Knowledge base

Local Coverage Determination (LCD)

a decision by a fiscal intermediary or a carrier under Medicare Part A or Part B, regarding whether and how to cover a particular service. An LCD may provide that a service is not reasonable and necessary for certain diagnoses and/or for certain diagnosis codes. An LCD does not include a determination of which procedure code, if any, is assigned to a service, or a determination with respect to the amount of payment to be made for the service.

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