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Medicare Coverage Database (MCD)

The official LCD version is in CMS Medicare Coverage Database This link will take you to an external website.

Active LCDs

All LCDS are the same for each state within a Jurisdiction and are accessible from the table below.

  1. To view locally hosted PDF, select applicable LCD Title OR
  2. To access CMS HTML version within Medicare Coverage Database (MCD), select applicable LCD Number

View the ICD-9 to ICD-10 LCD number crosswalk.

Once you access the LCD, the "Coding Guidelines" can be found under the heading, "LCD Attachments" near the end of the document. Note: All CPT/HCPCS codes listed are mentioned in the LCD, but are not necessarily subject to diagnosis codes or coverage criteria.

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LCD Title LCD Number Billing and Coding Companion Article CPT / HCPCS Codes Referenced
Allergy Testing [PDF] L34313 A57181 86003, 86005, 95004, 95017, 95018, 95024, 95027, 95028, 95044, 95052, 95056, 95060, 95065, 95070, 95071, 95076, 95079
B-type Natriuretic Peptide (BNP) Testing [PDF] L35526 A57083 83880
Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs) [PDF] L34233 A57161 11200, 11201, 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, 17110, 17111
Blepharoplasty, Eyelid Surgery and Brow Lift [PDF] L34194 A57190 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909
Botulinum Toxin Types A and B Policy [PDF] L35170 A57185 31513, 31570, , 43201, 43236, 43499, 46505, 52287, 64611, 64612, 64615, 64616, 64617, 64640, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 67345, 95873, 95874, J0585, J0586, J0587, J0588
Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography [PDF] L34324 A57183 93015, 93016, 93017, 93018, 93320, 93321, 93325, 93350, 93351, 93352, J0153, J0395, J1245, J1250, J3490
Cataract Surgery in Adults [PDF] L34203 A57195 66830, 66840, 66850, 66852, 66920, 66940, 66982, 66983, 66984, 66987, 66988
Chest X-Ray Policy [PDF] L37547 A57497 71045, 71046, 71047, 71048
Diagnostic and Therapeutic Colonoscopy [PDF] L34213 A57342 44388,44389,44390, 44391, 44392, 44394, 44401, 44402, 44404, 44405, 44406, 44407, 45378, 45379, 45380, 45381, 45382, 45384, 45385, 45386, 45388, 45389, 45391, 45392, 45393
Electrocardiograms [PDF] L34315 A57326 93000, 93005, 93010, 93040, 93041, 93042
Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy [PDF] L34993 A57727 64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T
Frequency of Hemodialysis [PDF] L37502 A55675 90999
GlycoMark Testing for Glycemic Control [PDF] L36864 A57237 84378, 84999
Helicobacter Pylori Infection Testing [PDF] L37624 A57226 78267, 78268, 83013, 83014, 87338
Immune Globulin Intravenous (IVIg) [PDF] L34314 A57187 J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1599
In Vitro Chemosensitivity & Chemoresistance Assays [PDF] L37628 A56071 84999, 89240
Injections-Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma [PDF] L34218 A57079 20526, 20527, 20550, 20551, 20612, 26341, 28899, 64455, 64632
Intensity Modulated Radiation Therapy (IMRT) [PDF] L34217 A57013 49411, 77301, 77338, G6015, G6016
Lab: Bladder/Urothelial Tumor Markers [PDF] L36678 A55028 86294, 86316, 86386, 88120, 88121
Lab: Coenzyme Q10 (CoQ10) [PDF] L37066 A55769 82542
Lab: Controlled Substance Monitoring and Drugs of Abuse Testing [PDF] L36668 A55001 80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659
Lab: Flow Cytometry [PDF] L34215 A57689 86355, 86356, 86357, 86359, 86360, 86361, 86367, 88182, 88184, 88185, 88187, 88188, 88189
Lab: Special Histochemical Stains and Immunohistochemical Stains [PDF] L36351 A57611 88312, 88313, 88341, 88342, 88344, 88360, 88361
Lumbar Epidural Injections [PDF] L34982 A57202 62322, 62323, 62326, 62327, 64483, 64484
