Payer policy
LCD / NCD
The coverage rules that decide what Medicare pays for, nationally or within a MAC's jurisdiction.
What it means in dermatology
Also known as: Local and national coverage determination
LCDs are jurisdiction-specific, so the same dermatology service can be covered differently in two states. Actinic keratosis destruction frequency and Mohs indications are the two that most affect dermatology.
Each LCD carries a companion billing and coding article listing the covered diagnosis codes — that article, not the LCD narrative, is what the claim is adjudicated against.
Why it matters to your revenue
Practices that bill in more than one MAC jurisdiction cannot run one rulebook.
See this term in your own numbers
A free claims audit reviews a de-identified sample of your dermatology claims and returns a line-item findings report — including where terms like this one are costing you money.
Request a free claims audit