Reader Questions:
LCD Diagnosis Reqs You Need to Know
Published on Tue Oct 27, 2020
Question: Does Medicare restrict coverage to only the diagnoses listed under the code’s Local Coverage Determination (LCD)? If so, can we appeal and argue medical necessity with a non-covered diagnosis? Nevada Subscriber Answer: If you know you are submitting a claim with a diagnosis code that is not covered based on the CPT® code’s LCD, you have a few options. [...]