LCDs, NCDs, Coverage Articles
Local Coverage Determinations (LCDs)
- Proposed LCDs
- Active LCDs
- Future Effective LCDs
- Retired LCDs
- MCD Archive
- Proposed LCDs one year after being released to the final LCD
- Retired LCDs and articles one year after their retirement dates
- Superseded versions of active LCDs and articles after one year
- All ICD-9 LCDs and articles now reside on the MCD archive
Articles
- MCD Articles
- Local Coverage Article for Self-Administered Drug Exclusion List: (A53066)
- Local Coverage Article for Billing and Coding: Independent Diagnostic Testing Facilities (IDTF) (A58559)
National Coverage Determinations (NCDs)
- NCDs
- The link to the Reconsideration Process must be used for any suggested changes to the Centers for Medicare & Medicaid Services (CMS). Only CMS can update NCDs.
The table below provides a current list of all active LCD and MCD articles.
| LCD Title | LCD ID # | Article Title | Article ID # | CPT®/HCPCS Codes | Contract |
|---|---|---|---|---|---|
| 4Kscore® Assay | L36763 | Billing and Coding: 4Kscore® Assay | A56932 | 81539 | A/B |
| Advance Care Planning | L38970 | Billing and Coding: Advance Care Planning | A58664 | G0438, G0439, 99201–99215, 99217–99226, 99231–99236, 99238, 99239, 99241–99245, 99251–99255, 99281–99285, 99291, 99292, 99304–99310, 99315, 99316, 99318, 99324–99328, 99334–99337, 99341–99345, 99347–99350, 99381–99397, 99468, 99469, 99471, 99472, 99475–99480, 99483, 99495, 99496, 99497, 99498 | A/B |
|
Allergy Skin Testing |
Billing and Coding: Allergy Skin Testing |
95004, 95017, 95018, 95024 |
B | ||
| Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin | L39270 | Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin | A59042 | 38240 | A/B |
| Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA | L39851 | Billing and Coding: Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA) | A59721 | 0623T, 0624T, 0625T, 0626T | A/B |
| Lab: Bladder/Urothelial Tumor Markers | L33420 | Billing and Coding: Lab: Bladder/Urothelial Tumor Markers | A53095 | 86294, 86316, 86386, 88120, 88121 | A/B |
|
Blepharoplasty, Eyelid Surgery and Brow Lift |
Billing and Coding: Blepharoplasty, Eyelid Surgery and Brow Lift |
15820, 15821, 15822, 15823, 67192, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924 |
A/B | ||
| Homocysteine Level, Serum | L34419 | Billing and Coding: Homocysteine Level, Serum | A56675 | 83090 | A/B |
|
Brain Natriuretic Peptide (BNP) Level |
Billing and Coding: Brain Natriuretic Peptide (BNP) Level |
83880 |
B | ||
| Bone Mass Measurement | L39268 | Billing and Coding: Bone Mass Measurement | A59040 | 76977, 77078, 77080, 77081, 77085, 78350, 78351, G0130, 0554T, 0555T, 0556T, 0557T, 0558T | A/B |
|
Cardiac Computed Tomography & Angiography (CCTA) |
Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA) |
75571, 75572, 75573, 75574 |
A/B | ||
|
Cardiac Radionuclide Imaging |
Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning — MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy |
78451, 78452, 78453, 78454, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, A4641, A9500, A9501, A9502, A9505, A9526, A9555 |
A/B | ||
|
N/A |
|
Billing and Coding: Cardiac Radionuclide Imaging | A56476 |
78431 |
A/B |
| Cardiac Resynchronization Therapy (CRT) | L39080 | Billing and Coding: Cardiac Resynchronization Therapy (CRT) | A58821 | 33224, 33225 | A/B |
|
Cataract Surgery |
Billing and Coding: Complex Cataract Surgery: Appropriate Use and Documentation |
