Local Coverage Determination (LCD) Reconsideration Process - Medical Policy Article

NGS accepts written LCD reconsideration requests only for final, effective LCDs (whole or by provision) submitted by beneficiaries, providers, or interested parties doing business in the NGS jurisdiction. Requests must include requestor identification, contact information, the LCD name, supporting published evidence, and proposed language changes; submissions may be sent by mail, email, or fax. NGS will notify the requestor within 60 days whether the request is valid and, if valid, will either open the LCD for review under CMS procedures or place it on the MAC waiting list; several document types (e.g., NCDs, proposed or retired LCDs, individual claims) are excluded.

"Reconsideration requests are accepted only for final, effective Local Coverage Determinations (LCDs) and may address the whole LCD or any individual provision."

Sign up to see full coverage criteria, indications, and limitations.