Policy / LCD FAQs

You can search for billing and coding articles by diagnosis code on the CMS website. The Medicare Coverage Database (MCD) allows you to search for billing and coding articles related to the LCDs in a variety of ways including keywords, “A number,” CPT/HCPCS procedure codes, and ICD-10 diagnosis codes. For more information, please review the finding First Coast LCDs and related coverage information -- how-to guide.

LCDs are developed to deny coverage or limit coverage of a service to specific conditions or frequencies. First Coast will consider reasonable and necessary services for payment in the absence of an LCD, billing and coding article, NCD, or CMS manual instruction limiting coverage.

The best way to stay informed is to subscribe to eNews, First Coast’s electronic mailing service. You’ll receive regular and special email notifications advising you of changes to the Medicare program. You may subscribe to as many lists as you wish including those exclusively focused on news related to LCDs. Subscribe to eNews.

You’ll find information regarding the status, comment periods, and release dates of proposed LCDs on the Proposed LCDs page. You can also learn how to submit comments on LCDs with this helpful article - Proposed LCD review/comment guidelines.

Local coverage determinations (LCDs) for a specific jurisdiction are developed by the MAC assigned to that jurisdiction. First Coast is the MAC for Florida, Puerto Rico, and the U.S. Virgin Islands. Although the majority of coverage determinations are local, in certain cases, CMS may develop a national coverage determination (NCD) that is applicable to all jurisdictions.

The Active, Future, and Retired LCDs page includes convenient links to First Coast’s LCDs published on the CMS Medicare Coverage Database (MCD). We’ve done the hard work for you -- just select the link for your location and line of business. 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. You can also choose links to view retired and future effective LCDs. For more information, please review the finding First Coast LCDs and related coverage information -- how-to guide.

The CMS Medicare coverage database (MCD) holds the official versions of local coverage determinations (LCD). First Coast’s LCD lookup provides an easy way to access the MCD.

The quickest way is to use the MCD quick find. You will need the LCD ID (“L” number to use the quick find feature); if you do not have the LCD ID but you do have the procedure code, you can use First Coast’s fee schedule lookup to find an LCD if one exists for that service. Complete the fee lookup form and if an LCD exists a link to it will be displayed beneath the fee results.

You’ll find the latest LCD news and information on the Medical Coverage page. For more information, please review the finding First Coast LCDs and related coverage information -- how-to guide.