Last Modified: 5/3/2024
Location: FL, PR, USVI
Business: Part A, Part B
Medicare Administrative Contractors (MAC) develop LCDs to describe circumstances for Medicare coverage for our jurisdictions. There are two ways to view LCDs, either by viewing the list of all active LCDs and articles on the medical policy/LCDs center or by performing a policy search.
This displays an alphabetical listing of all active LCDs. The applicable CPT/HCPCS codes are listed to the right of each LCD and/or article. Refer to the hyperlinked LCD and/or article for specific information.
Note: Utilize the search index box to locate a specific CPT/HCPCS code. Exception: Billing and coding article: Approved drugs and biologicals; includes cancer chemotherapeutic agents (A53049) *** this article is applicable to all drugs and biological CPT and HCPCS codes****
The related CPT/HCPCS code tables or related covered diagnoses are located within the corresponding articles. The corresponding articles are linked in the associated documents portion of the LCD.
When clicking on the specific LCD and/or article, a license agreement will appear. Please click the accept button located at the bottom of the page. Once you accept the license agreement, the LCD and/or article will populate.
Within the MCD search you can enter a keyword or document ID of the LCD. You will also need to select the document type: local coverage or national coverage. Select your state and First Coast as your contractor. You can also enter a CPT/HCPCS or ICD-10 diagnosis code. When searching by ICD-10, we suggest that you use only the first three digits because a range of diagnosis codes may be listed within the LCD article.
Search results will be based on the criteria entered.
Note: Other Medicare administrator contractors LCDs will also appear in the Medicare Coverage Database, so pay attention to the contractor information to ensure you are viewing the First Coast LCD.
There are many components that comprise an LCD:
• Contractor information
• LCD information
• CMS national coverage policy
• Coverage guidance
• General information
• Utilization guidance
• Revision history information and associated documents
Printing an LCD is not recommended; instead, retain these materials electronically. Review LCDs carefully and completely. We encourage providers, billing personnel and others who may be responsible for filing claims to Medicare to be aware of all information contained within an LCD.
Articles convey billing and coding information, guidelines and communicate any non-reasonable and necessary language. They are a companion to the LCD or could be a standalone document. The components of a billing and coding article include ICD-10 diagnosis codes, CPT and HCPCS codes. A link to the LCDs will appear in the associated document portion of the billing and coding article and a link to the billing and coding article will appear in the associated document portion of the LCD.
Note: Not every CPT/HCPCS has an LCD or a billing and coding article. If you do not find what you are looking for, a procedure may have other policies or guidelines besides an LCD. Use the standard web search function of our website for additional information.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.