LCD / NCD – policy information

LCD

Search for IDTF-related LCDs using these available tools:

• LCD interactive index tool
• View First Coast’s active / proposed LCDs / articles on CMS’ Medicare coverage database (MCD)

NCD

• Search CMS’ MCD
• CMS’ MCD - NCD alphabetical index

Medical documentation 

Medical record documentation is used to verify that services were billed correctly and to ensure that payment and processing of Medicare claim(s) are accurate and based on sound policy. Find information, tips, and resources regarding medical documentation.

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Education

Utilize educational information from First Coast and CMS on IDTF services.

• View First Coast’s upcoming events
• CMS open door forums 

CMS internet-only manual (IOM)

The CMS IOMs contain day-to-day operating instructions, policies, and procedures based on statutes, regulations, guidelines, models, and directives. The following CMS manuals contain information specific to IDTF providers:

• CMS IOM Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15, Sections 70 and 80
• CMS IOM Pub. 100-04 Medicare Claims Processing Manual, Chapter 26 and Chapter 35
• CMS IOM Pub. 100-08 Medicare Program Integrity Manual, Chapter 4 and Section 10.2.2.4

Resources

Listed below are additional resources identified specifically for IDTF providers:

• Appropriate use criteria (AUC) program
• IDTF performance standards
• Code of Federal Regulations
  • CFR, Title 42, Chapter IV, Part 410 §410.32(a) Ordering diagnostic tests
  • CFR, Title 42, Chapter IV, Part 410 §410.33 Independent diagnostic testing facility
• IDTF MLN booklet
• IDTF qualification and documentation requirements
• Completing the Medicare CMS-855B enrollment application

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