Coverage Determinations: Access to Policy Text

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The Access Point for Medical Necessity Code Pairs

Click any active LCD button to access all coverage determinations that apply to the code you are viewing:
• Review the ICD codes that are listed. If the ICD code does not justify the procedure that is to be performed, the provider must inform the patient that medicare will not pay for the service and have the patient sign an ABN

• Click the title of the Coverage Determination to view the Official CMS text

      -This will be displayed in a new window at the CMS site

      -You will be asked to click through an AMA licensing agreement (no fee)

All of the official text will be available for review and printing.



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