Welcome to the Medical Policy Center. Below you will find the LCDs and related billing and coding articles. Medical Policy Articles and other coverage articles can be found below the LCD index.
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| LCD | LCD # | Billing and Coding # | Response to Comments | Related CPT/HCPCS Codes |
|---|---|---|---|---|
| Autonomic Function Testing Related terms: tilt table, sudomotor |
L36236 | A57024 | A54403 | 95921, 95922, 95923, 95924, 95943 |
|
Biomarker Testing (Prior to Initial Biopsy) for Prostate Cancer Diagnosis
Related terms: N/A |
L37733 |
A56609 |
A56742 |
81539, 84153, 84154, 86316, 81479, 0005U
|
| Biomarker Testing for Neuroendocrine Tumors/Neoplasms Related terms: N/A |
L037851 | A57059 | A56247 | 0007M |
| Botulinum Toxins Related terms: Botox, Myobloc, Dysport,Xeomin, spasticity, chemodenervation |
L33646 | A52848 |
43201, 43236, 46505, 52287, 64611, 64612, 64615, 64616, 64617, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 67345, J0585, J0586, J0587, J0588 | |
| Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography Related terms: ultrasound, non-palpable masses, palpable masses |
L33585 | A52849 |
19030, 76641, 76642, 77046, 77047, 77048, 77049, 77053, 77054, C8903, C8905, C8906, C8908 |
|
| B-type Natriuretic Peptide (BNP) Testing Related terms: congestive heart failure, acute dyspnea |
L33573 | A56826 |
83880 | |
| Cardiac Catheterization and Coronary Angiography Related terms: heart, circulatory |
L33557 | A52850 |
36120, 36140, 36200, 36215, 36216, 36217, 36218, 36245, 36246, 36247, 36248, 36251, 36252, 36253, 36254, 75625, 75630, 75658, 75705, 75710, 75716, 92978, 92979, 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93462, 93463, 93464, 93505, 93530, 93531, 93532, 93533, 93561, 93562, 93563, 93564, 93565, 93566, 93567, 93568, 93571, 93572, G0269, G0278 | |
| Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) Related terms: heart, calcium, congenital, bypass |
L33559 | A56737 |
75571, 75572, 75573, 75574, 0501T, 0502T, 0503T, 0504T | |
| Cardiovascular Nuclear Medicine Related terms: cardiac scan, stress test, heart, coronary, ejection, perfusion, blood pool |
L33560 | A56743 |
78451, 78452, 78453, 78454, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78494, 78496, A9500, A9501, A9502, A9505, A9512, A9520, A9538, A9560, Q9969 | |
| Cataract Extraction Related terms: eyes, ophthalmology, complex, epinephrine |
L33558 | A56544 | A55257 | 66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984, 66987, 66988 |
| Computed Tomography Cerebral Perfusion Analysis (CTP) |
L38667 | A58152 | A58327 | 0042T |
| Computed Tomographic (CT) Colonography for Diagnostic Uses Related terms: virtual colonoscopy |
L33562 | A57026 | 74261, 74262 | |
| Corneal Hysteresis Related terms: N/A |
L38014 |
A56528 |
A56529 |
92145
|
| Corneal Pachymetry Related terms: cornea, ophthalmology, eyes |
L33630 | A56548 | 76514, 92499 | |
| Debridement Services Related terms: N/A |
L33614 | A56617 |
11000, 11001, 11042, 11043, 11044, 11045, 11046, 11047, 97597, 97598 | |
| Drugs and Biologicals, Coverage of, for Label and Off-Label Uses Related terms: administration, compendia, FDA |
L33394 | A52855
|
N/A | |
| EEG – Ambulatory Monitoring Related terms: electroencephalogram |
L33399 | A57030 | 95700, 95705, 95706, 95707, 95708, 95709, 95710, 95711, 95712, 95713, 95714, 95715, 95716, 95717, 95718, 95719, 95720, 95721, 95722, 95723, 95724, 95725, 95726 |
|
| Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy Related terms: Radiofrequency, Neurotomy, pain, cervical, lumbar, thoracic |
L35936 | A57826 |
64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636, 64625 |
|
| Fluid Jet System Treatment for LUTS/BPH |
L38367 | A56797 | A58465 A57922 |
C2596, 0421T
|
