# 42 CFR § 426.310: LCD and NCD reviews and individual claim appeals

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/ecfr-42-426.310

## Section

- **Citation:** 42 CFR § 426.310
- **Heading:** LCD and NCD reviews and individual claim appeals
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** September 22, 2026
- **Source:** Publisher's official text
- **Location:** Title 42—Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM > PART 426—REVIEW OF NATIONAL COVERAGE DETERMINATIONS AND LOCAL COVERAGE DETERMINATIONS > Subpart C—General Provisions for the Review of LCDs and NCDs

## Text

(a) LCD and NCD reviews are distinct from the claims appeal processes set forth in part 405, subparts G and H; part 417, subpart Q; and part 422, subpart M of this chapter.
(b) An aggrieved party must notify the ALJ or the Board, as appropriate, regarding the submission and disposition of any pending claim or appeal relating to the subject of the aggrieved party's LCD or NCD complaint. This reporting obligation continues through the entire LCD or NCD review process.

## Nearby sections

- [42 CFR § 426.100 § 426.100 Basis and scope.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.100.md)
- [42 CFR § 426.110 § 426.110 Definitions.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.110.md)
- [42 CFR § 426.120 § 426.120 Calculation of deadlines.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.120.md)
- [42 CFR § 426.130 § 426.130 Party submissions.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.130.md)
- [42 CFR § 426.300 § 426.300 Review of LCDs, NCDs, and deemed NCDs.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.300.md)
- [42 CFR § 426.310 § 426.310 LCD and NCD reviews and individual claim appeals.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.310.md)
- [42 CFR § 426.320 § 426.320 Who may challenge an LCD or NCD.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.320.md)
- [42 CFR § 426.325 § 426.325 What may be challenged.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.325.md)
- [42 CFR § 426.330 § 426.330 Burden of proof.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.330.md)
- [42 CFR § 426.340 § 426.340 Procedures for review of new evidence.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.340.md)
- [42 CFR § 426.400 § 426.400 Procedure for filing an acceptable complaint concerning a provision (or provisions) of an LCD.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.400.md)
- [42 CFR § 426.403 § 426.403 Submitting new evidence once an acceptable complaint is filed.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.403.md)
- [42 CFR § 426.405 § 426.405 Authority of the ALJ.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.405.md)
- [42 CFR § 426.406 § 426.406 Ex parte contacts.](https://www.frixlaw.com/law-library/statutes/ecfr-42-426.406.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/ecfr-42-426.310. Check the current official text before relying on it. Not legal advice.