RARCRemark
RARC N115: This decision was based on a Local Coverage Determination (LCD)
A Medicare local policy in your geographic area was used to decide whether to cover this service.
What this means for your claim
Medicare contractors can create Local Coverage Determinations (LCDs) that specify when and for whom certain services are covered. These are public documents.
What to do next
- 1
Look up the specific LCD on the CMS Coverage Database at cms.gov using the procedure code.
- 2
Verify whether your clinical situation meets the LCD's coverage criteria.
- 3
If your diagnosis and clinical circumstance qualify under the LCD, appeal with chart notes citing the relevant LCD language.
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