Active LCDs - JE Part B
Medicare Coverage Database (MCD)
The official LCD version is in CMS Medicare Coverage Database
- California Northern - Contractor ID 01112
- California Southern - Contractor ID 01182
- Hawaii and Territories - Contractor ID 01212
- Nevada - Contractor ID 01312
Active LCDs
All LCDS are the same for each state within a Jurisdiction and are accessible from the table below.
Access LCD or Article: Select the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD).
Print the LCD or Article: Select the LCD or Article number in the table below to view the policy or article on the Medicare Coverage Database (MCD).
- Click on the blue download arrow on the right side of page when LCD or Article appears.
- Click the print when PDF opens.
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.
LCD Title | LCD Number | Billing and Coding Companion Article | CPT / HCPCS Codes Referenced |
---|---|---|---|
Allergy Testing | L34313 | A57181 | 86003, 86005, 95004, 95017, 95018, 95024, 95027, 95028, 95044, 95052, 95056, 95060, 95065, 95070, 95076, 95079 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin | L39396 | A59175 | 38240 |
Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound | L39116 | A58865 | Q4112, Q4139, Q4145, Q4149, Q4155, Q4162, Q4168, Q4171, Q4174, Q4177, Q4185, Q4189, Q4192, Q4206, Q4212, Q4213, Q4215, Q4230, Q4231, Q4233, Q4240, Q4241, Q4242, Q4244, Q4245, Q4246 |
B-type Natriuretic Peptide (BNP) Testing | L35526 | A57083 | 83880 |
BDX-XL2 | L37054 | A57356 | 0080U |
Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs) | 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 | L34194 | A57190 | 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909 |
Botulinum Toxin Types A and B Policy | L35170 | A57185 | 31513, 31570, 43201, 43236, 43499, 46505, 52287, 64611, 64612, 64615, 64616, 64617, 64640, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 64999, 67345, 95873, 95874, J0585, J0586, J0587, J0588 |
Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography | L34324 | A57183 | 93015, 93016, 93017, 93018, 93320, 93321, 93325, 93350, 93351, 93352, J0153, J0395, J1245, J1250, J3490 |
Cataract Surgery in Adults | L34203 | A57195 | 66830, 66840, 66850, 66852, 66920, 66940, 66982, 66983, 66984, 66987, 66988 |
Cervical Fusion | L39758 | A59624 |
22548, 22551, 22552, 22554, 22585, 22590, 22595, 22600, 22614, 22800, 22802, 22808, 22810, 22812 |
Chest X-Ray Policy | L37547 | A57497 | 71045, 71046, 71047, 71048 |
Colon Capsule Endoscopy | L38824 | A58436 | 91113 |
Computed Tomography Cerebral Perfusion Analysis (CTP) | L38709 | A58223 | 0042T |
Diagnostic and Therapeutic Colonoscopy | 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 | L34315 | A57326 | 93000, 93005, 93010, 93040, 93041, 93042, 93319, 93593, 93594, 93595, 93596, 93597, 93598 |
Epidural Steroid Joint Injections for Pain Management | L39240 | A58993 | 62320, 62321, 62322, 62323, 64479, 64480, 64483, 64484 |
Facet Joint Interventions for Pain Management | L38801 | A58403 | 64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636, 0213T. 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T |
Frequency of Hemodialysis | L37502 | A55675 | 90999 |
GlycoMark Testing for Glycemic Control | L36864 | A57237 | 84378, 84999 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea | L38310 | A57948 | 64582, 64583, 64584 |
Immune Globulin Intravenous (IVIg) | L34314 | A57187 | J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1599 |
Implantable Continuous Glucose Monitor (I-CGM) | L38657 | A58133 | 0446T, 0447T, 0448T |
Injections-Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma | L34218 | A57079 | 20526, 20527, 20550, 20551, 20612, 26341, 28899, 64455, 64632 |
Intraosseous Basivertebral Nerve Ablation | L39642 | A59466 | 64628, 64629 |
In Vitro Chemosensitivity & Chemoresistance Assays | L37628 | A56071 | 84999, 89240, 0564T, 0083U |