Lumbar MRI [PDF] L34220 A57206 72148, 72149, 72158, A9585, Q9953
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor [PDF] L37729 A57512 0398T
Measurement of Salivary Hormones [PDF] L36846 A57612 84999
Mohs Micrographic Surgery [PDF] L35702 A56514 17311, 17312, 17313, 17314, 17315, 88302, 88304, 88305, 88307, 88309, 88314, 88331, 88332
MolDX: 4Kscore Assay [PDF] L37120 A57336 81539
MolDX: AlloSure® Donor-Derived Cell-Free DNA Test [PDF] L37303 A57456 81479
MolDX: APC and MUTYH Gene Testing [PDF] L36882 A57352 81201, 81202, 81203, 81401, 81403, 81406, 81435, 81436, 81479
MolDX: BDX-XL2 [PDF] L37054 A57356 0080U
MolDX: Biomarkers in Cardiovascular Risk Assessment [PDF] L36358 A57037 82172, 82610, 83090, 83695, 83698, 83700, 83701, 83704, 83719, 83721, 86141
MolDX: BRCA1 and BRCA2 Genetic Testing [PDF] L36161 A57354 81162, 81163, 81164, 81165, 81166, 81167, 81212, 81215, 81216, 81217, 81432, 81445, 81455, 81479, 0102U, 0103U, 0129U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U
MolDX: Breast Cancer Assay: Prosigna [PDF] L36380 A57363 81520
MolDX: Breast Cancer IndexTM (BCI) Gene Expression Test [PDF] L37822 A57773 81518
MolDX: Circulating Tumor Cell Marker Assays [PDF] L35710 A57815 86152, 86153
MolDX: ConfirmMDx Epigenetic Molecular Assay [PDF] L36327 A57605 81551
MolDX: Corus® CAD Assay [PDF] L37673 A57415 81493
MolDX: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing [PDF] L36310 A57378 0070U, 81225, 81226, 81227, 81355, 81479
MolDX: Cystatin C Measurement [PDF] L37616 A57643 82610
MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Very Low and Low Risk Disease [PDF] L37818 A57645 81479
MolDX: Decipher® Prostate Cancer Classifier Assay [PDF] L36343 A57623 81479
MolDX: Decision Dx-UM (Uveal Melanoma) [PDF] L37070 A57621 81552
MolDX: DecisionDx-Melanoma [PDF] L37750 A57417 81599
MolDX: EndoPredict® Breast Cancer Gene Expression Test [PDF] L37295 A57607 81599
MolDX: Envisia, Veracyte, Idiopathic Pulmonary Fibrosis Diagnostic Test [PDF] L37887 A57419 81479
MolDX: Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs) [PDF] L37350 A56706 87505, 87506, 87507, 0097U
MolDx: GeneSight® Assay for Refractory Depression [PDF] L36323 A57547 81479
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease [PDF] L36180 A57421 81206, 81207, 81208, 81219, 81270, 81402, 81403, 81445, 81450, 81455, 81479
MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR [PDF] L36155 A57423 81240, 81241, 81291
MolDX: Genetic Testing for Lynch Syndrome [PDF] L36370 A54995 81210, 81288, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299,81300, 81301, 81317, 81318, 81319, 81403, 81435, 81436, 81445, 81455, 81479, 88341, 88342, 0101U, 0130U, 0134U
MolDX: Genomic Health™ Oncotype DX® Prostate Cancer Assay [PDF] L36364 A56371 0047U
MolDX: Guardant360® Plasma-Based Comprehensive Genomic Profiling in Non-Small Cell Lung Cancer (NSCLC) [PDF] L37649 A57425 81479
MolDX: HLA-B*15:02 Genetic Testing [PDF] L36145 A57466 81381
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy [PDF] L36551 A57441 81383
MolDX: Inivata, InVisionFirst, Liquid Biopsy for Patients with Lung Cancer [PDF] L37897 A57664 81479
MolDX:MDS FISH [PDF] L37620 A57661 88271, 88273, 88274, 88275, 88291
MolDX: MGMT Promoter Methylation Analysis [PDF] L36188 A57432 81287
