Policy Revision(s) for Local Coverage Determinations - Effective February 14, 2025

Date Posted: February 20, 2025

The following Local Coverage Determinations (LCDs) have been revised under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).

Medicare Coverage Database Number LCD Title
L37616 Lab: Cystatin C Measurement
L35163 Plastic Surgery
L39058 Platelet Rich Plasma Injections for Non-Wound Injections
L39881 Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)
L39810 Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ)

Effective Date: February 14, 2025

Summary of Changes: Changed 'gender' to 'sex' throughout the LCD where applicable.

Visit the Noridian Active LCDs webpage to view the document or access it via the CMS Medicare Coverage Database (MCD).

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