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NCDs & LCDs: How to Use Them to Get Paid

About this program

Has your practice received a denial for medical necessity? Do you know what local coverage determinations (LCDs) are and how to access them? The Benefits Improvement and Protection Act (BIPA) defined an LCD as a decision by a fiscal intermediary or carrier whether to cover a particular service. Medicare contractors develop LCDs when there is no National Coverage Determination (NCD) to ensure that services being paid for by Medicare are medically necessary, or if there is a need to clarify an existing NCD.

Do you know where to check for LCDs and medical policies before you submit a claim? Have your appeals been denied because you failed to follow the insurance carrier's guidelines? Attend this session to learn about the impact of LCDs and how to find the carrier's medical policies. Learn how to include applicable LCDs and medical policies in an appeal and how to request a revision to an active LCD; the entire LCD or any part of it is subject to reconsideration.

Educate yourself and your providers and stay involved in safeguarding their reimbursement.