Billing and Coding Articles

The term "article" is used to describe any bulletin article, website article, educational handout or any other non-LCD document intended for public release that contains coverage/coding statements or medical review related billing or claims considerations.

Medicare contractors post articles into the Medicare Coverage Database (MCD). Articles address local coverage, coding or medical review related billing and claims considerations, and may include any newly developed educational materials, coding instructions or clarification of existing medical review related billing or claims policy.

View coverage information on topics found outside NCDs and LCDs. As articles are updated in the MCD, they will be published as webpages here as well. Watch the below list continue to expand as updates are made.

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Topic Article Number CPT/HCPCS Codes Referenced
Billing and Coding: Abbreviated Daytime Sleep Study (e.g. PAP-NAP) A55478 N/A
Billing and Coding: Arthroscopic Lavage and Arthroscopic Debridement for Osteoarthritic Knees A54061 29871
Billing and Coding: Bariatric Surgery Coverage A53026 43644, 43645, 43770, 43775, 43845, 43846, 43847
Billing and Coding: Billing Limitations for Pharmacies A56119 90637, 90638, 90653, 90655, 90656, 90657, 90658, 90660, 90661, 90662, 90664, 90666, 90667, 90668, 90670, 90672, 90673, 90674, 90682, 90683, 90684, 90685, 90686, 90687, 90688, 90689, 90695, 90732, 90756, G0008, G0009, J7170, J7180, J7181, J7182, J7183, J7185, J7186, J7187, J7188, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7198, J7199, J7200, J7201, J7202, J2703, J2704, J7205, J2707, J7208, J7209, J7210, J7211, J7212, J7214
Billing and Coding: Billing Medicare for the SphenoCath and Other Similar Devices A55584 64999
Billing and Coding: Chiropractic Services A57913 98940, 98941, 98942
Billing and Coding: Cryoneurolysis Instructions A59752 0440T, 0441T, 0442T
Billing and Coding: Fracture Care A53322 25500, 29000, 29010, 29015, 29020, 29025, 29035, 29055, 29058, 29065, 29075, 29085, 29105, 29125, 29126, 29130, 29131, 29305, 29325, 29345, 29355, 29365, 29400, 29404, 29405, 29425, 29435, 29440, 29445, 29450, 29505, 29515, Q4001, Q4002, Q4003, Q4004, Q4005, Q4006, Q4007, Q4008, Q4009, Q4010, Q4011, Q4012, Q4013, Q4014, Q4015, Q4016, Q4017, Q4018, Q4019, Q4020, Q4021, Q4022, Q4023, Q4024, Q4025, Q4026, Q4027, Q4028, Q4029, Q4030, Q4031, Q4032, Q4033, Q4034, Q4035, Q4036, Q4037, Q4038, Q4039, Q4040, Q4041, Q4042, Q4043, Q4044, Q4045, Q4046, Q4047, Q4048, Q4049, Q4050
Billing and Coding: Home PT/INR Monitoring (G0249) Billing and Coding A55754 G0249
Billing and Coding: Hydration Services A54635 96360, 96361
Billing and Coding: Implantable Automatic Defibrillators A56340 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
Billing and Coding: Implantable Infusion Pumps for Chronic Pain A55239 62325, 62327, 62350, 62351, 62355, 62360, 62361, 62362, 62365, 62367, 62368, 62369, 62370, 95990, 95991, J7999
Billing and Coding: Incident To Clarification for OPPS and CAH Outpatient A55215 N/A
Billing and Coding: Influenza Diagnostic Tests A59055 87252, 87253, 87254, 87275, 87286, 87400, 87501, 87502, 87503, 87804, 0528U
Billing and Coding: Intraocular Bevacizumab A53008 67028, 92134, C9257, J7999
Billing and Coding: IUD (Hormone-Eluting) for Endometrial Hyperplasia - CPT 58999 A55061 58999
Billing and Coding: JW and JZ Modifier Billing Guidelines A53024 N/A
Billing and Coding: Leadless Pacemakers A59819 33274, 0823T, 0795T, 0796T, 0797T, 0801T, 0802T, 0803T, 0825T
Billing and Coding: Medical Necessity of Therapy Services A53304 97161, 97162, 97163, 97165, 97166, 97167
Billing and Coding: Outpatient Therapy Biofeedback Training A53352 90901, 90912, 90913
Billing and Coding: Patients Supplied Donated or Free-of-Charge Drug A55044 N/A
Billing and Coding: Piriformis Injections A56027 20552
Billing and Coding: Pulmonary Rehabilitation Services A56152 94625, 94626, G0237, G0238, G0239
Billing and Coding: Reporting a Non-Covered Test Performed in Preparation for a Non-Covered Procedure A55774 92025
Billing and Coding: Routine Foot Care A57954 11055, 11056, 11057, 11719, 11720, 11721, G0127
Billing and Coding: Sacral Nerve Stimulation for Urinary and Fecal Incontinence A53359 64561, 64581, 64585, 64590, 64595, A4290, C1767, C1778, C1820, C1883, C1897, L8680
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers - Coding and Billing A54929 33206, 33207, 33208
Billing and Coding: Spinal Fusion Services: Documentation Requirements A53972 N/A
Billing and Coding: Spinraza® (Nusinersen) A58578 J2326
Billing and Coding: Tomosynthesis-Guided Breast Biopsy A57848 19081, 19082, 19083, 19084, 19085, 19086, 19100, 19101, 19281, 19282, 19283, 19284, 19285, 19286, 19287, 19288, 19499, 76098, 76376, 76377, 77011, 77053, 77054, 77061, 77062, 77063, 77065, 77066, 77067, C7501, C7502, G0279
Billing and Coding: Topical HBO and Physician Related Service Billing and Coding Guidelines A56025 99199, A4575, E0446
Billing and Coding: Wound Care & Debridement-Provided by a Therapist, Physician, NPP or as Incident-to Services A53296 29580, 97022, 97160, 97161, 97162, 97153, 97597, 97598, 97602, G0463
Billing and Coding: Zika Virus Testing by PCR and ELISA Methods A55326 86790, 86794, 87662, 87798, 87801
Dropless Cataract Surgery A53916 66982, 66984
Investigational Device Exemptions(IDE) - IDE Documentation Requirements for Studies with an FDA Approval dated January 01, 2015 or Later A54919 N/A
Lymphedema Decongestive Treatment A55710 29581, 29584, 97140, 97535
Non-Payment for Prefabricated Splints A56112 29105, 29125, 29126, 29130, 29131, 97760, 97799
Post Market Studies and Post Market Extension Studies - Percutaneous Transluminal Angioplasty (PTA) with Carotid Stenting and Embolic Protection N/A N/A
Sipuleucel-T (Provenge®) - Coverage Criteria for Prostate Cancer - Clarification A55719 Q2043
Sterilization A53356 55250, 58600, 58605, 58611, 58615, 58670, 58671
Therapeutic Apheresis for Familial Hypercholesterolemia A54543 36516
Waiver of Face-to-Face Visit for Home Dialysis Patients A55058 90963, 90964, 90645, 90646

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Last Updated Apr 24 , 2025