Alert: Codes are moving out of LCDs and into Billing and Coding Articles!
In response to a provision of the 21st Century Cures Act, the Centers for Medicare & Medicaid Services (CMS) revised chapter 13 of the Medicare Program Integrity Manual (PIM). This chapter describes the local coverage determinations (LCD) process. One significant change is the relocation of codes (ICD-10-CM, CPT/HCPCS, Bill Type, and Revenue) from LCDs and into local coverage Articles. The MACs were instructed to begin relocating codes process began in January 2019 and is expected to continue through January 2020.
During this transition period, codes may be found in either an LCD or an Article. However, when a particular LCD has its codes removed, the Medicare Administrative Contractor (MAC) will create a Billing and Coding Article which will contain the codes. The LCD and the Billing and Coding Article are companion documents. They will be related to each other, and MCD users can see the relationship and access the related document by navigating to the "Related Local Coverage Documents" section in either the LCD or Article.
More information on the changes made to PIM Chapter 13 and the LCD process can be found here: https://www.cms.gov/newsroom/fact-sheets/summary-significant-changes-medicare-program-integrity-manual-chapter-13-local-coverage
Last Updated: 2019-10-07
Please Note: For DME MACs only, CPT/HCPCS codes will remain located in LCDs. All other Codes will move to Articles for DME MACs, and Codes (CPT/HCPCS, ICD-10, Bill Type, and Revenue) will move for all other MAC types.