N115 Denial Code

This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered. A copy of this policy is available at www.cms.gov/mcd, or if you do not have web access, you may contact the contractor to request a copy of the LCD.

This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered. A copy of this policy is available at www.cms.gov/mcd, or if you do not have web access, you may contact the contractor to request a copy of the LCD.

These are non-covered services because this is not deemed a 'medical necessity' by the payer.
This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered.

Non-covered charge(s)
Procedure code billed is not correct/valid for the services billed or the date of service billed
This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered

Policy frequency limits may have been reached, per LCD

There is a date span overlap or overutilization based on related LCD

A recent break in medical need
13/15 months have been paid
Same and Similar equipment on file