LCD Number Crosswalk

The Part A LCD numbers are available to assist providers in locating the applicable policy based on the date of service.

ICD-10 ICD-9 LCD Title
L34054 L33322 B-type Natriuretic Peptide (BNP) Testing
L36279 L35529 Blepharoplasty, Eyelid Surgery, and Brow Lift
L35711 L35215 Circulating Tumor Cell Marker Assays
L34133 L33353 Cranial Computerized Tomography (CCT) Scans
L34165  L33356 Erythropoietin Stimulating Agents (ESA)
L34992 L34129 Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy
L36092 L35219 Flow Cytometry
L34173  L33359 High Sensitivity C-Reactive Protein (hsCRP) Testing
L36409 N/A Immune Globulin Intravenous (IVIg)
L34145 L33361 Infrared Coagulation (IRC) of Hemorrhoids
L34238 L33362 Laparoscopic Sleeve Gastrectomy for Severe Obesity
L34981  L34123 Lumbar Epidural Injections
L35701 L33321 Mohs Micrographic Surgery
L36313 N/A MolDX: Breast Cancer Index Genetic Assay
L36326 L35796 MolDX: ConfirmMDx Epigenetic Molecular Assay
L36309 N/A MolDX: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing
L36341 N/A MolDX: Decipher® Prostate Cancer Classifier Assay
L36322 L35522 MolDX: GeneSight® Assay for Refractory Depression
L36249 N/A MolDX: Molecular Diagnostic Tests (MDT)
L36340 N/A MolDX: Prolaris™ Prostate Cancer Genomic Assay
L35447 L34769 Nerve Blockade for Treatment of Chronic Pain and Neuropathy
L34185 L33324 Neuromuscular Junction Testing
L36217 L35238 Non-Covered Services
L34241 L33327 Ophthalmic Angiography (Fluorescein and Indocyanine Green)
L34184 L33665 Percutaneous Vertebral Augmentation
L34176 L33663 Polysomnography and Sleep Studies
L34149 L33334 Respiratory Care (Respiratory Therapy )
L36346 N/A Special Histochemical Stains and Immunohistochemical Stains
L34160 L33338 Surgical Decompression for Peripheral Polyneuropathy
L34161 L33664 Total Joint Arthroplasty
L36106 L35464 Treatment of Ulcers & Symptomatic Hyperkeratoses
L34182 L33341 Varicose Veins of the Lower Extremity, Treatment of


Last Updated Dec 09 , 2023