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Last Modified: 6/18/2010
Location: FL, PR, USVI
Business: Part A, Part B
Finding FCSO LCDs and related coverage information -- how-to guide
FCSO workload numbers
MAC-Part A:
• Florida: 09101
• Puerto Rico and U.S. Virgin Islands: 09201
MAC-Part B:
• Florida: 09102
• Puerto Rico: 09202
• U.S. Virgin Islands: 09302
Table of contents
FCSO Medical Coverage page
CMS Medical Coverage Database (MCD)
FCSO Medical Coverage page
Using the FCSO Medical Coverage (Part A or Part B) page is the easiest way to locate final and draft local coverage determinations for First Coast Service Options. The following section provides a brief overview of the Search Local Coverage Determinations (LCDs) area of the Medical Coverage page.
Search Local Coverage Determinations (LCDs)
• Search CMS' coverage database by title or keyword -- allows you to search the CMS MCD to find a procedure name or code within the title or content of a FCSO LCD for all J9 geographic locations. This is the simplest way to search for an LCD.
• Search CMS' site by LCD ID (L number) -- allows you to search for the “L number” in the CMS MCD.
• List of Active, Future, or Retired LCDs -- links you to the FCSO Active, Future, and Retired LCDs page, which includes LCD lists organized by line of business, location, and status.
• How-to Guide for Finding LCDs -- provides an overview of how to find LCDs and NCDs.
• Medical Coverage Database (MCD) quick reference guide -- provides assistance in finding LCDs/NCDs and related coverage details online.
CMS Medical coverage database (MCD)
Searching LCDs and NCD index listings
This section will help you find Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) by utilizing the resources available on the Centers for Medicare & Medicaid Services (CMS) website. A more extensive guide to navigating the First Coast Service Options (FCSO) Medicare website can be found on the Navigation help page.
List of LCDs
You can view a list of LCDs sorted alphabetically by title. This list can be filtered to display LCDs that are final, active, future effective or in draft status.
Depending upon your geographic location, select the appropriate Final/Active LCD List sorted by LCD Title link, which will take you to the CMS Medical Coverage Database (MCD) specific to FCSO LCDs. For this example, we have selected the Florida Part A active LCD list sorted by LCD title.
Once you arrive on the CMS site, you have several options to change the number of LCDs shown per page as well as how the list is sorted to facilitate your search.
Tip: To view other selections - Display Retired Documents, Display Future Effective Documents, and Display Draft Documents - select the appropriate link at the top of the page.
List of NCDs
A list of alphabetically sorted NCDs can be found in the CMS Medical Coverage Database list of NCDs. 
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. Database search for LCDs and NCDs
National and local searches may be done at the same time; however, this may be too confusing. We suggest initially selecting one or the other in Step 1.
Finding LCDs
Step 1- What do you want to search for? Select Local Coverage. Once selected, additional choices will become visible; deselect the Articles check box to restrict your search to Final Policies.
Step 2- Enter required search criteria.
• Geographic area OR Contractor: Choose your area or contractor. Area is the simplest option but may also include results for contractors other than FCSO. If you prefer to restrict your results to FCSO, use the contractor drop-down list and select the appropriate First Coast Service Options Inc. Medicare administrative contractor (MAC) workload number:
• MAC-Part A:
• Florida: 09101
• Puerto Rico and U.S. Virgin Islands: 09201
• MAC-Part B:
• Florida: 09102
• Puerto Rico: 09202
• U.S. Virgin Islands: 09302
• Pick one or more: Select one or more additional search criteria. After you have made your selection, enter the requested information and select the Search Now button. Note: The following selections are most commonly used to find LCDs.
• Checking the Keyword box will reveal a narrative box in which to type in a keyword used within the LCD you are looking for. Be sure to select the appropriate Title or Entire Document radio button, or you will be returned to the search page and will have to start over.
• Checking the CPT/HCPCS box will reveal additional options of entering either one code or a range of codes. We suggest using only one code unless you are sure about the range.
• Select the Search Now button.
• Return to the search page by selecting the Advanced Search link located in the top portion of the results page. We don’t suggest using New Search as it only allows you to search the title field and not the entire document. If you happen to land on the Search page, you can select Advanced Search from there.
Tip: When specifying multiple criteria, only records meeting ALL criteria are returned. If you select too many criteria, your search may return no results.
Finding NCDs
Step 1- What do you want to search for? Select National Coverage. Once selected, additional choices will become visible; deselect all the check boxes except Decisions (NCD) to restrict your search to final decisions.
Step 2- Enter optional search criteria if desired-Optional.
• Checking the Keyword box will reveal a narrative box in which to type in a keyword used within the NCD you are looking for. Be sure to select the appropriate Title or Entire Document radio button or you will be returned to the search page and will have to start over. You may also choose Exact Phrase, All words (and), and Any Words (or) to refine the search.
• Checking the Coverage topic and/or Benefit category allows you to narrow your search further, but we do not suggest using these options unless you are familiar with them.
• Select the Search Now button.
