Retired LCDs

Retired Local Coverage Determinations (LCDs) are available on the CMS Medicare Coverage Database (MCD). LCDs move to the MCD Archive one year after their retirement.

Retired Within One Year Archived More Than One Year Ago
Alaska This link takes you to an external website. – Contractor ID 02101 Alaska This link takes you to an external website. – Contractor ID 02101
Arizona This link takes you to an external website. – Contractor ID 03101 Arizona This link takes you to an external website. – Contractor ID 03101
Idaho This link takes you to an external website. – Contractor 02201 Idaho This link takes you to an external website. – Contractor ID 02201
Montana This link takes you to an external website. – Contractor ID 03201 Montana This link takes you to an external website. – Contractor ID 03201
North Dakota This link takes you to an external website. – Contractor ID 03301 North Dakota This link takes you to an external website. – Contractor ID 03301
Oregon This link takes you to an external website. – Contractor ID 02301 Oregon This link takes you to an external website. – Contractor ID 02301
South Dakota This link takes you to an external website. – Contractor ID 03401 South Dakota This link takes you to an external website. – Contractor ID 03401
Utah This link takes you to an external website. – Contractor ID 03501 Utah This link takes you to an external website. – Contractor ID 03501
Washington This link takes you to an external website. – Contractor ID 02401 Washington This link takes you to an external website. – Contractor ID 02401
Wyoming This link takes you to an external website. – Contractor ID 03601 Wyoming This link takes you to an external website. – Contractor ID 03601

Medicare Database Number LCD Title Retirement Date CPT / HCPCS Codes Referenced
L24409 Application of Bioengineered Skin Substitutes   15002, 15003, 15004, 15005
L26195 CT Colonography   74261, 74262
L34166 Laparoscopic Sleeve Gastrectomy 04/30/16 43775
L34137 Multidetector Computed Tomography of the Heart and Great Vessels 05/13/16 75571, 75572, 75573, 75574
L24426 Nerve Blockade: Somatic, Selective Nerve Root Block, and Epidural   62281, 62282, 62310, 62311, 62318, 62319, 64400, 64402, 64405, 64408, 64410, 64412, 64413, 64415, 64416, 64417, 64418, 64420, 64421, 64425, 64430, 64435. 64445, 64446, 64447, 64448, 64449, 64450, 64455, 64505, 64508, 64510, 64517, 64520, 64530, 64620, 64632, 64640
L30813 Paravertebral Facet Joint Nerve Blockade   64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636
L36107 Treatment of Ulcers and Symptomatic Hyperkeratoses 05/15/16 10060, 10061, 11042, 11043, 11044, 11045, 11046, 11047, 11055, 11056, 11057, 97597, 97598
L34060 Urinalysis 04/29/16 81000, 81001, 81002, 81003, 81005, 81007, 81015, 81020

 

Last Updated Dec 14, 2017