Question:

What are LCDs in regard to laboratory services?

Answer:

Understand that like NCDs, there may be local policies that affect the billing of certain laboratory procedures. The local policies—local coverage determinations (LCDs) —set forth whether your regional Medicare contractor will cover, or not cover, specific services, procedures, or technologies on a local basis. CMS requires that local policies be consistent with national guidance (although they can be more detailed or specific), and developed with scientific evidence and clinical practice. Like the NCD, the LCD format consists of only “reasonable and necessary” information. Since the LCD format does not address coding guidelines or Medicare’s benefit categories and statutory exclusions, you will need to access additional resources in order to find all of the coverage information needed to assure compliant billing of services provided by your laboratory.

This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

This question was answered in our Interventional Radiology Coder. For more hot topics relating to interventional radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.

Facebook
Twitter
LinkedIn
Email
Print

CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.