Hello I hope someone can help me. Since the northeast region has transitioned to a new Medicare carrier, National Government Services, we have been having difficulty getting paid for multiple pulmonary nodules, lung mass, and enlarged lymph nodes. Our previous carrier, NHIC, had and LCD for Pet scans, but NGS does not, they go by NCD which does not cover these except on a case by case basis in which claims are initially denied and have to be appealed with medical documentation and letters of medical necessity. Our medical and technical directors do not understand this, tell us we are wrong and this policy is not correct. We have explained to the numerous times that we have a new carrier that goes by the National Policy and the no longer have a local policy to follow. They insist we continue to take patients for these diag. We in coding and billing department have provided to them the NCD policy to show them they are not a payable codes. We do not agree with this and are concerned about billing these. Is anyone else experiencing this same problem and what are your policies regarding this. Any help would be appreciated.