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Thread: Medicare LCD's

  1. #1
    Join Date
    Apr 2007
    Posts
    10

    Question Medicare LCD's

    When a Medicare LCD is "retired" does it mean that the LCD is no longer in effect?
    Sounds like a silly question, but the Medicare representative (Noridian) told me that just because the policy is retired doesn't mean it isn't active. The only reason they retire them is because there have been no issues with the policy for the past 2-5 years.
    Another source told me that if it is retired, it is no longer in effect.
    If any one has any information on this it would really be helpful.
    Thanks
    Billie
    Billie Jo Kraft, CPC
    Wyoming Cardiopulmonary Services, PC

  2. #2
    Join Date
    Apr 2007
    Location
    Phoenix, AZ
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    I only trust one person at Noridian. Her name is Tammy Ewers. Her email is tammy.ewers@noridian.com. She always answers email. Although at times, she is in Fargo and will take a couple of hours up to a day. Hope this helps you. We use a retired LCD to check dx codes for echocardiograms.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  3. #3
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    Apr 2007
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    Thank you....I'm going to try that route!
    Billie Jo Kraft, CPC
    Wyoming Cardiopulmonary Services, PC

  4. #4

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    A medical director from Medicare presented at the STS coding workshop. He specifically said that just because a LCD is retired does NOT mean that it is inactive.

    As the first rep from Noridian told you, if nothing has changed with the LCD in a few years, they will retire it - I think they do this so that they don't need to review it every year - the policy is still active however.

    Lisi, CPC

    This medical director was from Noridian actually. VERY nice guy - you could probably contact him with your question - dick.whitten@noridian.com

  5. #5
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    Apr 2007
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    Phoenix, AZ
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    Dr. Whitten is a VERY nice guy. He was the medical director for Noridian but is now working on the DME side. I'm sure he will still answer your questions if you email him.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  6. #6
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    Apr 2007
    Location
    North Carolina
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    2017 ICD-10-CM Coding Book
    Q5. Can you please clarify the retired LCDs? If an LCD retired on 12/31/07 does this mean any date of service after 12/31/07 we do not have to go by this LCD?

    A5. Services with dates of service after a retired LCD will not be reviewed with the retired LCD for claim processing. However, any services billed after an LCD is retired must still follow the Medicare requirement of section 1862(a)(1)(A) of Title XVIII of the Social Security Act which provides in part that "&no payment may be made under Part A or B (of Medicare) for any expenses incurred for items or services which&are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

    https://www.noridianmedicare.com/sha...nd_Answers.htm

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