| Frequency of Hemodialysis Related terms: dialysis, kidney disease, end stage renal disease |
L37475 | A585672 | A56252 | 90999 |
| Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases Related terms: N/A |
L37606 | A56793 |
A55974 | 81450 |
| Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms Related terms: N/A |
L37810 | A56867 |
A56216 | 0048U, 81445 |
| Heavy Metal Testing Related terms: metal toxicity, aluminum, arsenic, iron, lead, nickel, zinc, mercury |
L35074 | A56767 |
82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999 | |
| Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea Related terms: N/A |
L38387 | A57092 | 64568, 0466T, 0467T, 0468T | |
| Implantable
Continuous Glucose Monitors (I-CGM)
Related terms: N/A |
L38623 | A58116 |
A58342 |
0446T, 0447T, 0448T |
| Implantable Miniature Telescope (IMT) Related terms: eye, blindness |
L33584 | A57411 |
A55261 | C1840, 0308T |
| Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures Related terms: paronychia, skin, carbuncle, boil |
L33563 | A56766 |
10060, 10061, 10080, 10081, 10140, 10160, 10180 |
|
| Lumbar Epidural Injections Related terms: spine, pain, transforaminal, sacral, steroid, spinal |
L35937 | A57494 | 62322, 62323, 62326, 62327, 64483, 64484 | |
| Magnetic Resonance Angiography (MRA) Related terms: gadolinium, contrast, imaging |
L33633 | A56747 |
70544, 70545, 70546, 70547, 70548, 70549, 71555, 72159, 72198, 73225, 73725, 74185, C8900, C8901, C8902, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, C8920, C8931, C8932, C8933, C8934, C8935, C8936 | |
| Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor Related terns: N/A |
L37421 | A57435 |
A55848 | 0398T |
| Micro-Invasive Glaucoma Surgery (MIGS) Related terms: N/A |
L37244 | A56588 |
A56783 | 0191T, 0376T, 0449T, 0450T, 0474T |
| Minimally-invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint Related terms: iFuse |
L36406 | A57431 |
27279 | |
| Molecular Pathology Procedures Related terms: genetic testing, genetic counseling, gene, Tier 1, Tier 2 |
L35000 | A56199 | A55982 | 81120, 81121, 81162, 81163, 81164, 81165, 81166, 81167, 81170, 81175, 81176, 81206, 81207, 81208, 81209, 81210, 81212, 81215, 81216, 81217, 81218, 81219, 81220, 81221, 81222, 81223, 81224, 81225, 81226, 81235, 81236, 81237, 81245, 81246, 81256, 81261, 81262, 81263, 81264, 81265, 81266, 81267, 81268, 81270, 81272, 81273, 81275, 81276, 81287, 81301, 81305, 81307, 81308, 81309, 81310, 81311, 81313, 81314, 81315, 81316, 81332, 81334, 81335, 81340, 81341, 81342, 81345, 81370, 81371, 81372, 81373, 81374, 81375, 81376, 81377, 81378, 81379, 81380, 81381, 81382, 81383, 81518, 81519, 81520, 81595, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81233, 81288, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81306, 81312, 81317, 81318, 81319, 81320, 81321, 81322, 81323, 81333, 81343, 81344, 81599, 81105‒81112, 81161, 81171, 81172, 81173, 81174, 81200, 81201, 81202, 81203, 81204, 81205, 81227, 81228, 81229, 81230, 81231, 81232, 81234, 81238, 81239, 81240, 81241, 81242, 81243, 81244, 81247, 81248, 81249, 81250, 81251, 81252, 81253, 81254, 81255, 81257, 81258, 81259, 81260, 81269, 81271, 81274, 81277, 81283, 81284, 81285, 81286, 81289, 81290, 81291, 81302, 81303, 81304, 81324, 81325, 81326, 81327, 81328, 81329, 81330, 81331, 81336, 81337, 81346, 81350, 81355, 81361‒81364, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81420, 81422, 81425, 81426, 81427, 81430, 81431, 81432, 81433, 81434, 81435, 81436, 81437, 81438, 81439, 81440, 81442, 81443, 81448, 81455, 81460, 81465, 81470, 81471, 81493, 81500, ,81503, 81504, 81507, 81521, 81522, 81525, 81535, 81536, 81538, 81540, 81541, 81542, 81545, 81551, 81552 |
| Multimarker Serum Tests Related to Ovarian Cancer Testing Related terms: N/A |
