• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

NCD vs LCA

M

mhaney

Contributor
Messages
20
Location
Yucaipa, CA
Can LCA can override an NCD? Our MAC, Noridian, is denying use of an impella (33990) during high risk PCI based on diagnosis; LCA - (A52966). The NCD (A53986) for this procedure show the service is covered for acute heart failure diagnosis. Trying to determine it I can appeal.
 
mhaney said:
Can LCA can override an NCD? Our MAC, Noridian, is denying use of an impella (33990) during high risk PCI based on diagnosis; LCA - (A52966). The NCD (A53986) for this procedure show the service is covered for acute heart failure diagnosis. Trying to determine it I can appeal.
Click to expand...

LCDs only exist when there is no NCD.

A53986 that you referenced is not an NCD - it is an LCD for Palmetto GBA. The link to that LCD number is below - I tried posting a screenshot, but it wouldn't accept the image.

 
Thank you, I did not catch that. Then I do not find an NCD for this service. Can you tell me the difference between an LCD and an LCA? Both seem to give the requirements for reimbursement. I appreciate the help.
 
You must log in or register to reply here.
Top