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Accessing ICD-10 Local Coverage Determinations in the CMS Medicare Coverage Database

With the transition to ICD-10 on 10/1/2015, the LCDs have been updated to include the ICD-10 codes and are located on the CMS Medicare Coverage Database or MCD

Please note it is important to use the correct ICD codes that were in effect at the time services were rendered. ICD-10 LCDs and SIAs are in effect for dates of service on or after 10/1/2015. ICD-9 LCDs and SIAs are in effect for dates of service prior to 10/1/2015.

At the end of this article, we have included a crosswalk of the LCDs and the SIAs, for ICD-9 to ICD-10.

Accessing the CMS MCD

Use the following steps to access the list of LCDs with ICD-10 codes:

  1. On the CMS MCD Homepage, click on the Indexes tab at the top of the page;
  2. Select the Local Coverage index;
    Image of the CMS Medicare Coverage Database web page. Arrows point to the Indexes tab, the local coverage link and the LCDs by Contractor link.
  3. Select one of the three display options for LCDs (LCDs by Contractor, LCDs by State, or LCDs Listed Alphabetically);
  4. If LCDs by Contractor is your choice, click on the LCDs by Contractor link;
  5. Select a contractor;
    • National Government Services, Inc.
      • 13102 – Connecticut
      • 13202 – New York (Downstate): Manhattan, Bronx, Brooklyn, Nassau, Rockland, Staten Island, Suffolk, Westchester, Columbia, Delaware, Dutchess, Greene, Orange, Putnam, Sullivan, Ulster
      • 13282 – New York (Upstate): Albany, Oneida, Allegany, Onondaga, Broome, Ontario, Cattaraugus, Orleans, Cayuga, Oswego, Chautauqua, Otsego, Chemung, Rensselaer, Chenango, Saratoga, Clinton, Schenectady, Cortland, Schoharie, Erie, Schuyler, Essex, Seneca, Franklin, Steuben, Fulton, St. Lawrence, Genesee, Tioga, Hamilton, Tompkins, Herkimer, Warren, Jefferson, Washington, Lewis, Wayne, Livingston, Wyoming, Madison, Yates, Monroe Montgomery, Niagara
      • 13292 – New York (Queens County)
      • 14112 – Maine
      • 14212 – Massachusetts
      • 14312 – New Hampshire
      • 14412 – Rhode Island
      • 14512 – Vermont
      • 06102 – Illinois
      • 06202 – Minnesota
      • 06302 – Wisconsin

Image of CMS MCD web page. LCDs by Contractor link is chosen, and links to Index Browser, select a Medicare contractor and click on checkbox for Active LCDs and then the Submit button. Arrows point to an NGS contract and the Submit button.

  1. In the Document types, select the box for Active LCDs;
  2. Click the Submit button;
  3. A list of active LCDs will display. LCDs with an Effective Date of 10/01/2015 are ICD-10 LCDs.
    Image of CMS MCD web page. After the Medicare contractor is selected and the Submit button has been clicked, a list of active LCDs will display. LCDs with an Effective Date of 10/1/2015 are ICD-10 LCDs.

Printing Documents on the CMS MCD

All documents on the CMS MCD may be printed. Use the following steps to print a document:

  • Click on the Title link to access the document, you may need to accept the License Agreements to continue;
    Image of the CMS MCD web page. An arrow points to the link of an active LCD. Click on the link to access the LCD for viewing and printing.
  • In the upper right corner of the web page, click on the Print button or use Control + P
  • Image of the CMS MCD web page. An arrow points to the print feature for printing the active LCD. Another arrow points to the Need a PDF print feature.
  • Alternatively, click on the Need a PDF? button and click on the Save a Copy icon on the bottom of your screen or use Shift + Control + S.
    Image of an Active LCD in PDF. If the Need a PDF? feature is used, click on the Save a Copy icon on the bottom of your screen or use Shift + Control + S. An arrow points to the Save a Copy icon.

 

Crosswalk: ICD-9 to ICD-10 LCD Document Numbers

The transition to the use of ICD-10, has resulted in the revision of the LCDs and SIAs. Below is a crosswalk of the ICD-9 to ICD-10 documents.

