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FRIDAY COMPLIANCE BRIEFING: 10/11/2002

Editor's Welcome

This week's compliance briefing will hopefully help clear up some of the confusion out there concerning the implementation of National Coverage Determinations (NCDs). The confusion we have seen expressed in emails and phone calls seems to stem from the two recent Program Memorandums published by CMS concerning NCDs.

As always please feel free to forward questions, concerns, or ideas for future Friday Compliance Briefings.

Sincerely,

Gregory Root, Esq.

Background: National Coverage Determinations and Local Medical Review Policies

As most laboratory professionals already know, CMS has developed 23 National Coverage Determinations (NCDs) for commonly ordered laboratory tests. NCDs are similar to, and will eventually replace, many Local Medical Review Policies (LMRPs). Both LMRPs and NCDs typically contain information concerning indications and limitations of coverage, frequency limitations, and most importantly, covered diagnosis codes (ICD-9 codes). CMS develope....

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