Local Coverage Determination - LCD 180.1

[Robert11]

Hello,

My wife recently saw a Nutritionist at the Hospital for getting hints
on her diet, etc.

We checked, and realized that general Nutritionist visits are not covered.

However,
when the Medicare statement came back, surprisingly it said that we did not owe anything; that it was Not Approved, but was covered via "Local Coverage Determination (LCD)". Code was 180.1

Can anyone perhaps explain this for us ?

Nice to know that it was covered, but most confused as to what this
LCD is/means, and why it was covered.

Thanks,
Bob

 

[MBSC]

Congress make general rules about what Medicare can and cannot cover. When those rules are vague, LCD's make a more precise determination as to when a service can be covered. It appears your claim was covered under a potentially diabetic consultation benefit since LCD 180.1 is "coverage of medical nutrition therapy services (MNT) for certain beneficiaries who have diabetes or a renal disease".