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Published byChester Wilson Modified over 8 years ago
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LCD or Medical Policy 2
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The rules by which a chart is judged during a Medicare audit 3
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LCDs Medicare Part B, Active Google: “(carrier name) Part B LCDs” 4
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Download: Current, Retired, & Articles Print, keep in binder Download NCDs too 5
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Nordian: (active Sep 2013) NonCovered ServiceGonioscopy (ret.) BotulinumBlepharoplasty (ret.) YAG for 2°Cataract (ret.) EO & Fundus Photo (ret.) Skin LesionTopography (ret.) Ophthal. Services (ret.) Scanning Image (OCT) (ret.) Pachymetry (ret.) VF (ret.) 6
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CGS: (active Sep 2013) BlepharoplastyPunctum Dilate-Probe BotulinumPhoto, External YAG for 2°CataractBiometry for IOL Cataract SurgeryEO & Fundus Photo Category 3 CPTsSkin Lesion TopographyScanning Image (OCT) PachymetryVF 7
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WPS: (active Sep 2013) BlepharoplastyLow Vision BotulinumVF Implant Telescope (ret.) Biometry for IOL (ret.) Cataract Surgery (ret.) EO & Fundus Photo (ret.) Category 3 CPTsSkin Lesion Topography (ret.) Scanning Image (OCT) Pachymetry (ret.) 8
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Novitas: (active Sep 2013) BlepharoplastyA & B Scan CoManage SurgeryVF E/M in SNFVision Rehab Cataract SurgeryEO Biometry for IOLSkin Lesion Not Reasnble & NecssryScanning Image (OCT) Fundus Photo 9
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Palmetto: (active Sep 2013) Blepharoplasty Category 3 CPTs Cataract Surgery EO & Fundus Photo Skin Lesion Pachymetry 10
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DME: (active Sep 2013) Refractive Lenses Google: “(carrier name) DME LCD refractive lenses” 11
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Provides Limitations on frequency, Indications - medical conditions that are covered, 12
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Provides Documentation Requirements - what must be in chart notes, ICDs which will show medical necessity 13
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Not necessarily good Can change or retire any time 14
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Retired policies can be useful if no other guide can be found 15
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NCDs Medicare National Coverage Determinations Google “Medicare NCDs” 16
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GLAUCOMA file://localhost/Users/alanhomestead/Doc uments/My Documents B 3-8- 13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Topic Modules/Glaucoma/Glc Aug 13.ppt 17
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