NGS LCD Title - J6 and JK ICD-9 LCD Number ICD-10 LCD Number ICD-9 SIA Number ICD-10 SIA Number
Autonomic Function Testing N/A L36236 N/A N/A
Biologic Products for Wound Treatment and Surgical Interventions L26003 L33391 A45056 A52847
Botulinum Toxins L26841 L33646 A46164 A52848
Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography L26890 L33585 A48362 A52849
B-type Natriuretic Peptide (BNP) Testing L26375 L33573 N/A N/A
Cardiac Catheterization and Coronary Angiography L26880 L33557 A50603 A52850
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) L25907 L33559 A45020 A52851
Cardiovascular Nuclear Medicine L26859 L33560 N/A N/A
Cataract Extraction L26853 L33558 A46178 A52819
Category III L25275 L33392 N/A N/A
Chiropractic Services L27350 L33613 A47385 A52853
Circulating Tumor Cell (CTC) Assay L32965 L33587 N/A N/A
Combined Ovarian Cancer Biomarker Tests L32589 L33588 N/A N/A
Computed Tomographic (CT) Colonography for Diagnostic Uses L25233 L33562 N/A N/A
Corneal Pachymetry L28142 L33630 A48393 A52820
Debridement Services L27373 L33614 A47396 A52854
Drugs and Biologicals, Coverage of, for Label and Off-Label Uses L25820 L33394 A44930 A52855
EEG – 24 Hour Monitoring L32963 L33399 N/A N/A
Endoscopic Treatment of GERD L33371 L35080 N/A N/A
Erythropoiesis Stimulating Agents (ESA) L25211 L33617 A44399 A52856
Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy  L35336 L35936 N/A N/A
Hospice - Determining Terminal Status L25678 L33393 A45194 A52842
Implantable Miniature Telescope (IMT) L32454 L33584 A51615 A52857
Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures L28490 L33563 A48000 A52858
Left Atrial Appendage Closure or Occlusion  L33506 L35956 N/A N/A
Lumbar Epidural Injections L35338 L35937 N/A N/A
Magnetic Resonance Angiography (MRA) L25367 L33633 N/A N/A
Molecular Pathology Procedures L34506 L35000 N/A N/A
Nerve Blocks for Peripheral Neuropathy L33385 L35029 N/A N/A
Nerve Conduction Studies (NCS)/Electromyography (EMG) L33386 L35098 N/A N/A
Noncovered Services L32456 L33629 N/A N/A
Noninvasive Vascular Studies L27355 L33627 A47394 A52859
Nonvascular Extremity Ultrasound L28178 L33619 A48353 A52860
Ophthalmic Biometry for Intraocular Lens Power Calculation L26441 L33621 A45936 A52821
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) L25466 L33567 A44439 A52861
Osteopathic Manipulative Treatment L32945 L33616 N/A N/A
Outpatient Physical and Occupational Therapy Services L26884 L33631 A50612 A52862
Pain Management L28529 L33622 A48042 A52863
Panretinal (Scatter) Laser Photocoagulation L28497 L33628 A48012 A52822
Percutaneous Coronary Intervention L28395 L33623 N/A N/A
Posterior Tibial Nerve Stimulation for Voiding Dysfunction L31391 L33396 N/A N/A
Psychiatric Inpatient Hospitalization L25507 L33624 A44896 A52823
Psychiatric Partial Hospitalization Programs L26398 L33626 A45932 A52824
Psychiatry and Psychology Services L26895 L33632 N/A N/A
Qualitative Drug Screening L28145 L33581 A48395 A52826
Radiofrequency Treatment for Urinary Incontinence L33388 L35054 N/A N/A
RAST Type Tests L28463 L33591 N/A N/A
Reduction Mammoplasty L34186 L35001 N/A N/A
Routine Foot Care and Debridement of Nails L26426 L33636 A45934 A52865
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) L34187 L34380 N/A N/A
Speech-Language Pathology L27404 L33580 A47407 A52866
Transcranial Magnetic Stimulation L32038 L33398 N/A N/A
Transesophageal Echocardiography (TEE) L27381 L33579 A48398 A52868
Transrectal Ultrasound L26876 L33578 A46192 A52869
Transthoracic Echocardiography (TTE) L27360 L33577 N/A N/A
Urodynamics L26851 L33576 N/A N/A
Varicose Veins of the Lower Extremity, Treatment of L25519 L33575 A44614 A52870
Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency L33389 L35028 N/A N/A
Vertebroplasty and Vertebral Augmentation (Percutaneous) L26439 L33569 A45937 A52871
Visual Fields Testing L26367 L33574 A45897 A52829
Vitamin D Assay Testing L29510 L33556 A49254 A52872

 

Please note it is important to use the correct ICD codes that were in effect at the time services were rendered. ICD-10 LCDs and SIAs are in effect for dates of service on or after 10/1/2015. ICD-9 LCDs and SIAs are in effect for dates of service prior to 10/1/2015.

Accessing ICD-10 Local Coverage Determinations in the CMS Medicare Coverage Database
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