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LCD/NCD Data Files


Description
Validating medical necessity is the key to successful healthcare procedure planning and reimbursement. When billing for Medicare services, the Centers for Medicare & Medicaid Services mandates that providers meet medical necessity guidelines according to their contractor's Local Medical Review Policies (LCD) and conform to many other coding conventions.

Updated monthly, our comprehensive data files provide the tools to meet Medicare compliance challenges. We bring together the technical expertise and medical knowledge necessary to maintain the LCD data with unmatched quality, accuracy and affordability.

At the point of scheduling, registration, or ordering of services, use this data to validate medical necessity and ensure ABNs are generated when necessary, prior to services rendered.

At the point of claims submission, use this data to ensure that claims are clear of errors prior to billing Medicare and private payers. Reducing denied submissions can significantly improve reimbursement and reduce the risk of audits.

Our LCD/NCD data files provide:
  • HCPCS/CPT® to fully specified ICD10CM crosswalks
  • Policy Titles, Effective Dates, LCD Numbers
  • URL pointers to each policy on the Carrier and CMS sites
  • Files are available for all MAC jurisdictions

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