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CodeMap Compliance Briefing: 7/25/03: NCD Misconceptions

Editor's Welcome:

Each week, our analysts field a wide a variety of phone calls concerning just about every aspect of diagnostic testing compliance. As you can imagine we hear a lot of interesting questions. Considering the complexity of the rules and regulations that govern Medicare and Medicaid, this is not unexpected. Recently we have heard of a number of misconceptions concerning National Coverage Determinations (NCDs). This week we hope to dispel at least two of these erroneous interpretations. As always feel free to forward comments, questions, and suggestions. We will do our best to answer all emails.

Sincerely,

Gregory Root, Esq.

Introduction: NCDs

As most laboratory professionals already know, CMS has developed 23 NCDs for commonly ordered laboratory tests. NCDs are similar to, and have replaced, many Local Medical Review Policies (LMRPs). Both LMRPs and NCDs typically contain information concerning indications and limitations of coverage, frequency limit....

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