• Return to the search page by selecting the Advanced Search link located in the top portion of the results page. We don’t suggest using New Search as it only allows you to search the title field and not the entire document. If you happen to land on the Search page, you can select Advanced Search from there.
Tip: When specifying multiple criteria, only records meeting ALL criteria are returned. If you select too many criteria, your search may return no results.
Local coverage reports – find recently updated LCDs
The CMS Medical Coverage Database Reports page contains several reports pertaining to local and national coverage. Use this page to access information about recently updated LCDs.
page contains several reports pertaining to local and national coverage. Use this page to access information about recently updated LCDs.
Under Local Coverage, choose one of the following reports.
LCD Last Updated Report. Use this report to determine when an LCD was last updated and for what reason(s).
Choose Select contractor(s) and select the appropriate First Coast Service Options Inc. Medicare administrative contractor (MAC) workload number:
• MAC-Part A:
• Florida: 09101
• Puerto Rico and U.S. Virgin Islands: 09201
• MAC-Part B:
• Florida: 09102
• Puerto Rico: 09202
• U.S. Virgin Islands: 09302
• Step 2 Select Reason for Change. The default selection is All but can be revised to narrow your search.
• Select the Submit Report button for results.
What’s New Report. Use this report to view all Local Coverage documents that were changed as a result of a specified database update.
• Step 1 Select contractor. Choose Select contractor(s) and select First Coast Service Options, Inc. (00090 FI-FL Part A, or 00590 Carrier-FL Part B). Use the contractor drop-down list and select the appropriate First Coast Service Options Inc. Medicare administrative contractor (MAC) workload number:
• MAC-Part A:
• Florida: 09101
• Puerto Rico and U.S. Virgin Islands: 09201
• MAC-Part B:
• Florida: 09102
• Puerto Rico: 09202
• U.S. Virgin Islands: 09302
• Step 2 Select database update. The date defaults to the most recent update to the database but can be changed as needed. The database is updated weekly.
Search for procedure to diagnosis code relationship (LCD Service Indication Report)
The Procedure/diagnosis code lookup tool allows you to determine the relationship between a specific procedure code and diagnosis code. If an LCD exists based on the codes you enter, it will be displayed once you submit your information.
allows you to determine the relationship between a specific procedure code and diagnosis code. If an LCD exists based on the codes you enter, it will be displayed once you submit your information.• Step 1 Enter CPT/HCPCS code. Enter a valid CPT or HCPCS procedure code.
• Step 2 Enter ICD-9 code. Enter a valid ICD-9 diagnosis code. There is also a code lookup link located to the right of the box should you need to verify or lookup a code.
• Step 3 Click on the desired radio button to see the available selections. Use the contractor list pull-down and select the appropriate First Coast Service Options Inc. Medicare administrative contractor (MAC) workload number:
• MAC-Part A:
• Florida: 09101
• Puerto Rico and U.S. Virgin Islands: 09201
• MAC-Part B:
• Florida: 09102
• Puerto Rico: 09202
• U.S. Virgin Islands: 09302
Note: You may choose one of the other options such as state, but your search may also include results for contractors other than FCSO.
• Select the Submit Report button.
If a match is found a linked number will be available on the results page in the Supports the Medical Necessity column. Select the link to view the results list.
If a match is not found the results page will indicate This contractor's LCD for the specified ICD-9 code does not contain the specified service in the Supports the Medical Necessity column.
Note: This report only retrieves the latest version of LCDs currently in effect. Draft and retired LCDs are excluded.
Download MCD datasets
Articles, LCDs, NCDs, and Public Comments for NCAs/CALs (national coverage analyses/coding analyses for labs) files in Microsoft Access 2000 database format can be downloaded.
Important: If you wish to download this data, please understand that downloading may take several hours (depending on the speed of your Internet connection) and may also require 700 megabytes or more of free disk space. These downloads are not intended for casual users of the MCD; they are intended for more experienced users, such as health policy researchers.
The MCD downloads page contains a tool you can use to download data.
contains a tool you can use to download data.Select the Downloads link in the left menu. You will be required to accept the CPT and CDT disclaimer to proceed.
• From this page, users may download the following data sets: LCDs, local coverage articles, and NCDs/Public Comments for NCAs/CALs.
• The Medicare Coverage Database is usually updated each Thursday.
• Downloads are in a compressed or zipped format and can be extracted using either the WinZip or PKUNZIP utility. Most operating systems already have one of these utilities installed; however, links to download these utilities are also available on this page. If you require assistance, you can also select the Help with File Formats and Plug-Ins link located at the bottom of the page.
Scroll down the download page to Which database would you like to download and use the dropdown menu to make your choice then press the Select Download button.
The extraction tool will display the available files, which include database and CSV (comma-separated values) file formats as well as help data dictionary and read-me-first files. Only the most recent version of any NCD, article, or LCD is included in each database; attachments and historical versions are excluded.
Note: The LCDs databases contain Draft LCDs. These Draft LCDs can be identified by using the DISPLAY_ID field. For more information, please refer to the data dictionaries included with the download files.
