LCD L38312: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea — Noridian
Sleep Medicine · Effective 2020-03-15
Specialty intelligence
Sleep Medicine Reimbursement Alerts
1 active CMS and MAC reimbursement alert affect Sleep Medicine billing teams — most recent: LCD L38312: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea — Noridian, effective 2020-03-15. Monitored daily across CMS, all seven MACs, and the Federal Register.
Daily CMS policy updates, MAC LCD revisions, and coding guidance for Sleep Medicine billing teams. All alerts sourced directly from CMS, MAC contractor sites, and the Federal Register.
Total alerts
1
Average signal
52/100
Sources monitored
15+
Latest Sleep Medicine alerts
1What is Sleep Medicine reimbursement leakage costing you?
Calculate your ROI with Sleep Medicine-specific CMS benchmarks pre-populated.
MAC contractor coverage
Sleep Medicine billing is subject to both national CMS policy and regional MAC contractor Local Coverage Determinations (LCDs). CLV Intelligence monitors all MAC contractor sites — Noridian, CGS, First Coast, NGS, Novitas, Palmetto GBA, and WPS — for LCD updates affecting Sleep Medicine codes. Coverage criteria vary by contractor jurisdiction.
NoridianCGS AdministratorsFirst CoastNational Government ServicesNovitas SolutionsPalmetto GBAWPS
Get Sleep Medicine alerts by email — free
Weekly digest of CMS and MAC policy changes for Sleep Medicine billing teams.
Frequently asked questions
What MAC contractors issue LCDs for Sleep Medicine billing?
Sleep Medicine billing is subject to regional Local Coverage Determinations (LCDs) from all seven Medicare Administrative Contractors: Noridian, CGS Administrators, First Coast Service Options, National Government Services, Novitas Solutions, Palmetto GBA, and WPS Government Health Administrators. Coverage criteria and medical necessity requirements vary by contractor jurisdiction. CLV Intelligence monitors all MAC contractor sites daily for LCD updates affecting Sleep Medicine codes.
How often does CMS update Sleep Medicine reimbursement policy?
CMS updates the Physician Fee Schedule annually, effective January 1, with proposed rules published in the summer and final rules in November. MAC contractors issue LCD updates on a rolling basis throughout the year with no fixed schedule. The Federal Register publishes proposed and final rules affecting Sleep Medicine reimbursement on a continuous basis. CLV Intelligence monitors all three sources daily and surfaces updates by signal strength.
What is a Local Coverage Determination (LCD) and how does it affect Sleep Medicine billing?
A Local Coverage Determination (LCD) is a decision by a Medicare Administrative Contractor specifying under what clinical circumstances a particular service is covered within its geographic jurisdiction. For Sleep Medicine billing teams, LCDs define medical necessity criteria, covered diagnoses, and documentation requirements for specific procedures. Failure to comply with LCD requirements is among the most common causes of Medicare claim denial in Sleep Medicine practices.
Reimbursement guides & resources
Plain-language guides to the policy cycles that drive Sleep Medicine reimbursement — the fee schedule, ICD-10, HCPCS, and Local Coverage Determinations.
2027 Fee Schedule Guide
How the CY2027 Medicare Physician Fee Schedule works and what to track.
ICD-10 Change Center
The FY2027 ICD-10-CM update cycle and the October 1 effective date.
HCPCS Quarterly Update
How HCPCS Level II changes every quarter — Jan, Apr, Jul, Oct.
Tracking LCD Changes
How LCDs change across all seven MACs and how to track them.
2027 Prep Checklist
A free, printable checklist for the CY2027 fee schedule cycle.
Other specialties