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Shyanne VandermarkWeek 7 LCD/NCD AssignmentThis Assessment is worth 10% of your grade.DeadlineDue by the end of Week 7 at 11:59 pm, ET.Completing this Assessment will help you to meet the following:Course OutcomeValidate medical necessity using LCD and NCD in provided scenarios.Directions1.Review the five scenarios below and assign the appropriate HCPCSLevel II and/or CPT code.2.Visit theMedicare Coverage Databaseto find and assign the LCDArticle ID or NCD Manual Section Number associated with the assignedHCPCS Level II/CPT code.3.Provide a rationale as to whether or not the HCPCS Level II/CPT codewill meet medical necessity based on the LCD Article ID or NCD ManualSection Number.Scenario 1Patient has been recently diagnosed with plantar fasciitis.The providerorders a static foot orthosis.CPT/HCPCS Level II code for staticfoot orthosis:L4396LCD Article ID:L33686State:IndianaRationale:Other Lower Extremity Orthotics falls under HCPCS code L4397for Static or dynamic ankle-foot orthosis,comprising soft interface material, adjustable for fit, for positioning, maybe used for minimal ambulation,prefabricated, off-the-shelf as maintained by CMS.For a beneficiary with a foot drop but no ankle flexion contracture, codesL4396, L4397, and L4392 will berefused as not reasonable and required. A foot drop splint/recumbentpositioning device (L4398) or replacementinterface are not covered by Medicare (L4394).
MCCG146 – LCD/NCD Assignment

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Term
Spring
Professor
NoProfessor
Tags
foot drop, Ankle foot orthosis, NCD Manual

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