Search for Local Policies in CMS's Medicare Coverage Database

The Centers for Medicare & Medicaid Services (CMS) maintains a comprehensive online database of all Local Medical Review Policies (LMRPs) and Local Coverage Determinations (LCDs) from Medicare Carriers around the country. The Medicare Coverage Database (MCD) is now the official source of all local payment policies. Carriers are required to post their policies to the MCD regardless of whether they post them to their own web site. CMS's site is updated weekly and provides the opportunity to access the most recent version of all local policies, including those related to oncology and hematology. There are several ways to access this information, and following are some examples of how to use the MCD.

(1) "Search" (http://www.cms.hhs.gov/mcd/search.asp?) - Enables you to search the MCD for specific policies by state, Carrier, Keyword, CPT/HCPCS code, ICD-9 code or Coverage Topic. This function allows a side-by-side comparison of policies on a certain topic from Carriers around the country.

Step 1. Click the "Local Coverage" box in the center of your screen. Check the "Policies (LMRP/LCD)" box and then choose "Final Policies Only," "Draft Policies Only," or "Both Final and Draft" from the drop-down menu.

Step 2. Select either your geographic area OR carrier's name. Next, enter the Keyword, CPT/HCPCS code, ICD-9 code or Coverage Topic in which you are interested.

Step 3. If desired, enter effective dates for policies for which you are searching.

Click the "Search Now" button at the bottom of the page, and your results will be listed, along with links to each of the policies. This comprehensive listing of results allows you to compare other Carriers' policies on a topic side-by-side, providing supporting documentation if you are working with your Carrier on developing its own policy.

Another helpful option is the "Basket" feature, which allows you to select certain policies of interest and e-mail them to yourself or to a colleague. For each policy in which you are interested, check the box on the far right column (there is a picture of a basket at the top of the column) and then click "Add selected items to basket" at the bottom of the page.

(2) "Indexes" (http://www.cms.hhs.gov/mcd/indexes.asp) - Allows you to view a complete list of LMRPs/LCDs organized by Carrier, by state, or alphabetically.

Under "Available Indexes," scroll halfway down to the page to the gray box titled "Local Coverage" and under the second item, "List of LMRPs/LCDs...," choose to view policies from one of three options.

By Contractor (Carrier). Find your Carrier's name, then click on the link that corresponds to your state's abbreviation in the first column, "Medicare Carriers." A list of all draft and current LMRPs/LCDs for your state will appear. (Be sure to refer to the list of state abbreviations, particularly if you live in a state such as New York, which has multiple carriers: http://www.cms.hhs.gov/mcd/state_list.asp.)

By State. Scroll down the page to find your state, then click on the link in the first ("Medicare Carriers") column. (Be sure to refer to the list of state abbreviations, particularly if you live in a state such as New York, which has multiple carriers: http://www.cms.hhs.gov/mcd/state_list.asp.) For those states covered by Cahaba and NHIC-New England, there are multiple links given. Be sure that you choose the link that corresponds to your state. For example, next to Alabama, there are three links to Cahaba, with each representing a state within Cahaba's jurisdiction (Alabama, Georgia and Mississippi). The links are listed in alphabetical order of the states represented (e.g. Alabama, Georgia, Mississippi for Cahaba), but you can be certain you are looking at the correct state by looking at the "Primary Geographic Jurisdiction" listed within each LMRP/LCD.

Alphabetically. This option is beneficial if you wish to compare LMRPs/LCDs from many different Carriers for a particular drug or procedure. When you are looking for a specific policy, be sure to check all possible titles for that topic. For example, if you were researching policies on Pamidronate Disodium, you would check P for Pamidronate Disodium, as well as A for Aredia.

(3) "Reports" (http://www.cms.hhs.gov/mcd/reports.asp) - Offers various types of data, including a listing of the most recently posted LMRPs/LCDs.

For example, you can view all LMRPs/LCDs in Draft status for an individual Carrier, or you can see a report of all changes that have occurred to the MCD during a specific period of time.