An LCD, as established by Section 522 of the Benefits Improvement and Protection Act, is a decision by a fiscal intermediary or carrier whether to cover a particular service on an intermediary-wide or carrier-wide basis in accordance with Section 1862(a)(1)(A) of the Social Security Act (i.e., a determination as to whether the service is reasonable and necessary).
For LCD Guidelines for determining a patient's prognosis of six months or less, review the LCD document. Catagories are: General Decline and Debility; Dementia; Heart Disease; Stroke, Pulmonary Disease; Renal Failure; Cancer; Liver Disease; ALS; Coma; and HIV.
