Medicare Billing Information
NCD: National Coverage Determination
LCD: Local Coverage Determination
FI: Fiscal Intermediary
CMS: Centers for Medicare & Medicaid Services
LMRP: Local Medical Review Policy
CPT: Current Procedural Terminology
ICD-9: International Classification of Diseases- ninth edition
MAC: Medicare Appeals Council; the division that reviews unfavorable administrative law judge decisions
Part A: Pertains to billing for Technical aspects of care delivery. The hospital bills under Part A
Part B: Pertains to billing for Professional aspects of care delivery. The physician bills under Part B
Contractor: A private company under contract with Medicare to review and pay claims under Part A and B
Fiscal Intermediary: A Medicare contractor that reviews Part A claims
Carrier: A Medicare contractor that reviews Part B claims
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Medicare Terms (PDF)
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National CMS Benefit Policy: 20.5.3 Physician Supervision-Outpatient Therapeutic Services-eff 1-1-11 (PDF)
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Medicare Guidelines for HBO Services
The National Coverage Determination (NCD) is used by many of the states for either part A, part B or both. NCD rev 6/19/2006.pdf
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Can't find current data for your state?
Search the CMS Medicare Coverage Database.
Select the state and type in keyword: "hyperbaric oxygen."
Supplemental Documents
1. Hyperbaric Oxygen Therapy in Treatment of Hypoxic Wounds 11/01/2001
2. Comments and Responses for Draft LCD for National Government Services 12/2007
3. Decision Memo on Hypoxic Wounds and Diabetic Ulcers for NCD 8/30/2002
4. Clarification on Skin Grafts transmittal 129 10/19/2000
5. Diabetic Ulcer Indication Addition NCD Transmittal 164 12/27/2002
6. Technical Correction NCD page 6 3/17/06
7. NGS indication revision 102908
8. BCBS Article for Billing HCPCS C1300 Documentation effective date 071108
9. CMS state map of MACs
10. NGS Arterial Insuff Ulcer Coding Rules