Article Detail - JE Part A
Policy Revision(s) for Local Coverage Determinations and Associated Billing and Coding Articles - Effective October 23, 2025
Date Posted: October 23, 2025
The following Local Coverage Determinations (LCDs) and associated Billing and Coding Articles 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 and Revision Number |
|---|---|
| L39116 | Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound - R1 |
| L37054 | BDX-XL2 - R4 |
| L34233 | Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs) - R10 |
| L38657 | Implantable Continuous Glucose Monitor (I-CGM) - R6 |
| L34220 | Lumbar MRI - R10 |
| L37620 | MDS FISH - R6 |
| L38299 | Micro-Invasive Glaucoma Surgery (MIGS) - R7 |
| L39810 | Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ) - R3 |
| L35702 | Mohs Micrographic Surgery - R10 |
| L37373 | MRI and CT Scans of the Head and Neck - R9 |
| L36524 | Nerve Conduction Studies and Electromyography - R8 |
| L34328 | Peripheral Nerve Stimulation - R11 |
| L36704 | ProMark Risk Score - R7 |
| L34211 | Trigger Point Injections - R10 |
| Medicare Coverage Database Number | Billing and Coding Article Title and Revision Number |
|---|---|
| A58865 | Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound - R7 |
| A57356 | Billing and Coding: BDX-XL2 - R4 |
| A57161 | Billing and Coding: Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs) - R6 |
| A58133 | Billing and Coding: Implantable Continuous Glucose Monitor (I-CGM) - R7 |
| A57206 | Billing and Coding: Lumbar MRI - R8 |
| A57661 | Billing and Coding: MDS FISH - R5 |
| A57863 | Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS) - R9 |
| A59695 | Billing and Coding: Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ) - R1 |
| A56514 | Billing and Coding: Mohs Micrographic Surgery - R7 |
| A57204 | Billing and Coding: MRI and CT Scans of the Head and Neck - R13 |
| A54969 | Billing and Coding: Nerve Conduction Studies and Electromyography - R13 |
| A55530 | Billing and Coding: Peripheral Nerve Stimulation - R12 |
| A57515 | Billing and Coding: ProMark Risk Score - R4 |
| A57701 | Billing and Coding: Trigger Point Injections - R8 |
Effective Date: October 23, 2025
Summary of Changes:
CONTRACTOR INFORMATION:
Added: JF contractor information
This update is to consolidate JE and JF to have one unified document and policy number.
Visit the Noridian Active LCDs webpage or Noridian Billing and Coding Articles webpages to view the document or access it via the CMS Medicare Coverage Database (MCD).
Last Updated Oct 23 , 2025
