This is a coverage-guidance tool only — not a complete compliance solution.
It checks CPT/ICD-10 code coverage against LCD data. It does not review, generate, store, or replace
progress notes, physician / doctor's notes, medical records, or any other clinical documentation needed to support a claim.
You remain responsible for maintaining that documentation.
Select a state on the left to activate claim validation.
How Your Score is Calculated
Your Compliance Health Score reflects the percentage of validated claims confirmed as covered under your active MAC Local Coverage Determination. It updates automatically with each validation.
A
Excellent
95–100% covered
B
Good
85–94% covered
C
Fair
70–84% covered
D
Poor
50–69% covered
F
Critical Risk
0–49% covered — high denial exposure
Active MAC Policy Versions
MAC
Contractor
Policy
JJ / JM
Palmetto GBA
L36021-Rev12
JF / J1 / J11
Noridian Healthcare Solutions
L35062-Rev09
J12
Novitas Solutions
L35062-Rev11
J6 / JK
National Government Services
L36898-Rev07
J7 / J5 / J8
WPS Gov't Health Administrators
L34900-Rev10
J9
First Coast Service Options
L35500-Rev11
J4
CGS Administrators
L35200-Rev06
0 session entries — cleared on page reload
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No audit entries yet. Validated claims appear here. No PHI is stored.
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This system processes billing codes only. No Protected Health Information (PHI) is stored, transmitted, or logged. All validation results are based on CMS Local Coverage Determination (LCD) reference data. This is a coverage-guidance aid only — it is NOT a complete compliance or documentation system. It does not review, produce, store, or replace progress notes, physician / doctor's notes, medical records, or any other clinical documentation required to support a claim; that responsibility remains entirely with the billing provider. This tool does not constitute legal, medical, or billing advice. Covered entities must maintain their own Business Associate Agreements (BAAs) with all downstream vendors.