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Local Coverage Determinations

Local coverage determinations (LCDS) are defined in Section 1869(f)(2)(B) of the Social Security Act (the Act). This section states: “For purposes of this section, the term ‘local coverage determination' means a determination by a fiscal intermediary or a carrier under part A or part B, as applicable, respecting whether or not a particular item or service is covered on an intermediary- or carrier-wide basis under such parts, in accordance with section 1862(a)(1)(A).”

As a result of the Benefits Improvement and Protection Act of 2000 (BIPA 2000), all Local Medical Review Policies (LMRPs) were converted to LCDs. The difference between LCDs and previously written LMRPs is that LCDs contain only reasonable and necessary conditions of coverage as allowed under section 1862(a)(1)(A) of the Act. LMRPs may have also contained other information such as coding and payment guidelines. Coding and payment information that is not related to section 1862(a)(1)(A) is not contained in an LCD, Contractors communicate such information in related articles.


 

Medicare Administrative Contractor (MAC) ICD-10 Policy

Inquiry Contact Information

Please use the mailboxes below to send your ICD 10 coding questions and any concerns or questions you may have related to the translation of ICD 9 to ICD 10 local policy determinations and articles. 

Contractor Name Jurisdiction Mailbox

Palmetto (A/B MAC)

M

ICD10.Policy@PalmettoGBA.com

NGS (A/B MAC)

6 & K

ICD-10-CMMPUdepartment@anthem.com

Novitas (A/B MAC)

L

vicki.kurland@novitas-solutions.com

Novitas (A/B MAC)

H

patricia.reidenbach@novitas-solutions.com

Noridian (A/B MAC)

E & F

medicalpolicy@noridian.com

Cahaba (A/B MAC)

10

cmd@cahabagba.com

CGS (A/B MAC)

15

cmd.inquiry@cgsadmin.com

FCSO (A/B MAC)

N

medical.policy@fcso.com

WPS (A/B MAC)

5 & 8

policycomments@wpsic.com

     

NHIC (DME MAC)

A

Outreach-Education@hp.com

NGS (DME MAC)

B

DMETraining@anthem.com

CGS (DME MAC)

C

Call CSR line: 1.866.270.4909

Noridian (DME MAC)

D

policydmedraft@noridian.com