L38371 | A57020 | A58112 | 81500, 81503, 0003U
|
| Nerve Conduction Studies and Electromyography Related terms: electrodiagnostic, neurologic, EMG, NCS, neuromuscular, motor, needle |
L35098 | A57668 |
51785, 92265, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95873, 95874, 95885, 95886, 95887, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95933, 95937, 95999, G0255 | |
| Noninvasive Vascular Studies Related terms: NonInvasive, leg, clot, plethysmography, duplex scan, Doppler, cerebrovascular, arterial, venous, hemodialysis |
L33627 | A56758 |
93880, 93882, 93886, 93888, 93890, 93892, 93893, 93922, 93923, 93924, 93925, 93926, 93930, 93931, 93970, 93971, 93975, 93976, 93978, 93979, 93970, 93971, 93985, 93986, 93990 |
|
| Nonvascular Extremity Ultrasound Related terms: clot, plantar fasciitis |
L33619 | A56787 |
76881, 76882 | |
| Ophthalmic Biometry for Intraocular Lens Power Calculation Related terms: cataract, biometry, eyes |
L33621 | A56549 | 76519, 92136 | |
| Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) Related terms: retinal, retinopathy, chorioretinitis, vitreous |
L33567 | A56726 | 92201, 92202, 92227, 92228, 92250 |
|
| Osteopathic Manipulative Treatment Related terms: somatic, skeletal, dysfunction |
L33616 | A56954 |
A55318 | 98925, 98926, 98927, 98928, 98929 |
| Outpatient Physical and Occupational Therapy Services Related terms: maintenance, restorative, skilled, modality, therapeutic, exercise, manual, cast, splint, biofeedback |
L33631 | A56566 | 29065, 29075, 29085, 29086, 29105, 29125, 29126, 29130, 29131, 29200, 29240, 29260, 29280, 29345, 29355, 29365, 29405, 29425, 29445, 29505, 29515, 29520, 29530, 29540, 29550, 29580, 29799, 90901, 90912, 90913, 95851, 95852, 95992, 96125, 97010, 97012, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97112, 97113, 97116, 97124, 97129, 97130, 97139, 97140, 97150, 97161, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 97530, 97533, 97535, 97537, 97542, 97602, 97605, 97606, 97607, 97608, 97750, 97755, 97760, 97761, 97763, 97799, G0281, G0283, G0295, G0329 |
|
| Pain Management Related terms: spine, spinal, trigger, injection, ganglion |
L33622 | A52863 |
20526, 20550, 20551, 20552, 20553, 20560, 20561, 20612, 27096, 28899, 64451, 64625, G0260 |
|
| Panretinal (Scatter) Laser Photocoagulation Related terms: N/A |
L33628 | A56550 | 67228 | |
| Percutaneous Coronary Intervention Related terms: heart, angina, intracoronary |
L33623 | A56823 |
92920, 92921, 92924, 92925, 92928, 92929, 92933, 92934, 92937, 92938, 92941, 92943, 92944, 92973, 92975, 92978, 92979, 93571, 93572, C9600, C9601, C9602, C9603, C9604, C9605, C9606, C9607, C9608 |
|
| Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) Related terms: compression, spine, fracture |
L33569 | A56178 |
A57436 A58445 A56178 |
22510, 22511, 22512, 22513, 22514, 22515, 76380 |
| Peripheral Nerve Blocks Related terms: N/A |
L36850 | A57452 |
A55421 | 64400, 64405, 64415, 64416, 64417, 64418, 64420, 64421, 64425, 64430, 64445, 64446, 64447, 64448, 64449, 64450, 64455, 64454, 64624, 20560, 20561 |
| Posterior Tibial Nerve Stimulation for Voiding Dysfunction Related terms: overactive bladder, urinary urgency, urinary frequency, urinary incontinence, percutaneous electrical stimulation |
L33396 | A57453 |
64566 | |
| Prostate Rectal Spacers Related terms: N/A |
L37485 | A756539 |
A58100 | 55874 |
| Proton Beam Therapy Related terms: radiation, radiotherapy |
A56827 |
A55124 | 77520, 77522, 77523, 77525 | |
| Psychiatric Inpatient Hospitalization Related terms: active treatment |
L33624 | A56865 |
N/A |
|
| Psychiatric Partial Hospitalization Programs Related terms: mental illness, family counseling, vocational training |
L33626 | A56850 |