66830, 66840, 66850, 66852, 66920, 66940, 66982, 66983, 66984 |
A/B | ||
| N/A | Billing and Coding: Cataract Surgery | A56613 | 66989, 66991 | A/B | |
| Cervical Disc Replacement | L38033 | Billing and Coding: Cervical Disc Replacement | A57021 | 22856, 22858, 22861, 0098T, 0375T, 97010–97036, 97039, 97110–97546 | A/B |
| Cervical Fusion | L39773 | Billing and Coding: Cervical Fusion | A59634 | 22548, 22551, 22552, 22554, 22590, 22595, 22600, 22800, 22802, 22808, 22810, 22812 | A/B |
|
Chemodenervation |
Billing and Coding: Chemodenervation |
46505, 52287, 64611, 64612, 64615, 64616, 64617, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 64999, 67345, 95873, 95874, J0585, J0586, J0587, J0588 |
B | ||
|
Chiropractic Services |
Billing and Coding: Chiropractic Services |
98940, 98941, 98942 |
B | ||
| Cognitive Assessment and Care Plan Service | L39266 | Billing and Coding: Cognitive Assessment and Care Plan Service | A59036 | 90785, 90791, 90792, 96127, 96146, 96160, 96161, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99242, 99243, 99244, 99245, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99366, 99367, 99368, 99483, 99497, 99498, 99605, 99606, 99607 | A/B |
| Colon Capsule Endoscopy (CCE) | L38755 | Billing and Coding: Colon Capsule Endoscopy (CCE) | A58321 | 91113 | A/B |
|
Colonoscopy / |
Billing and Coding: Incomplete Colonoscopy / Failed Colonoscopy |
G0105, G0121, 44388, 44389, 44390, 44391, 44392, 44394, 44401, 44402, 45300, 45303, 45305, 45307, 45308, 45309, 45315, 45317, 45320, 45321, 45327, 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45340, 45341, 45342, 45346, 45347, 45349, 45378, 45379, 45380, 45380, 45381, 45381, 45382, 45382, 45384, 45384, 45385, 45385, 45386, 45388, 45389, 45390, 45391, 45392, 45393, 45398 |
A/B | ||
|
N/A |
|
Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy |
G2204 |
A/B | |
| N/A | Billing and Coding: Colonoscopy / Sigmoidoscopy / Proctosigmoidoscopy | A56632 | G0105, G9998, G9999 | A/B | |
| Computed Tomography Cerebral Perfusion Analysis (CTP) | L38769 | Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) | A58354 | 0042T | A/B |
|
Computerized Axial Tomography (CT), Thorax |
Billing and Coding: Computerized Axial Tomography (CT), Thorax |
71250, 71260, 71270 |
A/B | ||
|
Continuous Peripheral Nerve Blocks (CPNB) |
Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB) |
64416, 64446, 64448, 64449 |
A/B | ||
|
Corneal Pachymetry |
Billing and Coding: Corneal Pachymetry |
76514 |
A/B | ||
|
Cosmetic and Reconstructive Surgery |
Billing and Coding: Oral Maxillofacial Prosthesis |
E0485, E0486, 15780, 15781, 15782, 15783, 15830, 15847, 19316, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 19318, 30400, 30410, 30420, 30430, 30435, 30450, 30460, 30462, 15730, 15733, 21076, 21077, 21079, 21080, 21081, 21082, 21083, 21084, 21086, 21087, 21088, 21089, 21120, 21121, 21122, 21123, 21125, 21127, 21137, 21138, 21139, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21155, 21159, 21160, 21172, 21175, 21179, 21180, 21181, 21182, 21183, 21184, 21188, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21208, 21209, 21210, 21215, 21230, 21240, 21242, 21243, 21244, 21245, 21246, 21247, 21248, 21249, 21255, 21256, 21260, 21261, 21263, 21267, 21268, 21270, 21275, 21280, 21282, 21295, 21296, 21299 |
A/B | ||
| N/A | Billing and Coding: Cosmetic and Reconstructive Surgery | A56658 | 30465 | ||
|
CT of the Abdomen and Pelvis |
Billing and Coding: CT of the Abdomen and Pelvis |
