The Centers for Medicare & Medicaid Services (CMS) recently posted detailed instructions for accessing updates to the International Classification of Diseases, 10th Edition (ICD-10) Local Coverage Determinations (LCDs). These policies are developed by the Medicare Contractors (MACs) at their own discretion within their jurisdiction and are located in the CMS Medicare Coverage Database (MCD).
An LCD can be a tool to assist providers in submitting correct claims by:
- Outlining coverage criteria, including any frequency guidance.
- Defining medical necessity with the appropriate covered diagnosis.
- Identifying codes that describe covered and/or non-covered services.
- Providing references supporting the policy.
Medicare providers can find the LCD access instructions outlined in the Medicare Learning Network Matters Special Edition article, SE1421. Users are instructed to search for “Future LCDs” to have a better understanding of the coding and documentation requirements when billing services to Medicare.
Providers can take advantage of this early release and prepare for the 10/1/2015 effective date for ICD-10-CM by following the steps below:
- Review and follow the access instructions in SE1421.
- Run a report of the top 50 CPT Procedure Codes utilized by the practice/group.
- Perform a search in the LCD database for the top 50 CPT codes and corresponding procedure descriptions.
- Compile all LCDs relevant to the practice.
- Review the relevant LCDs for ICD-10 codes.
- Incorporate ICD-10 codes identified into current billing and education resources/job-aids, administrative and coding processes, and system edits.
View the complete list of instructions for accessing ICD-10 updated Future LCDs here.
If you have questions about the CMS guidance or ICD-10 training and implementation, contact the expert listed below at PYA, (800) 270-9629.