MolDX: Molecular Diagnostic Tests (MDT) [PDF] L35160* A57526 0002M, 0003M, 0004M, 0006M, 0007M, 0008M, 0009M, 0011M, 0012M, 0013M, 0001U, 0002U, 0003U, 0005U, 0006U, 0007U, 0008U, 0009U, 0010U, 0011U, 0012U, 0013U, 0014U, 0016U, 0017U, 0018U, 0019U, 0021U, 0022U, 0023U, 0024U, 0025U, 0026U, 0027U, 0029U, 0030U, 0031U, 0032U, 0033U, 0034U, 0035U, 0036U, 0037U, 0038U, 0039U, 0040U, 0041U, 0042U, 0043U, 0044U, 0070U, 0084U, 0085U, 0086U, 0087U, 0088U, 0089U, 0090U, 0091U, 0092U, 0093U, 0094U, 0095U, 0096U, 0097U, 0098U, 0099U, 0100U, 0101U, 0102U, 0103U, 0104U, 81105, 81106, 81107, 81107, 81108, 81109, 81110, 81111, 81112, 81120, 88121, 81161, 81162, 81163, 81164, 91165, 81166, 81167, 81170, 81171, 81172, 81173, 81174, 81175, 81176, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81200, 81201, 81202, 81203, 81204, 81205, 81206, 81207, 81208, 81209, 81210, 81212, 81215, 81216, 81217, 81218, 81219, 81220, 81221, 81222, 81223, 81224, 81225, 81226, 81227, 81228, 81229, 81230, 81231, 81232, 81233, 81234, 81235, 81236, 81235, 81237, 81238, 81239, 81240, 81241, 81242, 81243, 81244, 81245, 81246,  81247, 81248, 81249, 81250, 81251, 81252, 81253, 81254, 81255, 81256, 81257, 81258, 81259, 81260, 81261, 81262, 81263, 81264, 81265, 81266, 81267, 81268, 81269, 81270, 81271, 81272, 81273, 81274, 81275, 81276, 81283, 81284, 81285, 81286, 81287, 81288, 81289, 81290, 81291, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81301, 81302, 81303, 81304, 81305, 81306, 81310, 81311, 81312, 81314, 81315, 81316, 81317, 81318,81319,  81320, 81321, 81322, 81323, 81324, 81325, 81326, 81327, 81328, 81329, 81330, 81331,  81332, 81333, 81334, 81335, 81336, 81337, 81340, 81341, 81342, 81343, 81344, 81345, 81346, 81350, 81355, 81361, 81362, 81363, 81364, 81370, 81371, 81372, 81373, 81374, 81375, 81376, 81377, 81378, 81379, 81380, 81381, 81382, 81383, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81407, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81420, 81422, 81425, 81426, 81427, 81430, 81431, 81432, 81433, 81435, 81435, 81436, 81437, 81438, 81439, 81440, 81442, 81443, 81445, 81448, 81450, 81455, 81460, 81465, 81470, 81471, 81479, 81490, 81493, 81500, 81503, 81504, 81506, 81507, 81508, 81509, 81510, 81511, 81512, 81518, 81519, 81520, 81521, 81525, 81528, 81535, 81536, 81538, 81539, 81540, 81541, 81545, 81551, 81595, 81596, 81599, 84999, 85999, 86152, 86153, 86849, 88120, 88121
MolDX: Molecular RBC Phenotyping [PDF] L36167 A57444 0001U
MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels [PDF] L37301 A57338 0098U, 0099U, 0100U, 0115U, 87631, 87632, 87633
MolDX: myPath Melanoma Assay [PDF] L37879 A57626 81479, 0090U
MolDX: NRAS Genetic Testing [PDF] L36335 A57486 81311, 81479
MolDX: Oncotype DX AR-V7 Nucleus Detect for Men with Metastatic Castrate Resistant Prostate Cancer (MCRPC) [PDF] L37746 A57601 81479
MolDX: Oncotype DX® Breast Cancer for (DCIS) Genomic Health™ [PDF] L36941 A57619 0045U
MolDX: Oncotype DX® Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer [PDF] L37305 A56371 0047U
MolDX: Percepta© Bronchial Genomic Classifier [PDF] L36886 A57502 81479
MolDX: Prolaris™ Prostate Cancer Genomic Assay [PDF] L36348 A57509 81541
MolDX: Prolaris™ Prostate Cancer Genomic Assay for Men with Favorable Intermediate Risk Disease [PDF] L37080 A57514 81541
MolDX: ProMark Risk Score [PDF] L36704 A57515 81479
MolDX: Prometheus IBD sgi Diagnostic Policy [PDF] L37299 A57516 81479, 82397, 83520, 86140
MRI and CT Scans of the Head and Neck [PDF] L37373 A57204 70336, 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70540, 70542, 70543, 70551, 70552, 70553, 70557, 70558, 70559, 72125, 72126, 72127, 72141, 72142, 72156
Nerve Blockade for Treatment of Chronic Pain and Neuropathy [PDF] L35456 A56034 62281, 62320, 62321, 62324, 62325, , 64405, 64408, , 64415, 64417, 64418, 64420, 64421, 64425, 64430, 64435, 64445, 64446, 64447, 64448, 64449, 64450, 64461, 64462, 64463, 64479, 64480, 64505, 64510, 64517, 64520, 64530, 64620, 64640, 64450, 76881, 76882, 76942, 76999, 97032, 97139, G0282, G0283
Nerve Conduction Studies and Electromyography [PDF] L36524 A54969 95873, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95933, 95937, 95999, G0255, 51785, 92265, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95874, 95885, 95886, 95887