Lab: Bladder/Urothelial Tumor Markers | L36678 | A55028 | 86294, 86316, 86386, 88120, 88121 |
Lab: Coenzyme Q10 (CoQ10) | L37066 | A55769 | 82542 |
Lab: Cystatin C Measurement | L37616 | A57643 | 82610 |
Lab: Flow Cytometry | L34215 | A57689 | 88182, 88184, 88185, 88187, 88188, 88189, 86053, 86355, 86356, 86357, 86359, 86360, 86361, 86363, 86367 |
Lab: Special Histochemical Stains and Immunohistochemical Stains | L36351 | A57611 | 88312, 88313, 88341, 88342, 88344, 88360, 88361 |
Lumbar MRI | L34220 | A57206 | 72148, 72149, 72158, A9585, Q9953 |
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor | L37729 | A57512 | 0398T |
MDS FISH | L37620 | A57661 | 88271, 88273, 88274, 88275, 88291 |
Measurement of Salivary Hormones | L36846 | A57612 | 84999 |
Micro-Invasive Glaucoma Surgery (MIGS) | L38299 | A57863 | 66989, 66991, 0449T, 0450T, 0474T, 0671T |
Mohs Micrographic Surgery | L35702 | A56514 | 17311, 17312, 17313, 17314, 17315, 88302, 88304, 88305, 88307, 88309, 88314, 88331, 88332 |
MRI and CT Scans of the Head and Neck | 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 | L35456 | A56034 | 62281, 62324, 62325, 64405, 64408, 64415, 64417, 64418, 64420, 64421, 64425, 64430, 64435, 64445, 64446, 64447, 64448, 64449, 64450, 64451, 64461, 64462, 64463, 64505, 64510, 64517, 64520, 64530, 64620, 64640, 64999, 64450, 76881, 76882, 76942, 76999, 97032, 97139, G0282, G0283 |
Nerve Conduction Studies and Electromyography | 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-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease | L38613 | A58095 | 0501T, 0502T, 0503T, 0504T |
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) | L34228 | A56572 | 22510, 22511, 22512, 22513, 22514, 22515 |
Peripheral Nerve Stimulation | L34328 | A55530 | 61885, 64553, 64555, 64561, 64569, 64570, 64575, 64581, 64585, 64590, 64595, 64999 |
Plastic Surgery | L35163 | A57221 | 15780, 15781, 15782, 15783, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15847, 15876, 15877, 15878, 15879, 19316, 19318, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 30400, 30410, 30420, 30430, 30435, 30450 |
Platelet Rich Plasma Injections for Non-Wound Injections | L39058 | A58788 | 86965, G0460, G0465, M0076, P9020, 0232T |
Polysomnography and Other Sleep Studies | L36861 | A57697 | G0398, G0399, G0400, 95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811 |
ProMark Risk Score | L36704 | A57515 | 81479 |
Respiratory Care | L34149 | A57224 | G0237, G0238, G0239, 31502, 31720, 94002, 94003, 94004, 94010, 94011, 94012, 94013, 94060, 94070, 94150, 94200, 94375, 94450, 94617, 94618, 94619, 94621, 94640, 94642, 94660, 94662, 94664, 94667, 94668, 94669, 94680, 94681, 94690, 94726, 94727, 94728, 94729, 94772 |
Sacroiliac Joint Injections and Procedures | L39462 | A59244 | 27096, 64451, 64625, 77002, 77012, G0260 |
Serum Magnesium | L36702 | A57189 | 83735 |
Spinal Cord Stimulators for Chronic Pain | L35136 | A57791 | 63650, 63655, 63663, 63664, 63685 |
Total Hip Arthroplasty | L34163 | A57683 | 27130, 27132, 27134, 27137, 27138 |
Total Knee Arthroplasty | L36575 | A57685 | 27445, 27447, 27486, 27487 |
Transcranial Magnetic Stimulation (TMS) | L37086 | A57692 | 90867, 90868, 90869 |
Transurethral Waterjet Ablation of the Prostate | L38705 | A58227 | C2596, 0421T |
Treatment of Males with Low Testosterone | L36538 | A57615 | 11980, 84410, 96372, J1071, J3121, J3145, J3490 |
Treatment of Varicose Veins of the Lower Extremities | 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 | L34211 | A57701 | 20552, 20553 |
Urine Drug Testing | L36668 | A55001 | 80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659 |
Vitamin D Assay Testing | L36692 | A57718 | 82306, 82652 |
Wound and Ulcer Care | L38902 | A58565 | 11000, 11001, 11004, 11005, 11006, 11008, 11010, 11011, 11012, 11042, 11043, 11044, 11045, 11046, 11047, 11055, 11056, 11057, 29445, 29580, 29581, 97597, 97598, 97602, 97605, 97606, 97607, 97608, 97610 |