Local Coverage Determinations by Title

The following table lists local coverage determinations (LCDs) that are currently active for National Government Services Medicare Part A and Part B providers. To search for and access LCDs, please use the Medical Policy Center.

LCDs for Jurisdiction 6 and Jurisdiction K

L26375 B-type Natriuretic Peptide (BNP) Testing
L26003 Biologic Products for Wound Treatment and Surgical Interventions
L26841 Botulinum Toxins
L26890 Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
L26880 Cardiac Catheterization and Coronary Angiography
L25907 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
L25447 Cardiac Output Measurement Thoracic Electrical Bioimpedance
L26859 Cardiovascular Nuclear Medicine
L26853 Cataract Extraction
L25275 Category III CPT® Codes
L27350 Chiropractic Services
L32965 Circulating Tumor Cell (CTC) Assay
L26404 Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
L32589 Combined Ovarian Cancer Biomarker Tests
L25233 Computed Tomographic (CT) Colonography
L28142 Corneal Pachymetry
L27373 Debridement Services
L25820 Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
L32963 EEG - 24 Hour Monitoring
L25211 Erythropoiesis Stimulating Agents (ESA)
L32977 Galectin-3
L32454 Implantable Miniature Telescope (IMT)
L28490 Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures
L25367 Magnetic Resonance Angiography (MRA)
L32456 Non-Covered Pre-operative Services
L27355 Non-Invasive Vascular Studies
L28178 Nonvascular Extremity Ultrasound
L26441 Ophthalmic Biometry for Intraocular Lens Power Calculation
L25466 Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
L32945 Osteopathic Manipulative Treatment
L26884 Outpatient Physical and Occupational Therapy Services
L26895 Outpatient Psychiatry and Psychology Services
L28529 Pain Management
L28497 Panretinal (Scatter) Laser Photocoagulation
L28395 Percutaneous Coronary Intervention
L31391 Posterior Tibial Nerve Stimulation for Voiding Dysfunction
L26428 Polysomnography and Sleep Studies
L31391 Posterior Tibial Nerve Stimulation for Voiding Dysfunction
L25507 Psychiatric Inpatient Hospitalization
L26398 Psychiatric Partial Hospitalization Programs
L28145 Qualitative Drug Screening
L28463 RAST Type Tests
L27362 Removal of Benign Skin Lesions
L26426 Routine Foot Care and Debridement of Nails
L28488 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
L27404 Speech-Language Pathology
L32038 Transcranial Magnetic Stimulation
L27381 Transesophageal Echocardiography (TEE)
L26876 Transrectal Ultrasound
L27360 Transthoracic Echocardiography (TTE)
L26851 Urodynamics
L25519 Varicose Veins of the Lower Extremity, Treatment of
L26439 Vertebroplasty and Kyphoplasty (Percutaneous)
L26367 Visual Fields Testing
L29510 Vitamin D Assay Testing


LCDs for Jurisdiction K Only

L26869 Nerve Conduction Studies (NCS)/Electromyography (EMG)
L26863 Stretta Procedure

LCDs for Jurisdiction 6 Only

L33371 Endoscopic Treatment of GERD
L33384 Heavy Metal Testing
L33385 Nerve Blocks for Peripheral Neuropathy
L33386 Nerve Conduction Studies and Electromyography
L33387 Proton Beam Therapy
L33388 Radiofrequency Treatment for Urinary Incontinence
L33390 Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
L33389 Venous Angioplasty With or Without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency

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Last Modified: 2/14/14