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Radiology Coding Alert

READER QUESTIONS:

Hold Local Medicare to NCDs

Published on Mon May 11, 2009

Question: Are National Coverage Determinations binding on contractors? Michigan Subscriber Answer: Yes. According to a Medicare FAQ, NCDs are binding on the following: " All Medicare carriers " Fiscal intermediaries " Quality improvement organizations " Health maintenance organizations " Competitive medical plans " Healthcare prepayment plans. Resource: You can find the link to the CMS FAQs at  www.cms.hhs.gov. Just click on Questions near the top of the page. Remember: NCDs describe Medicare coverage of the described procedure or service on a national basis. Contractors can create their own coverage decisions for items not specifically covered or mentioned in NCDs. You can search NCDs at  www.cms.hhs.gov/mcd/overview.asp or find them in the NCD manual at www.cms.hhs.gov/manuals/ by clicking Internet Only Manuals and choosing publication 100-03. For example, if you click on publication 100-03 and then choose chapter 1, youll find the percutaneous transluminal angioplasty NCD. --  The answers for You [...]
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