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CALs: Coding Analyses for Labs (CAL) is an abbreviated process, similar to the National Coverage Determination (NCD) process, for making changes to the coding component of the negotiated laboratory NCDs.The process is used for adjusting the list of covered (or non-covered) ICD-10-CM diagnosis codes and coding guidance in the NCDs when there is a question regarding whether the code flows from the narrative indications in the NCD.A tracking sheet is posted opening a CAL and a 30-day public comment period follows.A decision memorandum announcing and explaining the decision is posted following the comment period.Changes are implemented in the next available quarterly update of the laboratory edit module. More details regarding the process can be found in 68 FR 74607.CloseMEDCAC InfoThe Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) process was established to provide independent guidance and expert advice to CMS on specific clinical topics. It is used to supplement CMS's internal expertise and to ensure an unbiased and contemporary consideration of "state of the art" technology and science.The MEDCAC reviews and evaluates medical literature, reviews technology assessments, public testimony and examines data and information on the benefits, harms,and appropriateness of medical items and services that are covered under Medicare or that may be eligible for coverage under Medicare.The MEDCAC judges the strength of the available evidence and makes recommendations to CMS based on that evidence.They advise CMS on whether specific medical items and services are reasonable and necessary under Medicare law.They perform this task in an open and public forum. The MEDCAC is advisory in nature, with the final decision on all issues resting with CMS.MEDCAC members are valued for their background, education, and expertise in a wide variety of scientific, clinical, and other related fields.In composing the MEDCAC, CMS was diligent in pursuing ethnic, gender, geographic, and other diverse views, and to carefully screen each member to determine potentialconflicts of interest.You can read more about theFactors CMS Considers in Referring Topics to the Medicare Evidence Development & Coverage Advisory Committee.CloseTA InfoEach National Coverage Determination (NCD) is supported by a comprehensive Technology Assessment (TA) process, which often focuses on the quality of the evidence for a given technology.Health care Technology Assessment is a multidisciplinary field of policy analysis that studies the medical, social, ethical and economic implications ofthe development, diffusion and use of technologies.For some NCDs, external TAs are requested through the Agency for Health Research and Quality (AHRQ).You can read about theFactors CMS Considers in Commissioning External Technology Assessments, which includes a description of the TA process and guiding principles for selecting which topics are referred.CloseMCD InfoMedicare Coverage Documents are published by CMS to help to relay information that is related to coverage on a national level.Examples include guidance documents, compendia, and solicitations of public comments.CloseCPT/HCPCS InfoCurrent Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) procedure codes comprise the medical code set that identifies health care procedures, equipment, and supplies for claim submission purposes.HCPCS Level I, also known as the CPT codes, are 5-character numeric codes maintained by the American Medical Association (AMA).The CPT codes are used primarily to identify medical services and procedures furnished by physicians and other health care professionals.HCPCS Level II are 5-character alphanumeric codes maintained by CMS (except D codes, which are maintained by the American Dental Association).They are used to identify various items and services that are not included in the CPT code set because they are medical items or services that are regularly billed by suppliers other than physicians.For example, ambulance services, hearing and vision services, drugs, and durable medical equipment.When a provider submits a bill to insurance for reimbursement, each service is described by a CPT or HCPCS code, which is matched to an ICD-10-CM or ICD-10-PCS diagnosis code.If the CPT/HCPCS and ICD-10-CM / ICD-10-PCS codes don't align correctly with each other, payment may be rejected. Local Coverage Articles, authored by the Medicare Administrative Contractors (MACs),include these codes and, when paired with the related Local Coverage Determination (LCD), outline what is and is not covered by Medicare.On the Medicare Coverage Database (MCD) you can use CPT/HCPCS codes to search for documents.Results will return Billing and Coding Articles or other documents that include the specified code.(Note: Sometimes an EOB or MSN may display the CPT/HCPCS code with an associated modifier, which is represented by a dash and two characters.Examples: 76942-26 and 98941-GA. Occasionally, multiple modifiers may be listed together (e.g., A5514-RTKX).When searching the MCD for a CPT/HCPCS code, the modifier should be removed. (E.g., only 76942 or 98941 would be entered.)When viewing a document (e.g., a Billing and Coding Article) the user may want to then search within the document (CTRL+F) to look for the modifier code.CloseICD-10-CM InfoInternational Classification of Diseases, Revision 10, Clinical Modification (ICD-10-CM) is a medical classification list by the World Health Organizationused by physicians and other healthcare providers to classify and code all diagnoses recorded in conjunction with medical care in the United States.ICD-10-CM is the standard transaction code set for diagnostic purposes under the Health Insurance Portability and Accountability Act (HIPAA).These codes ensure that a patient gets proper treatment and is charged appropriately for any medical services received.ICD-10-CM contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.In the base classification, the code set allows for more than 72,000 different codes.Through the use of optional sub-classifications ICD-10-CM allows for specificity regarding the cause, manifestation, location, severity and type of injury or disease.ICD-10-CM codes have an alphanumeric structure and should be used to the highest number of digits available or highest specificity up to 7 characters.The CMS ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings.The Centers for Medicare and Medicaid Services in tandem with the National Center for Health Statistics, maintain the catalog in the U.S. releasing yearly updates.ICD-10-PCS codes have a structure of 7 alphanumeric characters and contains no decimals. The first character defines the major "section".Depending on the "section" the second through seventh characters mean different things.When a provider submits a bill to insurance for reimbursement, each service is described by a current procedural terminology (CPT) or healthcare common procedure code system (HCPCS) code, which is matched to an ICD-10-CM or ICD-10-PCS code.If the CPT/HCPCS and ICD-10-CM / ICD-10-PCS codes don't align correctly with each other, payment may be rejected.Local Coverage Articles, authored by the Medicare Administrative Contractors (MACs), include these codes and, when paired with the related Local Coverage Determination (LCD), outline what is and is not covered by Medicare.On the Medicare Coverage Database (MCD) you can use ICD-10-CM codes to search for documents.Results will return Billing and Coding Articles or other documents that include the specified code.CloseWarningIt looks like you're trying to enter a Document ID or a Code.  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Would you like to Continue to search the entire database or Cancel to complete your data entry?ContinueCancelList of Generic WordsFocusing on this allows you to scroll the modal using the keyboard.$0123456789_aaboutafterallalsoanandanotheranyareasatbbebecausebeenbeforebeingbetweenbothbutbyccamecancomecouldddiddodoeseeachelsefforfromggetgothhadhashaveheherherehimhimselfhishowiifinintoisititsjjustkllikemmakemanymemightmoremostmuchmustmynnevernonowoofononlyorotherouroutoverpqrressaidsameseeshouldsincesosomestillsuchttakethanthatthetheirthemthentherethesetheythisthosethroughtotoouunderupusevverywwantwaswaywewellwerewhatwhenwherewhichwhilewhowillwithwouldxyyouyourzCloseUpdate Your BookmarksCloseMCD Notice BoardCloseLicense AgreementsPlease review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes.LICENSE FOR USE OF PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT")End User Point and Click Amendment:CPT codes, descriptions and other data only are copyright2023American Medical Association. 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