Local Coverage Determinations

Local Coverage Determinations

This is  a setting that will check your claims entry against the Medicare determinations. Here is the definition from the CMS.gov website:

Medicare coverage is limited to items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). National coverage determinations (NCDs) are made through an evidence-based process, with opportunities for public participation. In some cases, CMS' own research is supplemented by an outside technology assessment and/or consultation with the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC). In the absence of a national coverage policy, an item or service may be covered at the discretion of the Medicare contractors based on a local coverage determination (LCD).

http://www.cms.gov/Medicare/Coverage/DeterminationProcess/index.html

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