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Currently Active LCDs94
Draft LCDs2
Retired LCDs2
Currently Active Articles240
Retired Articles44

Currently Active LCDs

LCD
Effective
Date
Revision
Effective
Date
Title
CPT Codes Covered in LCD
L34526 10/01/2015 07/27/2023 Surgical Treatment of Obstructive Sleep Apnea (OSA)
L34528 10/01/2015 12/28/2023 Blepharoplasty, Blepharoptosis and Brow Lift
L34536 10/01/2015 08/31/2023 Treatment of Varicose Veins of the Lower Extremities
L34594 10/01/2015 06/01/2023 Nerve Conduction Studies and Electromyography
L34596 10/01/2015 10/26/2023 Immunizations
L34614 10/01/2015 08/29/2024 Colonoscopy and Sigmoidoscopy-Diagnostic
L34615 10/01/2015 06/29/2023 Visual Fields
L34616 10/01/2015 10/31/2024 Psychiatry and Psychology Services
L34623 10/01/2015 02/01/2024 Intraoperative Neurophysiological Testing
L34624 10/01/2015 10/01/2023 Somatosensory Testing
L34633 10/01/2015 06/01/2023 Erythropoiesis Stimulating Agents (ESAs)
L34635 10/01/2015 10/01/2023 Botulinum Toxin Type A & Type B
L34636 10/01/2015 10/01/2023 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)
L34641 10/01/2015 04/25/2024 Transcranial Magnetic Stimulation (TMS)
L34645 10/01/2015 11/12/2023 Urine Drug Testing
L34646 10/01/2015 10/31/2024 Psychological and Neuropsychological Testing
L34648 10/01/2015 02/11/2024 Bisphosphonate Drug Therapy
L34658 10/01/2015 10/01/2023 Vitamin D Assay Testing
L34659 10/01/2015 08/29/2024 Endoscopic Treatment of GERD
L34760 10/01/2015 06/29/2023 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
L34761 10/01/2015 12/28/2023 Percutaneous Coronary Interventions
L34771 10/01/2015 02/29/2024 Immune Globulins
L35121 10/01/2015 11/30/2023 Coronary Computed Tomography Angiography (CCTA)
L35124 10/01/2015 10/26/2023 Autonomic Function Testing
L35222 10/01/2015 11/30/2023 Nerve Blocks for Peripheral Neuropathy
L35486 10/01/2015 10/26/2023 Pelvic Floor Dysfunction: Anorectal Manometry and EMG
L35490 10/01/2015 11/17/2024 Category III Codes
L35494 10/01/2015 10/31/2024 Mohs Micrographic Surgery
L35498 10/01/2015 10/26/2023 Removal of Benign Skin Lesions
L35751 10/01/2015 09/26/2024 Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
L35753 10/01/2015 10/26/2023 Non-Invasive Cerebrovascular Studies
L35755 10/01/2015 11/30/2023 Non-Invasive Abdominal / Visceral Vascular Studies
L35761 10/01/2015 10/26/2023 Non-Invasive Peripheral Arterial Vascular Studies
L35998 10/01/2015 01/01/2023 Non-Coronary Vascular Stents
L36000 12/17/2015 06/27/2024 Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain
L36400 04/16/2016 07/20/2023 MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)
L36402 03/18/2016 09/26/2024 Allergy Testing
L36408 03/18/2016 10/26/2023 Allergy Immunotherapy
L36523 06/16/2016 03/21/2024 MolDX: Biomarkers in Cardiovascular Risk Assessment
L36797 02/16/2017 07/27/2023 MolDX: NRAS Genetic Testing
L36805 02/16/2017 08/01/2024 Lab: Special Histochemical Stains and Immunohistochemical Stains
L36807 02/16/2017 04/27/2023 MolDX: Molecular Diagnostic Tests (MDT)
L36811 02/16/2017 03/30/2023 MolDX: Breast Cancer Assay: Prosigna®
L36815 02/16/2017 07/06/2023 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
L36839 02/16/2017 07/27/2023 Polysomnography and Other Sleep Studies
L37001 07/17/2017 08/31/2023 MolDX: MGMT Promoter Methylation Analysis
L37003 07/17/2017 08/24/2023 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy
L37011 07/17/2017 12/28/2023 ProMark® Risk Score
