The National Coverage Determinations (NCD) Policies are in place and have replaced the previous Local Medical Review Policies. These policies are updated every three months, with revisions published between final publications. It is ideal to use the latest version of the NCD policies. You can find the web site to download, use on line, or print HERE.

It is the policy of Regional Pathology Services and The Nebraska Health Systems to ensure that an appropriate Advanced Beneficiary Notice (ABN) is obtained from Medicare beneficiaries for laboratory tests prior to collection of the specimen(s) that are deemed to be not reasonable and necessary. This policy conforms to the Center for Medicare and Medicaid Services Program Memorandum Transmittals AB-02-110 and AB-02-114.

Note that the "CBC" is an "exclusionary" NCD, meaning it does not list the covered codes, only those expected to be denied. It is important to remember that any Panel that includes a medically necessary glucose test will require and ABN.

The following tests for Medicare Coverage Determinations (NCD) Coding Policies: