), and RHHIs (Rural Home Health Intermediaries)

41. Indexes – National Coverage
Click the “National Coverage” link to view the National Coverage Documents Index
Please note that
indexes for National
Coverage Analysis,
Coding Analysis for
Labs, and Medicare
Coverage Documents
are dynamic and may
not display as represented.

42. Indexes – Local Coverage
Click the “Local Coverage” link to view the Local Coverage Documents and Contacts Index 42

43. Index Example – National Coverage: NCAs Open FOR Public Comment
Click the “Open FOR Public Comment” link to view NCAs that are currently open for comment

44. Index Example – National Coverage: Submitting Public Comments
To Submit a Public Comment from the “Open FOR Public Comment Index” click on the COMMENT button.

45. Index Example – National Coverage: Submitting Public Comments
Before entering a public comment:
Click on the CMS PHI Posting Policy link and read the CMS PHI Posting Policy in the pop-up box.
Check the box indicating that you have read the policy.

46. Index Example – National Coverage: Submitting Public Comments
Enter identification information, your comment and additional information then click “Submit”.

47. Index Example - Local Coverage: List of Articles By Contractor
The index displays all Articles for selected contractor(s).
Make a selection from the list of contractors and click Submit. Multiple contractors may be selected.
Links to jurisdiction definitions and state abbreviations are also available.

48. Index Example - Local Coverage: List of Articles By Contractor
Select a contractor’s name to access their list of policies or articles.

49. Index Example - Local Coverage: List of Articles By Contractor
The index displayed by default shows a list of documents currently in effect. Selection criteria 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. Note: Key, SAD Exclusion, and FAQ articles will also appear in the Currently in Effect, Future Effective, or Retired lists, as applicable.

50. Index Example - Local Coverage: List of Articles By Contractor
Key articles will be identified in the index by a key icon.
Note: A "Key Article" is designated to be the primary source of information relating to a specific topic or subject matter. On the MCD, users can search and sort using the Key Article designator.

51. Index Example - Local Coverage: List of Draft LCDs by Contractor
After choosing a contractor from the LCDs by Contractor or LCDs by State list, a list of LCDs for that contractor will be displayed. The default display shows only documents that are currently in effect. The Contractor Browser is provided to access separate indexes of retired policies, policies with future effective dates, and draft policies for that contractor.
To see draft
policies, select
the draft radio
button and click
Submit.

52. Index Example - Local Coverage: List of Draft LCDs by Contractor
To sort by a
specific column,
click on the
sorting triangles
below the
column title.
To view the draft policy, click on the title

53. Reports

54. Reports – General Information
The Reports page provides various reports for National and Local Coverage documents.
The reports available for National Coverage are:
National Coverage What’s New Report
National Coverage Annual Report
The reports available for Local Coverage are:
Local Coverage What’s New Report
Local Coverage Determination (LCD) Status Report
Draft Local Coverage Determination (LCD) Status Report
Local Coverage Determination (LCD) Last Updated Report
Local Coverage Determination (LCD) Service Indication Report
Article Status Report
Self-Administered Drug (SAD) Exclusion List Report
Note: When in each report, use the MCD Page Help link on the top navigation bar for more information on the report use and execution.

55. Reports - General Information
Click the name of the report to view it.

56. Reports Example - National Coverage: What’s New Report
The National Coverage “What’s New” report provides users the ability to view a list of NCA, CAL, MEDCAC, TA, NCD, and/or Medicare Coverage Document postings for the last 90 days.

57. Reports Example - National Coverage What’s New Report
When initially selected the report will run based on the default settings of all document types that were posted in the last week. However, the user can change the criteria and re-run the report.
Select the radio button for desired documents, select the desired timeframe from the dropdown list and click Submit.

58. Reports Example - Local Coverage: LCD Status Report
The Local Coverage “LCD Status” report provides users the ability to view the status of a contractor’s LCDs.

59. Reports Example - Local Coverage: LCD Status Report
Use the browser to select the desired criteria for the report. The user must select the year to view either annually or quarterly. The user also has the option for selecting one of the following criteria: the geographic region by CMS Region(s), geographic region by State(s), contractor criteria by contractor type, or contractor criteria by contractor name.
Click Submit to view the report.

60. Reports Example - Local Coverage: LCD Status Report
The selected criteria are displayed at the top of the report.
Click the number link in the “Revised” column to view the list of revised LCDs.

61. Reports Example - Local Coverage: LCDs Status Report
Click the Title of the LCD to view the document.
The user can select the documents to print or to save to the basket.

62. Downloads

63. Downloads
The Downloads Page of the MCD offers users the ability to download complete data sets of many of the documents found on the MCD.
The available data sets are:
Current LCDs
Current and retired LCDs
Current Articles
Current and retired Articles
NCDs/Public comments for NCAs/CALs
Helpful Hints:
Intended audience - The data sets are intended for use by industry professionals who use them for research, program-wide support, etc. The sets are quite large and require knowledge of database management software. Users looking for documents for a specific geographic area, a particular topic, etc., should consider using the other functions on the MCD, such as Indexes and Search.

64. Downloads Helpful Hints:
Data formats - The data downloads are packaged into a “zip” file. Each download includes the data in a Microsoft Access (.mdb) file, as well as a comma separated value (.csv) file, so they may be imported into a user’s database management program.
Data Dictionary – Each data download includes a data dictionary that explains the content and structure of each database.
Hardware and software requirements – The user’s computer must meet minimum standards to support the downloads. The standards are indicated on the Downloads main page.
Attachments are excluded from the downloads - On the Medicare Coverage Database, LCDs, Articles, and NCDs may include supporting “attachment” documents. These attachments are not included in the downloads. The attachments must be viewed via the MCD.
Retired LCDs and Articles – The downloads for LCD and Articles offer a “Retired” documents option. Retired documents, sometimes known as archived documents, are those that are no longer in effect and for which the contractor has indicated they are “retired”.
Historical versions are excluded from the downloads – A document may have many published versions over time. The downloads only include the most recent version of each document.

65. Basket

66. Add to Basket Function
You can add items to the basket from a list of search results
Or from the “Add to Basket” option at the top of a details page.

67. Empty Basket Function
To empty the entire basket click the “Empty Basket Button”
To remove a document from the basket, select the checkbox next to the document to be removed, check the “Remove Only Selected Documents” box at the top of the page and click on the “Empty Basket” button to remove the items.
Click on the document title to view the document.

68. Basket Function
To the entire basket click the “ Basket Button”
To a document from the basket, select the checkbox next to the document to be ed, check the “ Only Selected Documents” box at the top of the page and click on the “ Basket” button to the items.
Click on the document title to view the document.

69. Print Basket Function
To print the entire basket click the “Print Basket Button”
To print a document from the basket, select the checkbox next to the document to be printed, check the “Print Only Selected Documents” box at the top of the page and click on the “Print Basket” button to print the items.
Click on the document title to view the document.

70. Appendix

71. Appendix – Full Page Views of Homepages
MCD Overview Homepage
MCD Advanced Search Homepage
MCD Indexes Homepage
MCD Reports Homepage
MCD Download Homepage

72. MCD Overview Homepage

73. MCD Advanced Search Homepage

74. MCD Indexes Homepage

75. MCD Reports Homepage

76. MCD Downloads Homepage