L37015 07/17/2017 10/01/2023 Visual Electrophysiology Testing
L37199 09/16/2017 10/26/2023 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)
L37205 09/16/2017 11/30/2023 Chemotherapy Drugs and their Adjuncts
L37210 09/16/2017 06/27/2024 MolDX: Decision Dx-UM (Uveal Melanoma)
L37216 09/16/2017 03/30/2023 BDX-XL2
L37228 04/16/2018 04/27/2023 Wound Care
L37537 03/01/2019 03/28/2024 Frequency of Hemodialysis
L37539 03/19/2018 02/29/2024 MolDX: Prometheus® IBD sgi Diagnostic® Policy
L37663 08/16/2018 04/27/2023 MolDX: EndoPredict® Breast Cancer Gene Expression Test
L37772 05/13/2019 06/01/2023 MDS FISH
L37913 04/15/2019 02/23/2023 MolDX: Breast Cancer Index® (BCI) Gene Expression Test
L37919 05/13/2019 06/29/2023 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test
L37921 04/15/2019 11/30/2023 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer
L38018 08/12/2019 06/20/2024 MolDX: Melanoma Risk Stratification Molecular Testing
L38158 02/09/2020 06/08/2023 MolDX: Next-Generation Sequencing for Solid Tumors
L38168 03/15/2020 10/26/2023 MolDX: Plasma-Based Genomic Profiling in Solid Tumors
L38176 02/09/2020 03/28/2024 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
L38178 04/12/2020 06/20/2024 MolDX: Pigmented Lesion Assay
L38211 10/14/2019 07/27/2023 Corneal Hysteresis
L38213 12/16/2019 08/01/2024 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)
L38429 06/14/2020 04/25/2024 MolDX: Repeat Germline Testing
L38433 11/08/2020 02/01/2024 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease
L38435 07/26/2020 08/24/2023 MolDX: Pharmacogenomics Testing
L38441 10/25/2020 11/07/2024 MolDX: Blood Product Molecular Antigen Typing
L38443 06/14/2020 07/20/2023 MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer
L38528 06/14/2020 04/25/2024 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
L38678 07/25/2021 05/26/2022 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells
L38680 06/06/2021 07/27/2023 MolDx: Molecular Testing for Solid Organ Allograft Rejection
L38682 12/27/2020 09/26/2024 Transurethral Waterjet Ablation of the Prostate
L38684 07/18/2021 08/13/2023 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer
L38686 10/11/2020 08/01/2024 Implantable Continuous Glucose Monitors (I-CGM)
L38835 12/26/2021 10/26/2023 MolDX: Minimal Residual Disease Testing for Cancer
L38837 03/28/2021 02/23/2023 Colon Capsule Endoscopy (CCE)
L38839 04/25/2021 06/27/2024 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease
L38841 04/25/2021 07/14/2024 Facet Joint Interventions for Pain Management
L39040 07/03/2022 04/18/2024 MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
L39042 07/03/2022 07/27/2023 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
L39044 04/17/2022 06/09/2022 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
L39051 11/14/2021 10/13/2024 Cosmetic and Reconstructive Surgery
L39054 12/05/2021 02/01/2024 Epidural Steroid Injections for Pain Management
L39356 05/14/2023 MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia
L39475 03/19/2023 08/31/2023 Sacroiliac Joint Injections and Procedures
L39477 02/12/2023 11/28/2024 Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin
L39479 08/13/2023 MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma
L39481 10/15/2023 08/01/2024 MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis
L39529 06/11/2023 Intraarticular Knee Injections of Hyaluronan



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