Thursday, October 14, 2021

Very Brief Blog: The somewhat clumsy search for "Future Effective" New Final LCDs

For the last few years, MAC websites have all had a "Medical Policy" section that lets you search for that MAC's proposed but unfinished LCDS, and, for finalized and "future effective" LCDs.   In the past,these links (when they worked correctly) would send a CMS website policy library, AND, to the specified category of result such as "future effective" LCDs.  

Currently, it seems like these MAC links for "future effective" LCDs still send you to the CMS policy database, but just dump you out at at the CMS home screen.  From there, it can be difficult to find "future effective" LCDs.   (I noted this in an earlier blog this week).

Below, some simple documentation of what I'm finding, to help you run your own searches for "future effective" or "in notice" (synonyms) LCDs.


Start here:

If you go to the CMS articles and policies home page search box (above), you can't search directly for "Future Effective" nor "In Notice" LCDs.   (Another issue is why CMS uses different synonyms in different places for the same thing, keyword "future effective" = keyword "in notice.")

If you go to REPORTS, there's report call LOCAL / WHAT's NEW (sounds appropriate) or or local reports for either FINAL LCD or PROPOSED LCD.  However, for me, the WHAT'S NEW search doesn't actually catch all that's new.  And, it also pulls up a ton of articles being updated only because of a single decimal point change in one ICD10 code, and you have to wade through those one click at a time.

Note however the "future effective LCDs," a super important category, are neither "Final" nor "Proposed," so there's no option to go straight to them.   Here are some workarounds.


If you ask for REPORT, Final LCDs, you'll get over 1000, but sort by "Effective date" present to past, then the future effective dates will rise to the top.


If you go to REPORT, Proposed LCDs by Contractor, you get 170 entries sorted by title.  Here, you now see that there's a status drop down box and you can pick "Future Effective" as a status but with the term "IN NOTICE."  However, in what should be a nationwide search, this pulls up only 7 LCDs as "in notice" right now, which seems like it might be an undercount, given the national volume of LCDs proposed (170).   Since they go into "notice" for 6 weeks, and must be finalized in 1 year, at any given time, about 10% of them should be rolling forward into the Notice status (10% of 170 is 17).   


If you go to Final LCDs by Contractor report, you get 1009 LCDs, and a drop down box with the particular option "FUTURE EFFECTIVE."


Proposed LCDs gives you 170 LCDs by "DL" or "Draft" number, and you can search by a drop down for IN NOTICE draft LCDs, meaning finaled, becoming effective.  N=7.

FINAL LCDs gives you 1000 LCDs by "L" or "LCD" number, and you can search by a drop down for FUTURE EFFECTIVE.  N=8, those 7 plus 1.


Local Coverage Report, Proposed, then search status IN NOTICE.  N=7

DL34635 (WPS Botulinum)

DL39051 (WPS, Cosmetic)

DL38737 (Palm, Fracture)

DL39027 (NGS, Resp Panel)

DL38968 (NGS, Thyroid nodule)

DL38902 (Noridian, Wound)

DL38904 (Noridian Wound)

Local Coverage Report, Final, then search status FUTURE EFFECTIVE.  N=8

Here, the LCDs are "L" final plus "future effective", so the numbers change from DL to L in this view.

Same as above plus also an 8th LCD:

     L33802, TENS, CGS & Noridian DME MAC