Reason Code 54NCD: NCD Denial: No Diagnosis, Documentation to Support Medical Necessity

Published 11/06/2019

Reason Code 54NCD
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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