MCD Search
Frequently Asked Questions (FAQs)
Many questions can be answered on the
Help & Resources page
in the How To Library or by viewing the FAQs below. Please take a look and if you still have questions or would like to leave feedback,
contact us!
Please contact your Medicare Administrative Contractor (
MAC
).
MAC
s can be found in the
MAC
Contacts Report
Please contact the Medicare Administrative Contractor (
MAC
) who owns the document. The contractor information can be found at the top of the document in the
Contractor Information section
(expand the section to see the details).
MAC
s can also be can be found in the
MAC
Contacts Report
Please call 1-800-Medicare or visit
Medicare.gov
Local Coverage
For the most part, codes are no longer included in the LCD (policy). You will find them in the Billing & Coding Articles. Try using the
MCD Search
to find what you're looking for. Enter the code you're looking for in the "Enter keyword, code, or document ID" box. The list of results will include documents which contain the code you entered.
Please Note:
For Durable Medical Equipment (DME)
MAC
s only, CPT/HCPCS codes remain located in LCDs. All other Codes (ICD-10, Bill Type, and Revenue) have moved to Articles for DME
MAC
s, as they have for the other Local Coverage
MAC
types.
National Coverage
NCDs do not contain claims processing information like diagnosis or procedure codes nor do they give instructions to the provider on how to bill Medicare for the service or item. For this supplementary claims processing information we rely on other CMS publications, namely Change Requests (CR) Transmittals and inclusions in the Medicare Fee-For-Service Claims Processing Manual (CPM).
In order for CMS to change billing and claims processing systems to accommodate the coverage conditions within the NCD, we instruct contractors and system maintainers to modify the claims processing systems at the national or local level through CR Transmittals. CRs are not policy, rather CRs are used to relay instructions regarding the edits of the various claims processing systems in very descriptive, technical language usually employing the codes or code combinations likely to be encountered with claims subject to the policy in question. As clinical or administrative codes change or system or policy requirements dictate, CR instructions are updated to ensure the systems are applying the most appropriate claims processing instructions applicable to the policy.
Enter the CPT/HCPCS code in the
MCD Search
and select your state from the drop down. (You may have to accept the AMA License Agreement.) Look for a Billing and Coding Article in the results and open it. (Or, for DME
MAC
s only, look for an LCD.) Review the article, in particular the Coding Information section.
If you need more information on coverage, contact the Medicare Administrative Contractor (
MAC
) who published the document. The contractor information can be found at the top of the document in the
Contractor Information section
(expand the section to see the details).
If you don’t find the Article you are looking for,
contact your
MAC
Was your Medicare claim denied? Here are some hints to help you find more information:
1) Check out the Beneficiary card on the
MCD Search
page.
2) Try using the
MCD Search
and enter your information in the "Enter keyword, code, or document ID" box. Your information could include a keyword or topic you're interested in; a Local Coverage Determination (LCD) policy or Article ID; or a CPT/HCPCS procedure/billing code or an ICD-10-CM diagnosis code. Try entering any of this type of information provided in your denial letter.
3) Contact your
MAC
4) Visit
Medicare.gov
or call 1-800-Medicare.
Please use the Reset Search Data function, found in the top menu under the Settings (gear) icon. If that doesn’t work please contact
technical support
Technical issues include things such as a link is broken, a report fails to run, a page is not displaying correctly, a search is taking an unexpectedly long time to complete. If you are having an issue like this please contact
technical support
Submit Feedback/Ask a Question
MCD Session Expiration Warning
Your MCD session is currently set to expire in 5 minutes due to inactivity. If your session expires, you will lose all items in your basket and any active searches. If you would like to extend your session, you may select the
Continue
Button.
Reset MCD Search Data
If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues.
Notice
You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles
Notice
You are leaving the CMS MCD and are being redirected to
MCD Alert