Article Detail - JF Part A
Facet Joint Interventions for Pain Management L38803 - R3 and Billing and Coding: Facet Joint Interventions for Pain Management A58405 - R5 - Effective July 7, 2024
Date Posted: August 1, 2024
This Local Coverage Determination (LCD) has been revised under contractor numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).
Medicare Coverage Database (MCD) Number: L38803 and A58405
Effective Date: July 7, 2024
Summary of Changes to the LCD:
Updated "Coverage Indications, Limitations and/or Medical Necessity" with the following:
- B. Therapeutic Facet Joint Procedures (IA or MBB) - removed (IA) under Frequency Limitations.
- Limitations #9 - removed, "intraarticular"
Summary of Changes to the Billing and Coding article:
- Added verbiage under Coding Guidance.
- Added ICD-10-CM codes M53.82, M53.83, M53.84, M53.85, M53.86, and M53.87 to ICD-10-CM Codes that Support Medical Necessity Group 1.
- Added Group 1: Medical Necessity ICD-10-CM Codes Asterisk Explanation: To be used for facet cyst.
Visit the Noridian Active LCDs webpage or the CMS MCD to view the entire LCD and Billing and Coding article.