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 02102 Alaska - Contractor ID 02102
Arizona - Contractor ID 03102 Arizona - Contractor ID 03102
Idaho - Contractor 02202 Idaho - Contractor ID 02202
Montana - Contractor ID 03202 Montana - Contractor ID 03202
North Dakota - Contractor ID 03302 North Dakota - Contractor ID 03302
Oregon - Contractor ID 02302 Oregon - Contractor ID 02302
South Dakota - Contractor ID 03402 South Dakota - Contractor ID 03402
Utah - Contractor ID 03502 Utah - Contractor ID 03502
Washington - Contractor ID 02402 Washington - Contractor ID 02402
Wyoming - Contractor ID 03602 Wyoming - Contractor ID 03602

 

Medicare Database Number LCD Title Retirement Date CPT / HCPCS Codes Referenced
L34995 Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy   64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T

 

Last Updated Fri, 23 Apr 2021 15:42:21 +0000