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November Humana News: Understand Humana's application of Medicare NCDs and LCDs

Understand Humana’s application of Medicare NCDs and LCDs

NCDs are established by the Centers for Medicare & Medicaid Services (CMS) and apply to claims nationwide. LCDs are established by each Medicare administrative contractor (MAC) and apply to claims within each MAC’s region. Articles are published by MACs to provide further billing guidance, and all coding guidance previously found in LCDs is being transitioned to articles. Typically NCDs, LCDs and any related articles define coverage in terms of the appropriateness of a procedure with certain diagnoses. 

The presentation, titled “Application of Medicare NCD/LCD Guidelines,” gives a detailed overview of Humana’s determination of coverage for patients with Medicare Advantage plans. It included examples of how claims are processed based on the appropriate NCDs and LCDs. 

Access the “Application of Medicare NCD/LCD Guidelines” presentation, and many more, at Humana.com/MakingItEasier. Each feature in the series consists of an on-demand presentation addressing a specific topic, with a downloadable tip sheet.

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