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N115N-series (general use)Coverage & Eligibility

N115: Denied per Local Coverage Determination

A Medicare contractor's LCD drove the decision — the service, diagnosis, or frequency didn't meet the LCD's coverage criteria.

Commonly appears with these denial codes

The denial code gives the category; N115 pinpoints the specific problem. Read them together before touching the claim.

What to do about it

Read the specific LCD (CMS Medicare Coverage Database). If documentation supports the covered indications, appeal with records; otherwise assess ABN status for patient billing.

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