Jurisdiction F Part A LCDs and LCAs - Effective December 1, 2019

The Jurisdiction F Part A Local Coverage Determination (LCDs) and Local Coverage Articles (LCAs) have been created and published for notice under contract numbers: 02101 (AK), 02201 (ID), 02301(OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Change Request 10901, dated February 12, 2019, and the 21st Century Cures Act require all coding (procedure, diagnosis, modifier, revenue, and type of bill) to be removed from LCDs and placed into billing and coding articles. There is no change in coverage. See the LCD title, Medicare Coverage Database (MCD) LCD number and the MCD article number below.

All LCD LCAs will be titled "Billing and Coding: LCD Title."

Effective Date: December 1, 2019

MCD LCD Number MCD LCA
Number
LCD Title
L37630 A56880 Invitro Chemosensitivity & Chemoresistance Assays
L36094 A57690 Lab: Flow Cytometry
L36353 A57614 Lab: Special histochemical stains and Immunohistochemical Stains
L35704 A56515 Mohs Micrographic Surgery
L36345 A57624 MolDX: Decipher® Prostate cancer Classifier Assay
L37072 A57622 MolDX: DecisionDX-UM (Uveal Melanoma)
L36339 A57487 MolDX: NRAS Genetic testing
L37744 A57499 MolDX: Onctotype DX AR-V7 Nucleus Detect for Men with Metastatic Castrate Resistant Prostate Cancer (MCRPC)
L36947 A57620 MolDX: Oncotype DX® Breatst Cancer for DCIS (Genomic Health™)
L36891 A57504 MolDX: Percepta© Bronchial Genomic Classifier
L36350 A57511 MolDX: Prolaris™ Prostate Cancer Genomic Assay
L37082 A57691 MolDX: Prolaris™ Prostate Cancer Genomic Assay for Men with Favorable Intermediate Risk Disease
L37313 A57517 MolDX: Prometheus IBD sgi Diagnostic Policy
L36706 A57609 MolDX: ProMark Risk Score
L38137 A57747 MolDX: TruGraf Blood Gene Expression Test
L35457 A52725 Nerve Blockade for Treatment of Chronic Pain and Neuropathy
L36526 A54992 Nerve Conduction Studies and Electromyography
L34106 A57695 Percutaneous Vertebral Augmentation
L37360 A55531 Peripheral Nerve Stimulation
L34040 A57698 Polysomnography and Other Sleep Studies
L37088 A57693 Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder
L34151 A57461 Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)
L36204 A55792 Spinal Cord Stimulators for Chronic pain
L36573 A57684 Total Hip Arthroplasty
L36577 A57686 Total Knee Arthroplasty
L34010 A57707 Treatment of Varicose Veins of the Lower Extremeties
L36859 A57702 Trigger Point Injections
L34051 A57719 Vitamin D Assay Testing

 

Visit the Active LCD webpage to view the locally hosted Active LCD or access it via the CMS MCD.

Visit the Noridian Medicare Coverage Articles webpage to view the complete listing of locally hosted coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD.

 

Last Updated Dec 10, 2019