Reason Code 53NCD: NCD Denial: No Diagnosis, Documentation to Support Medical Necessity

Published 05/22/2019

Reason Code 53NCD
NCD Denial: No Diagnosis/Documentation to Support Medical Necessity (Provider Liable) (Beneficiary Liable)

The service(s) billed (was/were) not covered because medical necessity was not supported as outlined in Palmetto GBA's Local Coverage Determination (LCD). Local Coverage Determination (LCD): Outpatient Physical Therapy (L34428).

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