Acknowledgement:

Information on reimbursement in the United States is provided as a courtesy. Due to the rapidly changing nature of the law and Medicare payment policy, and our reliance on information provided by outside sources, the information provided herein does not constitute a guarantee or warranty by Smith and Nephew,Inc that reimbursement will be received.

This information is provided "AS IS" and without any other warranty or guarantee, expressed or implied, as to completeness or accuracy or otherwise. This information has been compiled based on data gathered from many primary and secondary sources, including the American Medical Association and certain Medicare contractors.

Physicians and other providers must confirm or clarify coding and coverage from their respective payers, as each payer may have differing formal or informal coding, coverage policies, or decisions. Physicians and providers are responsible for accurate documentation of patient conditions, and for reporting of procedures and products in accordance with particular payer requirements.

Reimbursement


Local Coverage Determination (LCD) Guidelines

A Local Coverage Determination (LCD) is a decision by a Medicare contractor whether to cover a particular product, procedure, or service in its jurisdictional area in accordance with §1862 (a) (1) of the Social Security Act. All wound care providers should be knowledgeable about Medicare coverage prior to providing products, procedures, or services to Medicare beneficiaries.

Below, please find a list of websites where you can locate an LCD, article, or bulletin written by the Medicare Administrative Contractor (MAC) that processes your Medicare claims.

 

 

Cahaba Government Benefit Administrators, LLC (CAHABA GBA)

www.cahabagba.com
 

National Government Services (NGS)

www.ngsmedicare.com           

CGS Medicare (CGS)

www.cgsmedicare.com
 

Noridian Healthcare Solutions

www.noridianmedicare.com      
 

First Coast Service Options, Inc. (First Coast)

http://medicare.fcso.com
 

Palmetto GBA Medicare

http://www.palmettogba.com/medicare       
 

Novitas Solutions

www.novitas-solutions.com
 

Wisconsin Physicians Service Insurance Corporation (WPS)

www.wpsmedicare.com           
 

 

The Centers for Medicare & Medicaid Services (CMS) maintains all LCDs and articles in its Medicare Coverage Database. Review our Step-By-Step Guide to Navigating the Medicare Local Coverage Determination (LCD) Database to locate your Medicare contractor's LCD.

OASIS® is a registered trademark of Cook Biotech, Inc.

 




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