Active LCDs - JF Part A
Medicare Coverage Database (MCD)
The official LCD version is in CMS Medicare Coverage Database .
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).
Access MolDX LCDs and MolDX Articles
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.
The Coding Guidelines are indicated by an asterisk (*) after the LCD Number.
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 |
---|---|---|---|
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin | L39398 | A59177 | 38240 |
Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound | L39118 | A58867 | 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 | L34038 | A57084 | 83880 |
BDX-XL2 | L37062 | A57357 | 0080U |
Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs) | L33979 | A57162 | 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 | L36286 | A57191 | 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909 |
Botulinum Toxin Types A and B | L35172 | A57186 | J0585, J0586, J0587, J0588, 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 |
Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography | L36889 | A57184 | 93015, 93016, 93017, 93018, 93320, 93321, 93325, 93350, 93351, 93352, J0153, J0395, J1245, J1250, J3490 |
Cataract Surgery in Adults | L37027 | A57196 | 66830, 66840, 66850, 66852, 66920, 66940, 66982, 66983, 66984, 66987, 66988 |
Cervical Fusion | L39763 | A59645 |
22548, 22551, 22552, 22554, 22585, 22590, 22595, 22600, 22614, 22800, 22802, 22808, 22810, 22812 |
Chest X-Ray Policy | L37549 | A57498 | 71045, 71046, 71047, 71048 |
Colon Capsule Endoscopy | L38826 | A58438 | 91113 |
Computed Tomography Cerebral Perfusion Analysis (CTP) | L38700 | A58225 | 0042T |
Diagnostic and Therapeutic Colonoscopy | L36868 | A57343 | 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 | L37283 | A57327 | 93000, 93005, 93010, 93040, 93041, 93042, 93319, 93593, 93594, 93595, 93596, 93597, 93598 |
Epidural Steroid Joint Injections for Pain Management | L39242 | A58995 | 62320, 62321, 62322, 62323, 64479, 64480, 64483, 64484 |
Facet Joint Interventions for Pain Management | L38803 | A58405 | 64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636, 0213T. 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T |
Frequency of Hemodialysis | L37504 | A55676 | 90999 |
GlycoMark Testing for Glycemic Control | L36866 | A57238 | 84378, 84999 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea | L38312 | A57949 | 64582, 64583, 64584 |
Immune Globulin Intravenous (IVIg) | L34074 | A57194 | J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1599 |
Implantable Continuous Glucose Monitor (I-CGM) | L38659 | A58138 | 0446T, 0447T, 0448T |
Injections – Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma | L34076 | A57201 | 20526, 20527, 20550, 20551, 20612, 26341, 28899, 64455, 64632 |
Intraosseous Basivertebral Nerve Ablation | L39644 | A59468 | 64628, 64629 |
In Vitro Chemosensitivity & Chemoresistance Assays | L37630 | A56073 | 84999, 89240, 0564T, 0083U |
Lab: Bladder/Urothelial Tumor Markers | L36680 | A55029 | 86294, 86316, 86386, 88120, 88121 |
Lab: Coenzyme Q10 (CoQ10) | L37068 | A55770 | 82542 |
Lab: Cystatin C Measurement | L37618 | A57644 | 82610 |
Lab: Flow Cytometry | L36094 | A57690 | 88182, 88184, 88185, 88187, 88188, 88189, 86053, 86355, 86356, 86357, 86359, 86360, 86361, 86363, 86367 |
Lab: Special Histochemical Stains and Immunohistochemical Stains | L36353 | A57614 | 88312, 88313, 88341, 88342, 88344, 88360, 88361 |
Lumbar MRI | L37281 | A57207 | 72148, 72149, 72158, A9585, Q9953 |
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor | L37738 | A57513 | 0398T |
MDS FISH | L37622 | A57662 | 88271, 88273, 88274, 88275, 88291 |
Measurement of Salivary Hormones | L36857 | A57613 | 84999 |
Micro-Invasive Glaucoma Surgery (MIGS) | L38301 | A57864 | 66989, 66991, 0449T, 0450T, 0474T, 0671T |
Mohs Micrographic Surgery | L35704 | A56515 | 17311, 17312, 17313, 17314, 17315, 88302, 88304, 88305, 88307, 88309, 88314, 88331, 88332 |
MRI and CT Scans of the Head and Neck | L35175 | A57215 | 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 | L35457 | A52725 | 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 | L36526 | A54992 | 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 | L38615 | A58097 | 0501T, 0502T, 0503T, 0504T |
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) | L34106 | A56573 | 22510, 22511, 22512, 22513, 22514, 22515 |
Peripheral Nerve Stimulation | L37360 | A55531 | 61885, 64553, 64555, 64561, 64569, 64570, 64575, 64581, 64585, 64590, 64595, 64999 |
Plastic Surgery | L37020 | A57222 | 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 | L39060 | A58790 | 86965, G0460, G0465, M0076, P9020, 0232T |
Polysomnography and Other Sleep Studies | L34040 | A57698 | G0398, G0399, G0400, 95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811 |
ProMark Risk Score | L36706 | A57609 | 81479 |
Respiratory Care | L37293 | A57225 | 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 | L39464 | A59246 | 27096, 64451, 64625, 77002, 77012, G0260 |
Serum Magnesium | L36700 | A57198 | 83735 |
Spinal Cord Stimulators for Chronic Pain | L36204 | A57792 | 63650, 63655, 63663, 63664, 63685 |
Total Hip Arthroplasty | L36573 | A57684 | 27130, 27132, 27134, 27137, 27138 |
Total Knee Arthroplasty | L36577 | A57686 | 27445, 27447, 27486, 27487 |
Transcranial Magnetic Stimulation (TMS) | L37088 | A57693 | 90867, 90868, 90869 |
Transurethral Waterjet Ablation of the Prostate | L38707 | A58229 | C2596, 0421T |
Treatment of Males with Low Testosterone | L36569 | A57616 | 11980, 84410, 96372, J1071, J3121, J3145, J3490 |
Treatment of Varicose Veins of the Lower Extremities | L34010 | A57707 | 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 | L36859 | A57702 | 20552, 20553 |
Urine Drug Testing | L36707 | A55030 | 80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659 |
Vitamin D Assay Testing | L34051 | A57719 | 82306, 82652 |
Wound and Ulcer Care | L38904 | A58567 | 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 |