90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90846, 90847, 90849, 90853, 90899, 96101, 96102, 96103, 96116, 96118, 96119, 96120, G0129, G0176, G0177, G0410, G0411 |
|
| Psychiatry and Psychology Services Related terms: psychiatric, mental illness, Psychotherapy, electroconvulsive therapy, ECT, psychological testing, vocational training, dementia |
L33632 | A56937 |
90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90865, 90870, 90880, 90885, 90887, 90889, 90899, 96105, 96112, 96113, 96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146, G0451 | |
| RAST Type Tests Related terms: FAST, Radioallergosorbent, fluoroallergosorbent, antigen, allergen, IGE |
L33591 | A56844 |
86001, 86003, 86005, 86008 | |
| Reduction Mammaplasty Related terms: breast reconstruction, cosmetic surgery |
L35001 | A56837 |
19316, 19318 | |
| Routine Foot Care and Debridement of Nails Related terms: feet, toes, toenails, corns, calluses, trimming of nails, systemic disease |
L33636 | A57759 |
11055, 11056, 11057, 11719, 11720, 11721, G0127 |
|
| Salvage High-intensity Focused Ultrasound (HIFU) Treatment in Prostate Cancer (PCa) Related terms: N/A |
L38262 | A56702 | A57835 | 55899, C9747 |
| Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) Related terms: OCT, eyes, cornea, glaucoma |
L34380 | A56537 | 92132, 92133, 92134 | |
| Select Minimally Invasive GERD Procedures Related terms: N/A |
L35080 | A56863 |
A57890 | 43210, 43257, 43284, 43499, 43999, 49999 |
| Speech-Language Pathology Related terms: dysphagia, swallowing, communication |
L33580 | A52866 | 31579, 92507, 92508, 92521, 92522, 92523, 92524, 92597, 92607, 92608, 92609, 92626, 92627, 96105, 96110, 96112, 96113, 97129, 97130, 97533, G0451 |
|
| Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) Related terms: Related terms: ionizing, stereotactic guidance, robotic | L35076 | A56874 |
77371, 77372, 77373, 77432, 77435, G0339, G0340 | |
| Total Joint arrArthroplasty Related terms: Knee, TKA, Hip, THA |
L36039 | A57428 |
27130, 27132, 27134, 27137, 27138, 27445, 27447, 27486, 27487 | |
| Transcranial Magnetic Stimulation Related terms: depression, major depressive disorder, magnetic field |
L33398 | A57528 |
A58145 | 90867, 90868, 90869 |
| Transesophageal Echocardiography (TEE) Related terms: ultrasound, esophagus, doppler, color flow, contrast, heart |
L33579 | A52868 |
76376, 76377, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, C8925, C8926, C8927 | |
| Transrectal Ultrasound Related terms: prostate, ultrasound, echography |
L33578 | A57427 |
76872, 76873 | |
| Transthoracic Echocardiography (TTE) Related terms: cardiac, doppler, stress, cardovascular, myocardial, heart, contrast |
L33577 | A56781 |
76376, 76377, 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93350, 93351, 93352, A9700, C8921, C8922, C8923, C8924, C8928, C8929, C8930, J0153, J0280, J0461, J1245, J1250, J2785, Q9955, Q9956, Q9957 | |
| Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea Related Terms: N/A |
L37929 | A57548 |
A56267 | 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T, 0434T, 0435T, 0436T, C1787, C1823 |
| Urine Drug Testing Related terms: UDT, substance use disorder, SUD, chronic opioid therapy, COT |
L36037 | A56761 |
80305, 80306, 80307, G0480, G0481, G0482, G0483 | |
| Urodynamics Related terms: cystometrogram, uroflowmetry, urethral pressure profile, sphincter electromyogram, sphincter electromyogram, incontinence, voiding dysfunction |
L33576 | A57455 |
51726, 51727, 51728, 51729, 51736, 51741, 51792, 51797 | |
| Varicose Veins of the Lower Extremity, Treatment of Related terms: telangiectasia, spider veins, cosmetic, ligation and stripping, Endovenous radiofrequency ablation, EFRA, laser ablation |
L33575 | A52870 |
A55704 | 36465, 36466, 36468, 36470, 36471, 36473, 36474, 36475, 36476, 36478, 36479, 36482, 36483, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37799 |
| Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency Related terms: CCSVI, multiple sclerosis, MS |
L35028 | A56845 |
37248, 37249 | |
| Visual Electrophysiology Testing Related terms: N/A |
L36831 | A57060 | A55475 | 92273, 92274, 95930, 0509T, 0333T, 0464T |
| Visual Fields Testing Related terms: eyes, ophthalmology, vision |
L33574 | A56551 | 92081, 92082, 92083 | |
| Vitamin D Assay Testing Related terms: Bone Density, Osteopenia |
L37535 | A57736 |
A55852 | 82306, 82652 |
| Water Vapor Thermal Therapy for LUTS/BPH Related terms: N/A |
L37808 |
A56590 |
53854 |
| HHH LCD Title | LCD# | Billing and Coding # |
Related CPT/HCPCS Codes |
|---|---|---|---|
| Hospice - Determining Terminal Status Related terms: Decline, life expectancy |
L33393 |
A52830 |
N/A |
| Article Title | Article # | Related CPT/HCPCS Codes |
|---|---|---|
| Billing
and Coding: Arthroscopic Lavage and Arthroscopic Debridement for the
Osteoarthritic Knee – Medical Policy Article Related Terms: injection |
A52369 | 29877, 29999, G0289 |
| Billing and Coding: Bevacizumab and biosimilars Related Terms: drug, retinal | A52370 | C9257, J9035, 67028 |
| Billing and Coding: Bortezomib Related Terms: drug |
A52371 | J9041, J9044 |
| Billing and Coding: Denosumab (Prolia ™, Xgeva ™) Related Terms: drug, bone |
A52399 | J0897, 96372 |
| Billing and Coding: Eculizumab Related Terms: drug, hemolysis |
A54548 | J1300 |
| Billing and Coding: Filgrastim, Pegfilgrastim, Tbo-filgrastim and biosimilars Related Terms: drug, G-CSF |
A52408 | J1442, J1447, J2505, Q5101, Q5108, Q5110, Q5111, J3590 |
|
Billing and Coding: Hyaluronans Intra-articular Injections of Related Terms: drug, knee, ankle |
A52420
|
J7318, J7320, J7321, J7322, J7323, J7324, J7325, J7326, J7327, J7328, J7329, 20610, 20611 |
| Billing and Coding: Ibandronate Sodium Related Terms: drug, bone , osteoporosis |
A52421 | J1740 |
| Billing and Coding: Infliximab and biosimilars Related Terms: drug |
A52423 | J1745, Q5103, Q5104 |
| Billing and Coding: Intravenous Immune Globulin (IVIG) Related Terms: drug, immunodeficiency, ITP |
A52446 | 96365, 96366, J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1599 |
| Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs Related Terms: drug, endometriosis, leuprolide, goserelin |
A52453 | 11981, 11982, 11983, 96402, J1950, J3315, J3316, J9202, J9217, J9218, J9219, J9225 |
| Billing and Coding: Nivolumab Related Terms: drug |
A54862 | J9299 |
| Billing and Coding: Omalizumab Related Terms: drug |
A52448 | J2357 |
| Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™) Related Terms: drug |
A52450 | J9264, J9267 |
| Billing and Coding: Ranibizumab and Aflibercept Related Terms: eye, ophthalmology, macular |
A52451 | 67028, J0178, J2778, 67916, 67917, 67921, 67922, 67923, 67924, J0179 |
| Billing and Coding: Rituximab, Rituximab-abbs and Rituximab and hyaluronidase human (Rituxan Hycela™) Related Terms: drug |
A52452 |
J9311, J9312, Q5115 |
| Blepharoplasty - Medical Policy Article Related Terms: eye, cosmetic |
A52837 | 15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924 |
| Chiropractic Services –
Medical Policy Article
Related Terms: subluxation, manipulation |
A57889 | 98940, 98941, 98942 |
| Clinical Trials – Medical Policy Article Related Terms: IDE, Q0, modifier |
A52840 | N/A |
| Collagen Implantation for Urinary Incontinence - Medical Policy Article Related Terms: N/A |
A52374 | 51715, L8603, Q3031 |
| Colorectal Cancer Screening – Medical Policy Article Related Terms: colonoscopy, sigmoidoscopy, barium enema |
A52378 | 81528, 82270, G0104, G0105, G0106, G0120, G0121, G0122, G0328 |
| CPT Code 87641 (Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique) - Medical Policy Article Related Terms: staph, MRSA |
