Locate guidelines on the First Coast website

A procedure can have other policies or guidelines besides an LCD. Search our website for additional information.

Step 1: Perform a standard search in the First Coast website. 

A new window may open with results related to your search criteria. 

Step 2: Utilize the Fee Schedule lookup tool

Research the CPT/HCPCS procedure code by performing a single code search in the physician's fee schedule. Enter the applicable CPT or HCPCS procedure code, date of service, and locality.

Click on the submit button and a new window will open. The search results will be based on the criteria entered. Be sure to look at the status indicator of the procedure code. In the example below, the status indicator is "B". There are no payment amounts for these codes and no separate payment is ever made.

Step 3: Use the Provider Specialties center

The Provider Specialties center provides coverage requirements, documentation and billing information, modifiers, fee schedule and article information based on the specific specialty.

Note: For more information see Medicare physician fee schedule payment policy indicators descriptions and fee schedule news.

Step 4: Utilize the NCCI procedure to-procedure lookup

This tool illustrates procedure-to-procedure code pair edits apply to services provided on the same date of service by the same physician. Reporting both codes will generally result in the denial of payment for one the services. This tool is designed to help providers identify when certain codes are subject to the automated code pair edits. Search for the coding pairs by entering a procedure code and the performing date(s) of service. The search results display two coding pair lists: refer to Major-to-Minor and the Minor-to-Major tabs.

The column 2/minor code should not be reported with the column 1/major code unless documentation supports medical necessity for both services performed (same date of service / same provider), and the modifier policy indicator is equal to “1”. In this case, an appropriate modifier is appended to the Column 1 or Column 2 code.

Do not report column 2/minor or mutually exclusive codes when the modifier policy indicator is equal to “0”.

Use the search box above each column to narrow the results. Press ‘Enter’ to launch your specific search. To clear the search fields, click on the eraser icon located at in the upper right-hand corner of the table.

Note: After completing all the steps thus far in the FastTrack tool, if you do not find what you are looking for, an item or service may have coverage under reasonable and necessary guidelines.

Continue to No medical policies identified.

Back to the main FastTrack Medicare coverage policies.