Definition · Claims processing and coverage determinations
A Local Coverage Determination is a decision by a Medicare Administrative Contractor about whether an item or service is reasonable and necessary in that contractor's area. It is not a national rule. CMS posts LCDs in the Medicare Coverage Database. This page does not apply an LCD to a patient.
An LCD can list diagnosis codes. Seeing a code on an LCD is not an instruction from this site. Coverage still depends on the LCD text and the claim.
Source: CMS Medicare Coverage Database, https://www.cms.gov/medicare-coverage-database. Page read October 14, 2026.
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