Non-Covered Services [PDF] L36219 A57641 22857, 22862, 28446, 43257, 43284, 43285, 46707, 62263, 62264, 62287, 83987, 84431, 86305, 91132, 91133, 92145, 93050, 93702, 97026, 97033, 97545, 97546, 99605, 99606, 99607, J2010, J7330, 0042T, 0054T, 0055T, 0071T, 0072T, 0098T, 0100T, 0101T, 0102T, 0106T, 0107T, 0108T, 0109T, 0110T, 0111T, 0126T, 0163T, 0165T, 0174T, 0175T, 0198T, 0202T, 0205T, 0206T, 0207T, 0208T, 0209T, 0210T, 0211T, 0212T, 0219T, 0220T, 0221T, 0222T, 0232T, 0234T, 0235T, 0236T, 0237T, 0238T, 0253T, 0263T, 0264T, 0265T, 0266T, 0267T, 0268T, 0272T, 0273T, 0274T, 0278T, 0290T, 0300T, 0312T, 0313T, 0316T, 0317T, 0329T, 0330T, 0331T, 0332T, 0333T, 0335T, 0338T, 0339T, 0340T, 0341T, 0342T, 0347T, 0348T, 0349T, 0350T, 0351T, 0352T, 0353T, 0354T, 0355T, 0356T, 0357T, 0358T, 0361T, 0373T, 0374T, 0375T, 0376T, 0378T, 0379T, 0380T, 0381T, 0382T, 0383T, 0384T, 0385T, 0386T, 0396T, 0397T, 0398T, 0399T, 0400T, 0401T, 0403T, 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, 0450T, 0451T, 0452T, 0453T, 0454T, 0455T, 0456T, 0457T, 0458T, 0459T, 0460T, 0461T, 0462T, 0463T, 0464T, 0465T, 0466T, 0467T, 0468T
Noninvasive Cerebrovascular Studies [PDF] L34221 A57199 93880, 93882, 93886, 93888
Noninvasive Peripheral Arterial Studies [PDF] L34219 A57223 93922, 93923, 93924, 93925, 93926, 93930, 93931, 93990
Noninvasive Peripheral Venous Studies [PDF] L34229 A57485 93970, 93971
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) [PDF] L34228 A56572 22510, 22511, 22512, 22513, 22514, 22515, 0200T, 0201T
Peripheral Nerve Stimulation [PDF] L34328 A55530 61885, 64553, 64555, 64561, 64569, 64570, 64575, 64581, 64585, 64590, 64595, 64999
Plastic Surgery [PDF] L35163 A57221 15780, 15781, 15782, 15783, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15847, 15876, 15877, 15878, 15879, 19316, 19318, 19324, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19366, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 30400, 30410, 30420, 30430, 30435, 30450
Polysomnography and Other Sleep Studies [PDF] L36861 A57697 G0398, G0399, G0400, 95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811
Pulmonary Function Testing [PDF] L34247 A57216 94010, 94011, 94012, 94013, 94060, 94070, 94150, 94200, 94250, 94375, 94400, 94450, 94617, 94618, 94621, 94640, 94664, 94680, 94681, 94690, 94726, 94727, 94728, 94729, 94750
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder [PDF] L37086 A57692 90867, 90868, 90869
Respiratory Care (Respiratory Therapy) [PDF] L34149 A57224 G0237, G0238, G0239, 31502, 31720, 94002, 94003, 94004, 94010, 94011, 94012, 94013, 94060, 94070, 94150, 94200, 94250, 94375, 94400, 94450, 94617, 94618, 94621, 94640, 94642, 94660, 94662, 94664, 94667, 94668, 94669, 94726, 94727, 94728, 94729, 94750, 94772
Serum Magnesium [PDF] L36702 A57189 83735
Spinal Cord Stimulators for Chronic Pain [PDF] L35136 A57791 63650, 63655, 63663, 63664, 63685
Stereotactic Body Radiation Therapy [PDF] L34224 A57471 77373, 77435, G0339, G0340, G6017
Stereotactic Radiosurgery [PDF] L34223 A57458 61796, 61797, 61798, 61799, 61800, 63620, 63621, 77371, 77372, 77373, 77432, 77435, G0339, G0340
Total Hip Arthroplasty [PDF] L34163 A57683 27130, 27132, 27134, 27137, 27138
Total Knee Arthroplasty [PDF] L36575 A57685 27445, 27447, 27486, 27487
Treatment of Males with Low Testosterone [PDF] L36538 A57615 11980, 84410, 96372, J1071, J3121, J3145, J3490
Treatment of Ulcers & Symptomatic Hyperkeratoses [PDF] L34243 A57459 11042, 11043, 11044, 11045, 11046, 11047, 11055, 11056, 11057, 97597, 97598
Treatment of Varicose Veins of the Lower Extremities [PDF] L34209 A57706 36299, 36465, 36466, 36470, 36471, 36473, 36474, 36475, 36476, 36478, 36479, 36482, 36483, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37785, 37799, , 93970, 93971
Trigger Point Injections [PDF] L34211 A57701 20552, 20553
Vitamin D Assay Testing [PDF] L36692 A57718 82306, 82652

 

Last Updated Mar 24, 2020