72192, 72193, 72194, 74150, 74160, 74170, 74176, 74177, 74178 |
A/B | ||
|
CT of the Head |
Billing and Coding: CT of the Head |
G2187, G2188, G2189, G2190, G2191, G2192, G2193, G2194 G2195, 70450, 70460, 70470 |
A/B | ||
| Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®) | L38792 | Billing and Coding: Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®) | A58392 | 65800, 65810, 65815, 65820, 65850, 65855, 65860, 65865, 65870, 65875, 65880, 66170, 66172, 66180, 66183, 66184, 66185, 66820, 66821, 66825, 66982, 66984, 67005, 67010, 67015, 67025, 67027, 67028, 67030, 67031, 67036, 67039, 67040, 67041, 67042, 67043, 68841 | A/B |
|
Echocardiography |
Billing and Coding: Echocardiography |
91139, 93303, 93304, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, 93350, 93351, 93352, 93355, A9700, J0153, J0280, J0461, J1245, J1250, M1150 |
A/B | ||
| Echocardiography for Myocardial Perfusion | L38786 | Billing and Coding: Echocardiography for Myocardial Perfusion | A58503 | 0439T, 93306, 93307, 93308, 93350, 93351, 93352, A9700, Q9950, Q9955, Q9956 | A/B |
| Epidural Steroid Injections for Pain Management | L38994 | Billing and Coding: Epidural Steroid Injections for Pain Management | A58695 | 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 64479, 64480, 64483, 64484, 78630 | A/B |
| Erythropoiesis Stimulating Agents | L39237 | Billing and Coding: Erythropoiesis Stimulating Agents | A58982 | J0881, J0882, J0885, J0887, J0888, J0890, Q4081, Q5105, Q5106 | A/B |
| Extracorporeal Shock Wave Therapy (ESWT) | L38775 | Billing and Coding: Extracorporeal Shock Wave Therapy (ESWT) | A58367 | 0101T, 0102T | A/B |
| Facet Joint Interventions for Pain Management | L38765 | Billing and Coding: Facet Joint Interventions for Pain Management | A58350 |
64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T |
A/B |
| Lab: Coenzyme Q10 (CoQ10) | L37022 | Billing and Coding: Lab: Coenzyme Q10 (CoQ10) | A55709 | 82542 | |
| Lab: Cystatin C Measurement | L37581 | Billing and Coding: Lab: Cystatin C Measurement | A56948 | 82610 | A/B |
| Lab: Flow Cytometry | L34513 | Billing and Coding: Lab: Flow Cytometry | A55717 | 86355, 86356, 86357, 86359, 86360, 86361, 86367, 88182, 88184, 88185, 88187, 88188, 88189 | A/B |
| Lower Esophageal Magnetic Sphincter Augmentation | L39780 | Billing and Coding: Lower Esophageal Magnetic Sphincter Augmentation | A59654 | 43284, 43285 | A/B |
| Frequency of Hemodialysis | L34575 |
Billing and Coding: Frequency of Hemodialysis |
A55354 | 90999 | A/B |
| GlycoMark® Testing for Glycemic Control | L36761 | Billing and Coding: GlycoMark Testing for Glycemic Control | A56872 | 84378, 84999 | A/B |
|
HbA1c |
Billing and Coding: HbA1c |
83036, M1211 |
B | ||
|
Health and Behavior Assessment/Intervention |
Billing and Coding: Health and Behavior Assessment / Intervention |
G2214, 96150, 96151, 96152, 96153, 96154, 96155 |
A/B | ||
| Hyaluronic Acid Injections for Knee Osteoarthritis | L39260 | Billing and Coding: Hyaluronic Acid Injections for Knee Osteoarthritis | A59030 | J7318, J7320, J7321, J7322, J7324, J7325, J7326, J7327, J7328, J7329, J7331, J7332, 20610, 20611 | A/B |
| Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea | L38276 | Billing and Coding: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea | A58075 | 61886, 61888, 64582, 64583, 64584 | A/B |
| Implantable Continuous Glucose Monitors (I-CGM) | L38743 | Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) | A58277 | 0446T, 0447T, 0448T | A/B |
|
Implantable Infusion Pump |
