RARCRemark
RARC N386: This decision was based on a National Coverage Determination (NCD)
A nationwide Medicare coverage policy was used to decide whether this service is covered.
What this means for your claim
National Coverage Determinations (NCDs) are Medicare policies that apply across the entire country, specifying when a service is covered. These are public documents you can look up and cite in an appeal.
What to do next
- 1
Look up the relevant NCD in the CMS Coverage Database at cms.gov using the service or procedure code.
- 2
Compare your clinical situation to the NCD's coverage criteria.
- 3
If you meet the NCD requirements, appeal with chart notes citing the specific NCD provisions.
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