Acceptable National Coverage Determination (NCD) Complaints
Board Docket Number
Ocular Photodynamic Therapy
Durable Medical Equipment Reference List — (Air Cleaners)
Decision issued finding that record supports validity of the NCD. (DAB No. 1999)
Vagus Nerve Stimulation
Magnetic Resonance Angiography
Presbyopia-Correcting and Astigmatism-Correcting Intraocular Lenses
CMS Manual System, Pub. 100-04, Ch. 32, §120
Decision issued finding that record supports validity of the NCD. (DAB No. 2418 - PDF)
Bariatric Surgery for Treatment of Morbid Obesity
Adult Liver Transplantation
Ruling issued finding that NCD record is not complete and adequate to support the validity of the NCD. (NCD Ruling No. 2)***
* The Board ruled that the record was not complete and adequate to support the validity of the NCD. The Centers for Medicare and Medicaid (CMS) agreed to reconsider the NCD. The NCD complaint was dismissed after CMS revised the NCD to address the concerns raised.
** The Board ruled that the beneficiary was not entitled to challenge the NCD for carcinoembryonic antigen (CEA) testing because CMS had determined that the NCD did not bar coverage for indications not specifically listed in the NCD as either covered or excluded from coverage. Rather, CMS determined that coverage of CEA testing for such indications required individual showings that testing was reasonable and necessary based on individual medical circumstances. A redacted copy of the Board’s dismissal ruling can be viewed through the following link: CEA NCD DISMISSAL RULING (PDF).
***The Board will take evidence on the validity of the NCD under the reasonableness standard. The Board has reopened the period for petitions for participation (intervention).