Billing and Coding: Implantable Infusion Pump | A56695 |
J2274, J2278, J7999 |
B | |
|
Infliximab |
Billing and Coding: Infliximab |
J1745, Q5103, Q5104, Q5109, Q5121 |
A/B | ||
| Intraoperative Radiation Therapy | L37779 |
Billing and Coding: Intraoperative Radiation Therapy |
19294, 76145, 77424, 77425, 77469, C9726 | A/B | |
|
Intravenous Immunoglobulin (IVIG) |
Billing and Coding: Intravenous Immunoglobulin (IVIG) |
J1459,J1554, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1576, J1599, J2791, J2792 |
A/B | ||
| In Vitro Chemosensitivity & Chemoresistance Assays | L34554 | Billing and Coding: In Vitro Chemosensitivity & Chemoresistance Assays | A56871 | 80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659, 0143U, 0144U, 0145U, 0146U, 0147U, 0148U, 0149U, 0150U, 0227U, 0328U, 0435U | A/B |
| Urine Drug Testing | L35724 | Billing and Coding: Urine Drug Testing | A54799 | 80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659, 0227U, 0328U | A/B |
| Lab: Coenzyme Q10 (CoQ10) | L37022 | Billing and Coding: Lab: Coenzyme Q10 (CoQ10) | A55709 | 82542 | A/B |
| Lab: Special Histochemical Stains and Immunohistochemical Stains | L35922 | Billing and Coding: Lab: Special Histochemical Stains and Immunohistochemical Stains | A56838 | 88312, 88313, 88341, 88342, 88344, 88360, 88361 | A/B |
|
Laparoscopic Sleeve Gastrectomy for Severe Obesity |
Billing and Coding: Laparoscopic Sleeve Gastrectomy for Severe Obesity |
43775 |
A/B | ||
| Lumbar Artificial Disc Replacement | L37826 | Billing and Coding: Lumbar Artificial Disc Replacement | A56390 | 22857, 22860, 22862, 0165T | A/B |
| Lumbar Spinal Fusion | L37848 | Billing and Coding: Lumbar Spinal Fusion | A56396 | 22533, 22558, 22612, 22630, 22633 | A/B |
| Luteinizing Hormone-Releasing Hormone (LHRH) Analogs | L39387 | Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs | A59160 | 11981, 11982, 11983, 96402, J1950, J1952, J1954, J9202, J9217, J9219, J9225, J3315 | A/B |
| Magnesium | L39400 | Billing and Coding: Magnesium | A59186 | 83735 | A/B |
| Magnetic Resonance Angiography | L34424 | Billing and Coding: Magnetic Resonance Angiography | A56775 | 70544, 70545, 70546, 70547, 70548, 70549, C8900, C8901, C8902, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, C8920, C8934, C8935, C8936 | A/B |
| Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor | L37761 |
Billing and Coding: Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor |
0398T | A/B | |
| Magnetic Resonance Imaging of the Head and Neck | L34425 | Billing and Coding: Magnetic Resonance Imaging of the Head and Neck | A56729 | 70540, 70542, 70543 | A/B |
| MDS FISH | L37602 | Billing and Coding: MDS FISH | A56913 | 88271, 88273, 88274, 88275, 88291 | A/B |
| Micro-Invasive Glaucoma Surgery (MIGS) | L37531 | Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS) | A56866 |
65820, 66174, 66175, 66183, 66710, 66711, 66982, 66987, 66988 66989, 66991, 66999, 0253T, 0449T, 0450T, 0474T, 0621T, 0622T, 0671T |
A/B |
| Minimally Invasive Surgical (MIS) Fusion of the Sacroiliac Joint (SIJ) | L39025 | Billing and Coding: Minimally Invasive Surgical (MIS) Fusion of the Sacroiliac Joint (SIJ) | A58739 | 27279 | A/B |
|
Mohs Micrographic Surgery (MMS) |
Billing and Coding: Mohs Micrographic Surgery (MMS) |
17311, 17312, 17313, 17314, 17315 |
B | ||
| Near-Infrared Spectroscopy in Wound and Flap Management | L39385 | Billing and Coding: Near-Infrared Spectroscopy in Wound and Flap Management | A59158 | 0640T, 0641T, 0642T | A/B |
|
Nerve Blocks and Electrostimulation for Peripheral Neuropathy |
Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy |
64450, 97032, 97139, G0282, G0283 |
A/B | ||
|
Nerve Conduction Studies and Electromyography |
Billing and Coding: Nerve Conduction Studies and Electromyography |
51785, 92265, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95885, 95886, 95887, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95933, 95937, 95999, G0255 |
A/B | ||
| Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease | L38278 | Billing and Coding: Non- Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease | A58406 | 0501T, 0502T, 0503T, 0504T | A/B |
|
Octreotide Acetate for Injectable Suspension (Sandostatin LAR depot) |
Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin LAR® depot) |
J2353 |
B | ||
|
Ophthalmic Angiography (Fluorescein and Indocyanine Green) |
Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green) |
92235, 92240, 92242 |
A/B | ||
|
Ophthalmology: Extended Ophthalmoscopy and Fundus Photography |
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography |
92201, 92202, 92227, 92228, 92250 |
A/B | ||
| Opioid Treatment Programs | L39849 | Billing and Coding: Opioid Treatment Programs | A59718 | G0137, G1028, G2067, G2068, G2069, G2070, G2071, G2072, G2073, G2074, G2075, G2076, G2077, G2078, G2079, G2080, G2215, G2216 | A/B |
| Outpatient Psychotherapy | L39853 | Billing and Coding: Outpatient Psychotherapy | A59723 | 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90846, 90847, 90849, 90853, 90863, 90887, 90889, 90899, G0017, G0018, G0323, G0409, G0410, G0411 | A/B |
| Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) | L38737 | Billing and Coding: Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) | A58275 | 22510, 22511, 22512, 22513, 22514, 22515 | A/B |
| Peroral Endoscopic Myotomy (POEM) | L38747 | Billing and Coding: Peroral Endoscopic Myotomy (POEM) | A58287 | 43497 | A/B |
| Platelet Rich Plasma | L38745 | Billing and Coding: Platelet Rich Plasma | A58282 | G0465, M0076, P9020, S9055, 0232T | A/B |
|
Polysomnography |
Accreditation and Credentialing Requirements for Polysomnography |
95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400 |
A/B | ||
| N/A | Billing and Coding: Polysomnography | A56995 | A/B | ||
| N/A | Billing and Coding: E/M Coding for Oral Surgeons | A56006 | 99202–99215 | B | |
|
Pulmonary Stress Testing |
Billing and Coding: Pulmonary Stress Testing |
94617, 94618, 94619, 94621 |
B | ||
| Radiation Therapies | L39553 | Billing and Coding: Radiation Therapies | A59350 | 61796, 61797, 61798, 61799, 61800, 77293, 77301, 77338, 77371, 77372, 77373, 77385, 77386, 77432, 77435, G0339, G0340, G6015, G6016 | A/B |
|
Removal of Benign and Malignant Skin Lesions |
Billing and Coding for Removal of Benign and Malignant Skin Lesions |
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, 11600, 11601, 11602, 11603, 11604, 11606, 11620, 11621, 11622, 11623, 11624, 11626, 11640, 11641, 11642, 17000, 17003, 17004, 17110, 17111, 17260, 17261, 17262, 17263, 17264, 17266, 17270, 17271, 17272, 17273, 17274, 17276, 17280, 17281, 17282, 17283, 17284, 17286, |
A/B | ||
|
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder |
Billing and Coding: Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder |
90867, 90868, 90869 |
B | ||
|
Respiratory Therapy and Oximetry Services |
Billing and Coding: Respiratory Therapy and Oximetry Services |
31720, 94640, 94664, 94760, 94761, 94762 |
B | ||
|
Retroperitoneal Ultrasound |
Billing and Coding: Retroperitoneal Ultrasound |
76770, 76775, 76776 |
A/B | ||
|
Rituximab |
Billing and Coding: Rituximab |
J3590, J9311, J9312, Q5123, Q5115 |
A/B | ||
|
Routine Foot Care |
Billing and Coding: Routine Foot Care |
11055, 11056, 11057, 11719, 11720, 11721, G0127 |
A/B | ||
| Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence | L39543 | Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence | A59332 | 64561, 64581, 64585, 64590, 64595, 64596, 64597, 64598, 95970, 95971, 95972, A4290, C1767, C1778, C1820, C1883, C1897, L8678 | A/B |
| Sacroiliac Joint Injections and Procedures | L39402 | Billing and Coding: Sacroiliac Joint Injections and Procedures | A59192 | 27096, 64451, 64625, 77002, 77012, G0260 | A/B |
| Scalp Cooling for the Prevention of Chemotherapy-Induced Alopecia | L39573 | Billing and Coding: Scalp Cooling for the Prevention of Chemotherapy-Induced Alopecia | A59371 | 0662T, 0663T | A/B |
|
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) |
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) |
92132, 92133, 92134 |
A/B | ||
|
Somatosensory Testing |
Billing and Coding: Somatosensory Testing |
95925, 95926, 95927 |
A/B | ||
|
Special Electroencephalography |
Billing and Coding: Special Electroencephalography |
95700, 95705, 95708, 95717, 95719, 95721, 95812, 95813, 95816, 95819, 95822 |
B | ||
|
Spinal Cord Stimulators for Chronic Pain |
Billing and Coding: Spinal Cord Stimulators for Chronic Pain |
63650, 63655, 63661, 63662, 63663, 63664, 63685, 63688, 95970, 95971, 95972, L8680 |
A/B | ||
| Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication | L37774 |
Billing and Coding: Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication |
93668 | A/B | |
| Surgical Treatment of Nails | L39258 | Billing and Coding: Surgical Treatment of Nails | A59028 | 11730, 11732, 11750, 11765 | A/B |
|
Swallowing Studies for Dysphagia |
Billing and Coding: Swallowing Studies for Dysphagia |
70370, 70371, 74230 |
B | ||
| Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain | L39420 | Billing and Coding: Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain | A59205 | 64628, 64629 | A/B |
| Topical Oxygen Therapy | L37873 | Billing and Coding: Topical Oxygen Therapy | A56431 | A4575 | A/B |
|
Total Joint Arthroplasty |
Billing and Coding: Total Joint Arthroplasty |
27130, 27132, 27134, 27137, 27138, 27445, 27447, 27486, 27487 |
A/B | ||
| Total Shoulder Arthroplasty | L39956 | Billing and Coding: Total Shoulder Arthroplasty | A59878 | 23472 | A/B |
| Transanal Endoscopic Surgery (TES) | L38551 | Billing and Coding: Transanal Endoscopic Surgery (TES) | A58000 | 0184T | A/B |
| Transurethral Waterjet Ablation of the Prostate | L38549 | Billing and Coding: Transurethral Waterjet Ablation of the Prostate | A58008 | C2596, K1010, K1011, K1012, 0421T | A/B |
| Treatment of Males with Low Testosterone | L39086 | Billing and Coding: Treatment of Males with Low Testosterone | A58828 | 11980, 84410, 96372, J1071, J3121, J3145, J3490 | A/B |
| Treatment of Varicose Veins of the Lower Extremities | L39121 | Billing and Coding: Treatment of Varicose Veins of the Lower Extremities | A58876 | 36465, 36466, 36468, 36470, 36471, 36473, 36474, 36475, 36476, 36478, 36479, 36482, 36483, 37500, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37785 | A/B |
| Trigger Point Injections (TPI) | Billing and Coding: Trigger Point Injections (TPI) | A59498 |
20552, 20553 |
A/B | |
|
Upper Gastrointestinal Endoscopy and Visualization |
Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization |
43191, 43192, 43193, 43194, 43195, 43196, 43197, 43198, 43200, 43201, 43202, 43204, 43205, 43206, 43210, 43211, 43212, 43213, 43214, 43215, 43216, 43217, 43220, 43226, 43227, 43229, 43231, 43232, 43233, 43235, 43236, 43237, 43238, 43239, 43240, 43241, 43242, 43243, 43244, 43245, 43246, 43247, 43248, 43249, 43250, 43251, 43252, 43253, 43254, 43255, 43259, 43260, 43261, 43262, 43263, 43264, 43265, 43266, 43270, 43274, 43275, 43276, 43277, 43278, 43499, 74235, 0652T, 0653T, 0654T |
A/B | ||
| Vitamin D Assay Testing | L39391 | Billing and Coding: Vitamin D Assay Testing | A59170 | 82306, 82652 | A/B |
|
Vestibular Function Testing |
Billing and Coding: Vestibular Function Testing |
92517, 92519, 92537, 92538, 92540, 92541, 92542, 92544, 92545, 92546, 92547, 92548, 92549, 92552, 92553, 92556, 92557, 92581 |
B | ||
|
Virtual Colonoscopy (CT Colonography) |
Billing and Coding: Virtual Colonoscopy (CT Colonography) |
|
74261, 74262 |
B | |
| Voretigene Neparvovecrzyl (Luxturna®) | L37863 | Billing and Coding: Voretigene Neparvovecrzyl (Luxturna®) | A56419 | J3398, 67036, 67299 | A/B |
|
White Cell Colony Stimulating Factors |
Neulasta® (pegfilgrastim) Onpro® Kit (On-Body Injector) |
96372, 96377, J1442, J1447, J2506, J2820, Q5101, Q5108, Q5110, Q5111 |
A/B | ||
| N/A | Billing and Coding: White Cell Colony Stimulating Factors | A56748 | J1449, Q5120, Q5122, Q5125, Q5127, Q5130 | A/B | |
|
Wireless Capsule Endoscopy |
Billing and Coding: Wireless Capsule Endoscopy |
91110, 91111 |
A/B | ||
|
Wireless Gastrointestinal Motility Monitoring Systems |
Billing and Coding: Wireless Gastrointestinal Motility Monitoring Systems |
91112 |
B | ||
|
YAG Capsulotomy |
Billing and Coding: YAG Capsulotomy |
66821 |
A/B | ||
| N/A |
N/A |
Billing and Coding: Aflibercept (EYLEA®) Coding and Billing Guidelines |
67028, J0177, J0178 |
B | |
|
N/A |
N/A |
Billing and Coding: Guidance for Anti-Inhibitor Coagulant Complex (AICC) National Coverage Determination (NCD) 110.3 |
A56065 | J7170, J7175, J7179, J7180, J7181, J7183, J7182, J7185, J7186, J7187, J7188, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7196, J7197, J7198, J7200, J7201, J7202, J7203, J7204, J7205, J7207, J7208, J7209, J7210, J7211, J7212 | B |
|
N/A |
N/A |
Billing and Coding: Instructions for Lemtrada® (alemtuzumab) When Used in the Treatment of Relapsing Multiple Sclerosis |
J0202 |
A/B | |
|
N/A |
N/A |
Billing and Coding: Additional Claim Documentation Requirements for Not Otherwise Classified (NOC) Drugs and Biological Products with Specific FDA Label Indications |
A4641, A9699, J3490, J3590, J9999 |
A/B | |
|
N/A |
N/A |
Billing and Coding: Amniotic Membrane Billing Guidelines for HCPCS Code V2790 |
65775, 65778, 65779, 65780, V2790 |
B | |
|
N/A |
N/A |
Billing and Coding: Chemotherapy | A56141 |
|
A/B |
|
N/A |
N/A |
Billing and Coding: Endometrial Hyperplasia Treatment |
58999 |
B | |
| N/A | N/A | Billing and Coding: FDA Approved CLL Companion Diagnostic Test | A56008 | 88271, 88275, 88291, 88374, 88377 | A/B |
|
N/A |
N/A |
Billing and Coding: FDA approves Iluvien for Diabetic Macular Edema |
67028, J7313 |
B | |
|
N/A |
N/A |
Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation |
93797, 93798, G0422, G0423 |
A/B | |
|
N/A |
N/A |
Billing and Coding: Gender Reassignment Services for Gender Dysphoria |
11950, 11951, 11952, 11954, 15775, 15776, 15820, 15821, 15822, 15823, 15824, 15825, 15826, 15828, 15829, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15876, 15877, 15878, 15879, 17380, 19303, 19304, 19316, 19325, 19350, 21120, 21121, 21122, 21123, 21125, 21127, 21208, 21209, 30400, 30410, 30420, 30430, 30435, 30450, 53420, 53425, 53430, 54660, 54125, 54520, 54690, 55175, 55180, 55866, 55970, 55980, 56625, 56800, 56805, 57106, 57110, 57291, 57292, 57295, 57296, 57335, 57426, 58150, 58180, 58260, 58262, 58275, 58290, 58291, 58541, 58542, 58543, 58544, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573, 58720 |
A/B | |
| N/A | N/A |
Billing and Coding: Hemorrhoid Artery Ligation |
46948 |
B | |
| N/A | N/A | Billing and Coding: IDTFs and Low Dose CT Scan for Lung Cancer Screening for CPT® Code 71271 | A58641 | 71271, G0296 | A/B |
|
N/A |
N/A |
Billing and Coding: Implantable Automatic Defibrillators | A56343 | 33202, 33203, 33215, 33216, 33217, 33218, 33220, 33223, 33224, 33225, 33230, 33231, 33240, 33241, 33243, 33244, 33249, 33262, 33263, 33264, 33270, 33271, 33272, 33273, C7537, C7538, C7539, C7540, G0448 | A/B |
|
N/A |
N/A |
Billing and Coding: Implantable Miniature Telescope (IMT) for Macular Degeneration |
0308T |
B | |
|
N/A |
N/A |
Billing and Coding: Intravesical Instillation of Bacillus Calmette-Guérin (BCG) | A56754 | A/B | |
|
N/A |
N/A |
Billing and Coding: Low frequency, non-contact, non-thermal ultrasound |
97597, 97598, 97602, 97605, 97606, 97610 |
B | |
|
N/A |
N/A |
Billing and Coding: Percutaneous Ventricular Assist Device |
33990, 33991, 33992, 33993 33995, 33997 | B | |
| N/A | N/A | Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemaker | 33206, 33207, 33208, 33274 and 33275 | A/B | |
|
N/A |
N/A |
Billing and Coding: Thermal Capsulorrhaphy |
29999 |
B | |
|
N/A |
N/A |
Billing and Coding: Use of Laterality Modifiers | A56869 | 15820, 15821, 15822, 15823, 20610, 20611, 66940, 66982, 66983, 66984, 66987, 66988, 66989, 66991, 67027, 67028, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67917, 67921, 67922, 67923, 68841, 0449T, 0671T and 0699T | A/B |
|
N/A |
N/A |
Billing and Coding: Xofigo Billing Instructions |
A9606 |
B | |
|
N/A |
N/A |
Billing and Coding: External Components for Cochlear Implants |
L7510, L7520, L8614, L8615, L8616, L8617, L8618, L8619, L8621, L8622, L8623, L8624, L8627, L8628, L8629, L9900 |
B | |
|
N/A |
N/A |
Billing and Coding: High Resolution Anoscopy | A59323 |
46601, 46607 |
B |
|
N/A |
N/A |
CPT® Modifier 59: Gastroenterology |
45380, 45385 |
B | |
|
N/A |
N/A |
Fracture of Ribs with Internal Fixation |
21811, 21812, 21813 |
B | |
|
N/A |
N/A |
Glaucoma Screening |
G0117, G0118 |
B | |
|
N/A |
N/A |
Billing and Coding: Medicare Preventive Coverage for Certain Vaccines |
90630, 90637, 90638, 90653, 90654, 90655, 90656, 90657, 90660, 90661, 90662, 90670, 90671, 90672, 90673, 90674, 90675, 90676, 90677, 90682, 90685, 90686, 90687, 90688, 90689, 90694, 90702, 90714, 90715, 90732, 90739, 90740, 90743, 90744, 90746, 90747, 90756, 90759, G0008, G0009, G0010, Q2034, Q2035, Q2036, Q2037, Q2038, Q2039 |
A/B | |
|
N/A |
N/A |
Once in a Lifetime Abdominal Aortic Aneurysm (AAA) Screening Article |
76706 |
A/B | |
| N/A | N/A | Billing and Coding: Periodic Adjustment of Gastric Restrictive Device after the Global Period (Codes added Modifier 25) | A53444 | 43999 | B |
|
N/A |
N/A |
Billing and Coding: Pre/Postoperative Care: Date of Service |
66982, 66987, 66988 |
B | |
| N/A | N/A | Billing and Coding: Radiology Services: Multiple, Identical Services on Same Day | A53488 | 73000 | B |