A comment window runs about 45 days. Once it shuts, only a Medicare beneficiary with a denied claim and their doctor’s letter can ask for a review — the manufacturer cannot.

Medicare does not decide what it pays for in one place. Three kinds of document do it, they open to argument at different moments, and the one most likely to name your code never opens at all.

National decision NCD

Made once, in Washington, and binding on the whole country. There are 357 of them and most were settled decades ago. If one covers your question it is the answer, and a local contractor cannot override it. These carry their own statutory comment process when CMS opens a national coverage analysis, which is a different and rarer moment than the local windows this site tracks.

Local policy LCD

Medicare does not pay claims itself. It hires private companies, called contractors, to pay them region by region, and each one writes its own rules about what it will pay for and under what conditions. There are 854 of these in force, written by eight Medicare Administrative Contractors. This is where most coverage is actually decided, and it is why the same test can be paid in one state and refused in another.

Billing article

The attachment that names the actual codes and diagnoses a policy applies to. When you look up a code, this is usually what names it, and it is the one document here with no comment period at all. Coding and payment questions are also outside what 42 CFR 426.325 allows anyone to appeal afterwards, so an article is argued only indirectly, through the policy it hangs from.

Before a local policy takes effect, the contractor has to publish it as a draft and take comments for about 45 days. Anyone can write in. The contractor then has to publish every comment it received and its own written answer to each one, in public.

That published back-and-forth is what this site collects: 7852 comments across 820 comment periods, each with what the contractor said back and whether it changed anything. 4028 of them sit in the 344 periods where CMS recorded a closing date; on the other 3824 it published the comments and left the date blank.

The window is the widest opening. Once it closes your route under 42 CFR 426 closes with it: there, only a Medicare beneficiary who needs the service, or their estate, with their treating physician’s documentation, may challenge the policy. A manufacturer, a hospital or a society cannot. A separate mechanism, LCD reconsideration, does remain open to interested parties; it is slower and narrower than commenting, and it is not the subject of this site.

1. Start with a code. On Look up a code, type the code you bill, or just a word from the policy: "oxygen", "cardiac". You do not need to know the number.
2. See if it is open. If a draft names your code, you get the deadline and the exact criteria the contractor is proposing, quoted.
3. Read what worked before. The record searches every published comment and the contractor's reply. Search the argument, not just the code: "medical necessity", "frequency".
4. Hand it to an agent. Any result becomes a corpus with a short id. Paste that to an agent running the Hammer plugin and it pulls the rows, the vintage they came from and the query that selected them, so the claim can be re-run and cited months later.

10 drafts are accepting comment, naming 35 distinct codes between them. The nearest shuts in 21 days.

The number counts comments whose text contains the code itself. Only 478 of the 7852 comments name any code at all, because people argue about a policy rather than about a numeral, so no number here means nobody typed it and not that nobody argued. Search the policy name on the record to find those.

Nothing moved between these two vintages.

Every comment CMS published with the contractor’s written reply. Search by code, company, contractor or phrase.

Every line is a link CMS publishes. Click any node to re-centre on it.