In CMS who guidelines reign surpreme? National Coverage Determination or Local?
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Wiki NCD vs LCD with CMS
- Thread starter glielmia
- Start date
thomas7331
Guest
The local MACs are the ones paying the claims so I imagine the LCDs would be the most strict. I would think that they would still be required to follow the NCDs which apply to everyone, but could add their own local guidelines on top of those. Do you have an example of a situation where the two sets of guidelines conflict?
amyjph
True Blue
NCD trumps but you have to meet the LCD (if there is one) to get the claim through edits so from a claim submission perspective the LCD is your guide. That's why you have to follow the MAC.
• LCD can supplement existing NCD but cannot supersede
This is well presented and informative:
• LCD can supplement existing NCD but cannot supersede
This is well presented and informative:
