Palmetto GBA - JJ Part B - LCDs and Related Articles

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Published Date:02/23/2018

Printed Date: 9/22/2015

URL: http://palmgba.com/marlowe/redesign6/article.html

LCDs and Related Articles

Below is a list of Local Coverage Determinations (LCDs) and associated coverage articles. Search within this current listing by LCD or article number or title by using the CTRL+F function. The CMS Medicare Coverage Database: Advanced Search feature allows you to search by additional filters.

*Note: Scroll to the bottom of the Future Effective Policy under "Associated Links" and select the previous version to see an Active Policy.

Note: Part B of A LCDs and articles should be submitted by the Part A entity. These services should not be submitted as Part B claims.

LCD Title	LCD ID #	Article Title	Article ID #	CPT/HCPCS Codes	Contract
Allergy Skin Testing	L33417	Billing and Coding: Allergy Skin Testing	A56559	95004, 95017, 95018, 95024	B
Assays for Vitamins and Metabolic Function	L33418	Billing and Coding: Assays for Vitamins and Metabolic Function	A56485	82180, 82306, 82379, 82607, 82652, 82746, 83090, 83698, 84207, 84252, 84425, 84446, 84590, 84591, 84597, 85385, 86141, 86352, 86353	B
Blepharoplasty, Eyelid Surgery and Brow Lift	L34411	Billing and Coding: Blepharoplasty, Eyelid Surgery and Brow Lift	A56503	15820, 15821, 15822, 15823, 67192, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924	A/B
Brain Natriuretic Peptide (BNP) Level	L33422	Billing and Coding: Brain Natriuretic Peptide (BNP) Level	A56565	83880	B
Cardiac Computed Tomography & Angiography (CCTA)	L33423	Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA)	A56691	75571, 75572, 75573, 75574, 0501T, 0502T, 0503T, 0504T	A/B
Cardiac Radionuclide Imaging	L33457	Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy	A54768	78451, 78452, 78453, 78454, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, A4641, A9500, A9501, A9502, A9505, A9526, A9555	A/B
		Billing and Coding: Cardiac Radionuclide Imaging	A56476
Cataract Surgery	L34413	Billing and Coding: Complex Cataract Surgery: Appropriate Use and Documentation	A53047	66830, 66840, 66850, 66852, 66920, 66940, 66982, 66983, 66984	A/B
		Billing and Coding: Cataract Surgery	A56613
Cervical Disc Replacement	L38033	Billing and Coding: Cervical Disc Replacement	A57021	22856, 22858, 22861, 0098T, 0375T, 97010 – 97039, 97110 - 97546	A/B
Chemodenervation	L33458	Billing and Coding: Chemodenervation	A56646	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	L37387	Billing and Coding: Chiropractic Services	A56616	98940, 98941, 98942	B
Colonoscopy / Sigmoidoscopy / Proctosigmoidoscopy	L34454	Billing and Coding: Incomplete Colonoscopy / Failed Colonoscopy	A55227	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
		Billing and Coding: Screening Colonoscopy Converted to a Diagnostic and/or Therapeutic Colonoscopy	A55069
		Billing and Coding: Colonoscopy / Sigmoidoscopy / Proctosigmoidoscopy	A56632
Computerized Axial Tomography (CT), Thorax	L33459	Billing and Coding: Computerized Axial Tomography (CT), Thorax	A56580	71250, 71260, 71270	A/B
Continuous Peripheral Nerve Blocks (CPNB)	L37641	Billing and Coding: Continuous Peripheral Nerve Blocks (CPNB)	A56607	64416, 64446, 64448, 64449	A/B
Corneal Pachymetry	L34512	Billing and Coding: Corneal Pachymetry	A56611	76514	A/B
Cosmetic and Reconstructive Surgery	L33428	Oral Maxillofacial Prosthesis	A53497	E0485, E0486, 15780, 15781, 15782, 15783, 15830, 15847, 19316, 19324, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19366, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 19318, 21235, 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
		Billing and Coding: Cosmetic and Reconstructive Surgery	A56658
CT of the Abdomen and Pelvis	L34415	Billing and Coding: CT of the Abdomen and Pelvis	A56421	72192, 72193, 72194, 74150, 74160, 74170, 74176, 74177, 74178	A/B
CT of the Head	L34417	Billing and Coding: CT of the Head	A56612	70450, 70460, 70470	A/B
Echocardiography	L37379	Billing and Coding: Echocardiography	A56625	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	A/B
Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy	L36471	Billing and Coding: Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy	A56687	64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636	A/B
Frequency of Hemodialysis	L34575	Billing and Coding: Frequency of Hemodialysis	A55354	90999	A/B
HbA1c	L33431	Billing and Coding: HbA1c	A56686	83036	B
Health and Behavior Assessment/Intervention	L37638	Billing and Coding: Health and Behavior Assessment / Intervention	A56562	96150, 96151, 96152, 96153, 96154, 96155	A/B
Hyaluronate Polymers	L33432	Billing and Coding: Hyaluronate Polymers	A56694	J7318, J7320, J7321, J7331, J7322, J7323, J7324, J7325, J7326, J7327, J7328, J7329	B
Implantable Infusion Pump	L33461	Billing and Coding: Implantable Infusion Pump	A56695	J2274, J2278, J7999	B
Infliximab	L35677	Billing and Coding: Infliximab	A56432	J1745, Q5103, Q5104, Q5109	A/B
Intraoperative Radiation Therapy	L37779	Billing and Coding: Intraoperative Radiation Therapy	A56684	19294, 77424, 77425, 77469, C9726	A/B
Intravenous Immunoglobulin (IVIG)	L34580	Billing and Coding: Intravenous Immunoglobulin (IVIG)	A56718	J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1599, J2791, J2792	A/B
Laparoscopic Sleeve Gastrectomy for Severe Obesity	L34576	Billing and Coding: Laparoscopic Sleeve Gastrectomy for Severe Obesity	A56852	43775	A/B
Lumbar Artificial Disc Replacement	L37826	Billing and Coding: Lumbar Artificial Disc Replacement	A56390	22857, 22862, 0163T, 0165T	A/B
Lumbar Epidural Steroid Injections	L35148	Billing and Coding: Lumbar Epidural Steroid Injections	A56721	62322, 62323, 64483, 64484	B
Lumbar Spinal Fusion	L37848	Billing and Coding: Lumbar Spinal Fusion	A56396	22533, 22558, 22612, 22630, 22633	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	A56690	0398T	A/B
Micro-Invasive Glaucoma Surgery (MIGS)	L37531	Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS)	A56866	0191T, 0449T, 0376T, 0450T	A/B
Minimally Invasive Treatment for Benign Prostatic Hyperplasia Involving Prostatic Urethral Lift (Urolift®)	L36109	Billing and Coding: Minimally Invasive Treatment for Benign Prostatic Hyperplasia Involving Prostatic Urethral Lift (Urolift®)	A56723	52441, 52442, C9739, C9740, L8699	A/B
Mohs Micrographic Surgery (MMS)	L33436	Billing and Coding: Mohs Micrographic Surgery (MMS)	A56732	17311, 17312, 17313, 17314, 17315	B
Nerve Blocks and Electrostimulation for Peripheral Neuropathy	L37642	Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy	A56731	64450, 97032, 97139, G0282, G0283	A/B
Nerve Conduction Studies and Electromyography	L35048	Billing and Coding: Nerve Conduction Studies and Electromyography	A56619	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-Covered Category III CPT Codes	L34555	Billing and Coding: Non-Covered Category III CPT Codes	A56480	0042T, 0058T, 0071T, 0072T, 0095T, 0098T, 0101T, 0102T, 0106T, 0107T, 0108T, 0109T, 0110T, 0111T, 0126T, 0174T, 0175T, 0184T, 0198T, 0200T, 0201T, 0202T, 0207T, 0208T, 0209T, 0210T, 0211T, 0212T, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T, 0228T, 0229T, 0230T, 0231T, 0232T, 0234T, 0235T, 0236T, 0237T, 0238T, 0253T, 0263T, 0264T, 0265T, 0266T, 0267T, 0268T, 0269T, 0270T, 0271T, 0272T, 0273T, 0274T, 0278T, 0290T, 0312T, 0313T, 0314T, 0315T, 0316T, 0317T, 0329T, 0330T, 0331T, 0332T, 0333T, 0335T, 0338T, 0339T, 0342T, 0347T, 0348T, 0349T, 0350T, 0351T, 0352T, 0353T, 0354T, 0355T, 0356T, 0358T, 0362T, 0373T, 0381T, 0382T, 0383T, 0384T, 0385T, 0386T, 0394T, 0395T, 0396T, 0397T, 0398T, 0400T, 0401T, 0403T, 0404T, 0405T, 0408T, 0409T, 0410T, 0411T, 0412T, 0413T, 0414T, 0415T, 0416T, 0417T, 0418T, 0419T, 0420T, 0421T, 0422T, 0423T, 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T, 0434T, 0435T, 0436T, 0437T, 0439T, 0440T, 0441T, 0442T, 0443T, 0444T, 0445T, 0446T, 0447T, 0448T, 0449T, 0450T, 0451T, 0452T, 0453T, 0454T, 0455T, 0456T, 0457T, 0458T, 0459T, 0460T, 0461T, 0462T, 0463T, 0464T, 0465T, 0466T, 0467T, 0468T, 0469T, 0470T, 0471T, 0472T, 0473T, 0474T, 0475T, 0476T, 0477T, 0478T	A/B
Noncovered Services other than CPT® Category III Noncovered Services	L36954	Billing and Coding: Noncovered Services other than CPT® Category III Noncovered	A56506	01990, 15824, 15825, 15826, 15828, 15829, 15876, 15877, 15878, 15879, 17380, 19105, 20985, 21073, 21811, 22586, 22862, 22865, 28035, 28446, 28890, 29868, 32998, 41530, 43257, 46707, 53860, 58321, 58322, 58323, 58670, 58671, 58970, 58974, 58976, 59012, 62263, 62264, 62287, 64702, 64704, 64708, 64712, 64714, 64722, 64726, 64727, 65785, 76981, 76982, 76983, 82016, 82017, 82777, 83006, 83987, 84066, 84134, 84431, 86305, 86343, 87084, 88375, 89250, 89251, 89253, 89254, 89255, 89257, 89258, 89259, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89290, 89291, 89335, 89337, 89342, 89343, 89344, 89346, 89352, 89353, 89354, 89356, 90476, 90477, 90581, 90585, 90620, 90621, 90625, 90632, 90633, 90634, 90644, 90647, 90648, 90649, 90650, 90680, 90681, 90690, 90691, 90849, 91132, 91133, 92145, 92970, 92971, 92997, 92998, 93702, 94014, 94015, 94016, 97545, 97546, C1749, C1830, C9727, C9734, J2010, J3530, J7297, J7298, J7330	A/B
Nonobstetric Pelvic Ultrasound	L37636	Billing and Coding: Nonobstetric Pelvic Ultrasound	A56671	76856, 76857	B
Octreotide Acetate for Injectable Suspension (Sandostatin LAR depot)	L33438	Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin LAR® depot)	A56531	J2353	B
Ophthalmic Angiography (Fluorescein and Indocyanine Green)	L34426	Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)	A56774	92235, 92240, 92242	A/B
Ophthalmology: Extended Ophthalmoscopy and Fundus Photography	L33467	Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography	A53060	92201, 92202, 92227, 92228, 92250	A/B
Polysomnography	L36593	Accreditation and Credentialing Requirements for Polysomnography	A55958	95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400	A/B
		Billing and Coding: Polysomnography	A56995
		E/M Coding for Oral Surgeons	A56006	99201-99215
Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control	L33443	Billing and Coding: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control	A56719	64566	B
Pulmonary Stress Testing	L33444	Billing and Coding: Pulmonary Stress Testing	A56784	94617, 94618, 94621	B
Removal of Benign and Malignant Skin Lesions	L33445	Billing and Coding for Removal of Benign and Malignant Skin Lesions	A56346	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	L34869	Billing and Coding: Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder	A57813	90867, 90868, 90869	B
Respiratory Therapy and Oximetry Services	L33446	Billing and Coding: Respiratory Therapy and Oximetry Services	A56730	31720, 94640, 94664, 94760, 94761, 94762	B
Retroperitoneal Ultrasound	L34577	Billing and Coding: Retroperitoneal Ultrasound	A55336	76770, 76775, 76776	A/B
Rituximab	L35026	Billing and Coding: Rituximab	A56380	J9311, J9312, Q5115	A/B
Routine Foot Care	L37643	Billing and Coding: Routine Foot Care	A56680	11055, 11056, 11057, 11719, 11720, 11721, G0127	A/B
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)	L34431	Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)	A56825	92132, 92133, 92134	A/B
Somatosensory Testing	L34433	Billing and Coding: Somatosensory Testing	A56769	95925, 95926, 95927	A/B
Special Electroencephalography	L33447	Billing and Coding: Special Electroencephalography	A56771	95700, 95705, 95708, 95717, 95719, 95721, 95812, 95813, 95816, 95819, 95822	B
Spinal Cord Stimulators for Chronic Pain	L37632	Billing and Coding: Spinal Cord Stimulators for Chronic Pain	A56876	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	A56384	93668	A/B
Swallowing Studies for Dysphagia	L33449	Billing and Coding: Swallowing Studies for Dysphagia	A56621	70370, 70371, 74230	B
Topical Oxygen Therapy	L37873	Billing and Coding: Topical Oxygen Therapy	A56431	A4575	A/B
Total Joint Arthroplasty	L33456	Billing and Coding: Total Joint Arthroplasty	A56777	27130, 27132, 27134, 27137, 27138, 27445, 27447, 27486, 27487	A/B
Trigger Point Injections	L37635	Billing and Coding: Trigger Point Injections	A56745	20552, 20553	B
Upper Gastrointestinal Endoscopy and Visualization	L34434	Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization	A56389	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, 43257, 43259, 43260, 43261, 43262, 43263, 43264, 43265, 43266, 43270, 43274, 43275, 43276, 43277, 43278, 43284, 43285, 43499, 74235	A/B
Varicose Veins of the Lower Extremities	L33454	Billing and Coding: Varicose Veins of the Lower Extremities	A56368	36465, 36466, 36470, 36471, 36473, 36474, 36475, 36476, 36478, 36479, 37700, 37718, 37722, 37765, 37766, 37780, 37785, 37500, 37735, 37760, 37761, 93970, 93971	B
Vertebroplasty/Kyphoplasty	L33473	Billing and Coding: Vertebroplasty/Kyphoplasty	A56819	22510, 22511, 22512, 22513, 22514, 22515, 22899	B
Vestibular Function Testing	L34537	Billing and Coding: Vestibular Function Testing	A56497	92537, 92538, 92540, 92541, 92542, 92544, 92545, 92546, 92547, 92548, 92549, 92552, 92553, 92556, 92557	B
Virtual Colonoscopy (CT Colonography)	L33452	Billing and Coding: Virtual Colonoscopy (CT Colonography)	A56772	74261, 74262	B
Voretigene Neparvovec-rzyl (Luxturna™)	L37863	Billing and Coding: Voretigene Neparvovec-rzyl (Luxturna™)	A56419	J3398, 67036, 67299	A/B
White Cell Colony Stimulating Factors	L37176	Neulasta® (pegfilgrastim) Onpro® Kit (On-body Injector)	A54682	96372, 96377, J1442, J1447, J2505, J2820, Q5101, Q5108, Q5110, Q5111	A/B
		Billing and Coding: White Cell Colony Stimulating Factors	A56748
Wireless Capsule Endoscopy	L36427	Billing and Coding: Wireless Capsule Endoscopy	A56727	91110, 91111	A/B
Wireless Gastrointestinal Motility Monitoring Systems	L33455	Billing and Coding: Wireless Gastrointestinal Motility Monitoring Systems	A56724	91112	B
YAG Capsulotomy	L37644	Billing and Coding: YAG Capsulotomy	A56792	66821	A/B
N/A	N/A	Billing and Coding: Aflibercept (EYLEA®) Coding and Billing Guidelines	A53387	67028, J0178	B
N/A	N/A	Anesthetic "Caine Drugs"	A53432	N/A	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, J7205, J7207, J7208, J7209, J7210, J7211	B
N/A	N/A	Billing and Coding Instructions for Lemtrada® (alemtuzumab) When Used in the Treatment of Relapsing Multiple Sclerosis	A55310	J0202	A/B
N/A	N/A	Billing and Coding: Drug and Biological Infusions	A55297	96360-96379, 96401-96549, G0498, J0129, J0202, J0490, J0638, J0897, J1602, J1745, J2182, J2357, J2786, J2793, J3262, J3357, J3380, J3590, J9000-J9999, J9145, J9176, J9205, J9217, J9271, J9352, J9295, Q2017, Q2050, Q5103, Q5104	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	A54880	A4641, A9699, J3490, J3590, J9999	A/B
N/A	N/A	Billing and Coding: Amniotic Membrane Billing Guidelines for HCPCS Code V2790	A53441	65775, 65778, 65779, 65780, V2790	B
N/A	N/A	Billing and Coding: ArgusM II Retinal Prosthesis System	A53044	0100T	B
N/A	N/A	Billing and Coding: Chemotherapy	A56141	A9513, J0202, J9019, J9022, J9023, J9024, J9032, J9033, J9034, J9036, J9039, J9042, J9047, J9057, J9145, J9153, J9173, J9176, J9179, J9203, J9205, J9207, J9228, J9229, J9271, J9285, J9295, J9299, J9301, J9302, J9306, J9308, J9315, J9330, J9352, J9354, J9355, J9400, Q2017, Q2049, Q2050, Q5112, Q5113, Q5114	A/B
N/A	N/A	Billing and Coding: Endometrial Hyperplasia Treatment	A53043	58999	B
N/A	N/A	Billing and Coding: FDA approves Iluvien for Diabetic Macular Edema	A54750	67028, J7313	B
N/A	N/A	Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation	A53775	93797, 93798, G0422, G0423	A/B
N/A	N/A	Billing and Coding: Gender Reassignment Services for Gender Dysphoria	A53793	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	A53006	46948	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, G0448	A/B
N/A	N/A	Billing and Coding: Implantable Miniature Telescope (IMT) for Macular Degeneration	A53501	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	A54555	11042, 11043, 11044, 11045, 11046, 11047, 97597, 97598, 97602, 97607, 97608, 97610	B
N/A	N/A	Billing and Coding: Percutaneous Ventricular Assist Device	A53986	33990, 33991, 33992, 33993	B
N/A	N/A	Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemaker	A54831	33206, 33207, 33208	A/B
N/A	N/A	Billing and Coding: Spiracur SNaP® Wound Care System	A53781	97607, 97608	A/B
N/A	N/A	Billing and Coding: Thermal Capsulorrhaphy	A53435	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, 67027, 67028, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67917, 67921, 67922, 67923, 0191T, 0449T	A/B
N/A	N/A	Billing and Coding: Xofigo Billing Instructions	A54559	A9606	B
N/A	N/A	Billing and Coding: External Components for Cochlear Implants	A53708	L7510, L7520, L8614, L8615, L8616, L8617, L8618, L8619, L8621, L8622, L8623, L8624, L8627, L8628, L8629, L9900	B
N/A	N/A	Coverage for High Resolution Anoscopy	A53408	46601, 46607	B
N/A	N/A	CPT Modifier 59: Gastroenterology	A53399	45380, 45385	B
N/A	N/A	Fracture of Ribs with Internal Fixation	A53931	21811, 21812, 21813	B
N/A	N/A	Glaucoma Screening	A53495	G0117, G0118	B
N/A	N/A	Billing and Coding: IDTFs and Low Dose CT Scan for Lung Cancer Screening for HCPCS Code G0297	A55816	G0296, G0297	A/B
N/A	N/A	Billing and Coding: Medicare Preventive Coverage for Certain Vaccines	A54767	90630, 90653, 90654, 90655, 90656, 90657, 90660, 90661, 90662, 90670, 90672, 90673, 90674, 90675, 90676, 90682, 90685, 90686, 90687, 90688, 90689, 90694, 90702, 90714, 90732, 90739, 90740, 90743, 90744, 90746, 90747, 90756, G0008, G0009, G0010, Q2034, Q2035, Q2036, Q2037, Q2038, Q2039	A/B
N/A	N/A	Neuromodulation for Fecal Incontinence	A53419	N/A	B
N/A	N/A	Once in a Lifetime Abdominal Aortic Aneurysm (AAA) Screening Article	A55071	76706	A/B
N/A	N/A	Oral Surgery and Maxillofacial Surgery Specialty Codes	A53446	N/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	A53472	66982, 66987, 66988	B
N/A	N/A	Billing and Coding: Radiology Services: Multiple, Identical Services on Same Day	A53488	73000	B
N/A	N/A	Repeat or Duplicate Services on the Same Day	A53482	N/A	B
N/A	N/A	Billing and Coding: Repeat X-ray or EKG Interpretations by Same or Different Physicians	A53423	N/A	B
N/A	N/A	Sacroiliac-Bone Implant System	A53452	27279	B
N/A	N/A	Spiracur SNaP® Wound Care System	A53781	97607, 97608	A/B
N/A	N/A	Videostroboscopy and Nasopharyngoscopy Procedures Performed by Speech-Language Pathologists (SLPs)	A53430	N/A	B

Last Updated: 1/01/2020

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