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 - Contractor ID 02101 Alaska - Contractor ID 02101
Arizona - Contractor ID 03101 Arizona - Contractor ID 03101
Idaho - Contractor 02201 Idaho - Contractor ID 02201
Montana - Contractor ID 03201 Montana - Contractor ID 03201
North Dakota - Contractor ID 03301 North Dakota - Contractor ID 03301
Oregon - Contractor ID 02301 Oregon - Contractor ID 02301
South Dakota - Contractor ID 03401 South Dakota - Contractor ID 03401
Utah - Contractor ID 03501 Utah - Contractor ID 03501
Washington - Contractor ID 02401 Washington - Contractor ID 02401
Wyoming - Contractor ID 03601 Wyoming - 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
L34202* Erythropoietin Stimulating Agents (ESA) 01/01/18 J0881, Q4081
L34166 Laparoscopic Sleeve Gastrectomy 04/30/16 43775
L36542 MolDX: Chromosome 1p/19q Deletion Analysis 01/01/18 81402, 88367, 88368, 88369, 88373
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 Apr 06, 2018