Compliance Info

Name Downloads
​Advance Beneficiary Notice (ABN) Information Download PDF
​ABN and Other Notices of Patient Financial
Liability Policy
Download PDF
​Disclosure of Medicare Regulations Download PDF
​Medicare Compliance and Coverage Limitations Download PDF
​Medicare PAP Smear Guidlines Download PDF
​Screening Pap Tests and Pelvic Examination Brochure Download PDF
​Non-Covered ICD-10-CM Codes for all Lab NCD's Download PDF
Medicare Parts A and B Coverage and Preauthorization ​Download PDF
​​Laboratory Preventative Screening: Quick Reference Download PDF
​Molecular Pathology: Quick Reference Guide ​Download PDF
​Naturopathic Physicians and Doctors of Chiropractic Ordering Diagnostic Laboratory Testing, May 2012 Download PDF

Patient Potential Financial Liability Forms

Advanced Beneficiary Notice of Non-Coverage Form Download PDF
Advance Notice of Potential Non-coverage by a Commercial Insurer Form Download PDF
​Notice of Financial Responsibility to Medicaid Beneficiary Form Download PDF
Tricare Request for Non-covered Services ​Download PDF

​Preventive Services

​Medicare Preventive Screening Educational Tool Go To Site
​Cardiovascular Screening Go to Site
​Cervical Cancer and HPV Screening Go to Site
​Colorectal Cancer
Go to Site
​Colorectal Cancer Screening LC Article A52378 ​Download PDF
​Diabetes Screening ​Go to Site
​HCV Screening ​Go to Site
​Hepatitis B Virus Infection Screening
​Download PDF
​HIV Screening ​Go to Site
​Pap Test and Pelvic Exam for Early Detection of Cervical or Vaginal Cancer Go to Site
​Prostate Cancer Screening Go to Site
​Sexually Transmitted Infections Screening Go to Site

Coverage Decisions​

Alpha Fetoprotein NCD-190.25 Download PDF
Blood Counts NCD-190.15 Download PDF
B-Type Natriuretic Peptide (BNP) Testing LCD-L33573 Download PDF
CEA NCD-190.26 Download PDF
Collagen Crosslinks NCD-190.19 Download PDF
​Cytogenetic Studies NCD-190.3 ​Download PDF
Digoxin NCD-190.24 Download PDF
​Drug Screen Urine LCD-L36037 ​Download PDF
​​Genomic Sequence Analysis in the Treatment of Acute Myelogenous Leukemia (AML) LCD-L36926 ​Download PDF
​Genomic Sequence Analysis Panels in the Treatment of Myelodysplastic Syndrome (MDS) LCD-L37078 ​Download PDF
​Genomic Sequence Analysis in the Treatment of Non-Small Cell Lung Cancer LCD-L36376 Download PDF
GGT NCD-190.32 Download PDF
​Glucose Testing NCD-190.20 Download PDF
​Glycated Hemoglobin (A1c) NCD-190.21 Download PDF
HCG NCD-190.27 Download PDF
​Heavy Metal Screening LCD-L35074 ​Download PDF
​Hepatitis Panel / Acute Hepatitis Panel NCD-190.33 ​Download PDF
​Histocompatibility NCD-190.1 ​Download PDF
HIV (Diagnosis) NCD-190.14 Download PDF
HIV (Monitoring) NCD-190.13 Download PDF
Iron Testing NCD-190.18 Download PDF
Lipid Testing NCD-190.23 Download PDF
​Next Gen Sequencing (NGS) for Medicare Beneficiaries with Advanced Cancer - CAG-0045N ​Download PDF
Occult Blood NCD-190.34 Download PDF

Molecular Pathology Procedures LCD-35000

Commercial payers might require preauthorization for Molecular Pathology tests

Download PDF
​Noncovered Services L33629 LCD ​Download PDF
Prothrombin Time NCD-190.17 Download PDF
PSA NCD-190.31 Download PDF
PTT NCD-190.16 Download PDF
RAST Type Tests LCD-L33591 Download PDF
​Sweat Testing NCD-190.5 ​Download PDF
Thyroid Testing NCD-190.22 Download PDF
Tumor Antigen CA 125 NCD-190.28 Download PDF
Tumor Antigen CA 15-3 and CA 27.29 NCD-190.29 Download PDF
Tumor Antigen CA 19-9 NCD-190.30 Download PDF
Urine Culture NCD-190.12 Download PDF
Vitamin D Assay LCD-L33556
Download PDF