A52379 | 87641 |
| Health and Behavior Assessment/Intervention – Medical Policy Article Related Terms: mental, psychologist |
A52434 | 96156, 96158, 96159, 96164, 96165, 96167, 96168, 96170, 96171 |
| Billing and Coding: Implantable Automatic Defibrillators Related Terms: N/A |
A56326 | 33202, 33203, 33215, 33216, 33217, 33218, 33220, 33223, 33224, 33225, 33230, 33231, 33240, 33241, 33243, 33244, 33249, 33262, 33263, 33264, 33270, 33271, 33272, 33273, G0448 |
| Investigational Device Exemption Requests - Medical Policy Article Related Terms: IDE, clinical, Q0 modifier |
A52841 | N/A |
| Laparoscopic Sleeve Gastrectomy (LSG) – Medical Policy Article Related Terms: morbid, obesity, weight |
A52447 | 43775 |
| Local Coverage Determination (LCD) Reconsideration Process - Medical Policy Article Related Terms: N/A |
A52842 | N/A |
| New Local Coverage Determination (LCD) Request Process Related Terms: N/A |
A56198 |
N/A |
| Polysomnography and Sleep Studies – Medical Policy Article Related Terms: N/A |
A53019 | 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400 |
| Process for Determining Self-Administered Drug Exclusions – Medical Policy Article Related Terms: SAD |
A53020 | N/A |
| Psychological Services Coverage under the Incident to Provision for Physicians and Nonphysicians – Medical Policy Article Related Terms: psychiatric, mental |
A52825 | 90785, 90832, 90833, 90834, 90836, 90837, 90838, 90846, 90847, 90849, 90853, 90880, 90899 |
| Billing and Coding: Removal of Benign Skin Lesions Related Terms: cosmetic |
A54602 | 11200, 11201, 11300, 11301, 11302, 11303, 11305, 11306, 11307, 11308, 11310, 11311, 11312, 11313, 11400, 11401, 11402, 11403, 11404, 11406, 11420, 11421, 11422, 11423, 11424, 11426, 11440, 11441, 11442, 11443, 11444, 11446, 17000, 17003, 17004, 17106, 17107, 17108, 17110, 17111, 17340 |
| Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction K Only) Related Terms: SAD |
A53021 | C9399, J0135, J0270, J0364, J0593, J0599, J0630, J1324, J1438, J1559, J1562, J1595, J1628, J1675, J1744, J1815, J1817, J1830, J2170, J2212, J2354, J2440, J2502, J2760, J2940, J2941, J3030, J3031, J3110, J3355, J3357, J3490, J3590, J7999, J9212, J9213, J9216, J9218, Q0515 |
| Self-Administered Drug Exclusion List - Medical Policy Article (Jurisdiction 6 Only) Related Terms: SAD |
A53022 | C9399, J0135, J0270, J0364, J0593, J0599, J0630, J1324, J1438, J1559, J1562, J1595, J1628, J1675, J1744, J1815, J1817, J1830, J2170, J2212, J2354, J2440, J2502, J2760, J2940, J2941, J3030, J3031, J3110, J3355, J3490, J3590, J3357, J7999, J9212, J9213, J9216, J9218, Q0515 |
| Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers Related Terms: pacemaker |
A54909 | 33206, 33207, 33208 |
| Billing and Coding: Stem Cell Transplantation Related Terms: marrow, BMT, autologous, allogeneic, bone |
A52879 | 38240, 38241 |
| Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based – Medical Policy Article Related Terms: N/A |
A53018 | 93282, 93283, 93284, 93287, 93289, 93292, 93295, 93296 |
| HHH Article | Article # | Related CPT/HCPCS Codes |
|---|---|---|
| Home Health Skilled Nursing Care: Teaching and Training for Dementia Patients with Behavioral Disturbances - Medical Policy Article Related Terms: N/A |
A52845 | G0164 |
| Local Coverage Determination Reconsideration Process - Medical Policy Article Related Terms: N/A |
A52842 | N/A |
All of the ICD-9 LCDs and Supplemental Instructions/Medical Policy Articles for Jurisdiction 6 and Jurisdiction K have been moved to the MCD Archive Site and can be searched with the LCD identifier (L number) and/or article identifier (A number). Note: Providers must use the ICD-10 LCDs for all claims with DOS on or after 10/1/2015.
Note: The official LCD is the version on the Medicare Coverage Database.
