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Currently Active LCDs123
Draft LCDs16
Retired LCDs9
Currently Active Articles304
Retired Articles37

Currently Active LCDs

LCD
Effective
Date
Revision
Effective
Date
Title
CPT Codes Covered in LCD
L32553 10/01/2015 10/27/2022 Allergy Immunotherapy
L33943 10/01/2015 12/01/2022 B-type Natriuretic Peptide (BNP) Testing
L33944 10/01/2015 10/27/2022 Blepharoplasty
L33945 10/01/2015 02/03/2022 Cerumen (Earwax) Removal
L33946 10/01/2015 10/27/2022 Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy
L33947 10/01/2015 10/06/2022 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
L33949 10/01/2015 11/25/2021 Botulinum Toxins
L33950 10/01/2015 12/01/2022 Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
L33952 10/01/2015 12/01/2022 Cardiac Event Detection
L33954 10/01/2015 01/06/2022 Cataract Extraction
L33959 10/01/2015 10/27/2022 Cardiac Catheterization and Coronary Angiography
L33960 10/01/2015 02/03/2022 Cardiovascular Nuclear Medicine
L33996 10/01/2015 08/04/2022 Vitamin D Assay Testing
L33999 10/01/2015 02/03/2022 Corneal Pachymetry
L34005 10/01/2015 02/03/2022 Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
L34008 10/01/2015 02/03/2022 Computerized Corneal Topography
L34032 10/01/2015 10/06/2022 Debridement Services
L34037 10/01/2015 02/10/2022 Flow Cytometry
L34045 10/01/2015 10/27/2022 Non-Invasive Vascular Studies
L34046 10/01/2015 08/04/2022 Speech-Language Pathology
L34049 10/01/2015 06/02/2022 Outpatient Physical and Occupational Therapy Services
L34055 10/01/2015 10/06/2022 Virtual Colonoscopy (CT Colonography)
L34056 10/01/2015 10/06/2022 Urodynamics
L34061 10/01/2015 08/04/2022 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
L34062 10/01/2015 02/10/2022 Dialysis Access Maintenance
L34063 10/01/2015 08/04/2022 RAST Type Tests
L34064 10/01/2015 03/03/2022 Panretinal (Scatter) Laser Photocoagulation
L34081 10/01/2015 03/03/2022 Endoscopy by Capsule
L34082 10/01/2015 10/06/2022 Varicose Veins of the Lower Extremity, Treatment of
L34084 10/01/2015 09/01/2022 Transcatheter Infusion Therapy
L34085 10/01/2015 03/03/2022 Post-Void Residual Urine and/or Bladder Capacity by Ultrasound
L34087 10/01/2015 09/01/2022 Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based
L34090 10/01/2015 03/24/2022 Laser Ablation of the Prostate
L34171 10/01/2015 06/02/2022 Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation
L34175 10/01/2015 06/03/2021 Ophthalmic Angiography (Fluorescein and Indocyanine Green)
L34181 10/01/2015 06/02/2022 Ophthalmic Biometry for Intraocular Lens Power Calculation
L34183 10/01/2015 03/03/2022 Psychiatric Inpatient Hospitalization
L34195 10/01/2015 04/14/2022 Mohs Micrographic Surgery
L34196 10/01/2015 03/03/2022 Psychiatric Partial Hospitalization Programs
L34200 10/01/2015 08/04/2022 Removal of Benign Skin Lesions
L34246 10/01/2015 08/04/2022 Routine Foot Care and Debridement of Nails
L34337 10/01/2015 09/01/2022 Transesophageal Echocardiography (TEE)
L34338 10/01/2015 10/06/2022 Transthoracic Echocardiography (TTE)
L34353 10/01/2015 06/02/2022 Outpatient Psychiatry and Psychology Services
L34356 10/01/2015 04/28/2022 Erythropoiesis Stimulating Agents (ESA)
L34393 10/01/2015 04/14/2022 Ocular Photography - External
L34394 10/01/2015 10/06/2022 Visual Fields Testing
L34399 10/01/2015 06/02/2022 Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
L34539 10/01/2015 03/04/2021 Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians
L34540 10/01/2015 09/01/2022 Stretta Procedure
L34541 10/01/2015 10/06/2022 Transtelephonic Spirometry
L35249 10/01/2015 04/14/2022 Nerve Blocks for Peripheral Neuropathy
L35442 10/01/2015 08/11/2022 MolDX: NRAS Genetic Testing
L35891 10/01/2015 03/24/2022 Intravenous Immune Globulin
L35897 10/01/2015 04/14/2022 Nerve Conduction Studies and Electromyography
L35906 10/01/2015 03/31/2022 Somatosensory Testing
L35984 10/01/2015 06/16/2022 MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)
L35986 10/01/2015 10/20/2022 Special Histochemical Stains and Immunohistochemical Stains
L36006 10/05/2015 04/21/2022 MolDX: ConfirmMDx Epigenetic Molecular Assay
L36021 10/01/2015 08/18/2022 MolDX: Molecular Diagnostic Tests (MDT)
L36029 10/05/2015 02/10/2022 Controlled Substance Monitoring and Drugs of Abuse Testing
L36113 10/05/2015 08/11/2022 MolDX: MGMT Promoter Methylation Analysis
L36117 10/05/2015 06/30/2022 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
L36139 10/05/2015 03/10/2022 MolDX: Biomarkers in Cardiovascular Risk Assessment
L36425 02/01/2016 03/10/2022 MolDX: Breast Cancer Assay: Prosigna®
L36460 02/01/2016 01/06/2022 Bone Mass Measurement
L36469 02/08/2016 12/04/2022 Transcranial Magnetic Stimulation (TMS)
L36485 02/15/2016 07/08/2021 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy
L36494 02/01/2016 01/06/2022 Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint
L36658 10/24/2016 10/06/2022 Proton Beam Therapy
L36675 10/10/2016 11/24/2022 ProMark® Risk Score
L36690 10/10/2016 09/01/2022 Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities
L36902 03/06/2017 02/03/2022 Polysomnography and Other Sleep Studies
L36906 03/06/2017 02/10/2022 GlycoMark® Testing for Glycemic Control
L36908 03/13/2017 10/06/2022 MolDX: Percepta® Bronchial Genomic Classifier
L36951 03/06/2017 10/06/2022 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)
L36975 03/06/2017 02/03/2022 Bladder/Urothelial Tumor Markers
L37126 07/10/2017 02/03/2022 Coenzyme Q10 (CoQ10)
L37130 07/10/2017 06/30/2022 MolDX: DecisionDx-UM (Uveal Melanoma)
L37254 11/06/2017 02/03/2022 Chiropractic Services
L37352 11/06/2017 11/17/2022 MolDX: Prometheus IBD sgi Diagnostic® Policy
L37356 03/06/2018 04/21/2022 MolDX: EndoPredict Breast Cancer Gene Expression Test
L37364 01/07/2019 02/03/2022 Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)
L37575 04/01/2019 02/03/2022 Frequency of Hemodialysis
L37578 03/19/2018 05/05/2022 Micro-Invasive Glaucoma Surgery (MIGS)
L37598 12/17/2018 06/09/2022 Cystatin C Measurement
L37608 05/06/2019 06/30/2022 MDS FISH
L37790 10/01/2018 09/01/2022 Magnetic Resonance Guided Focused Ultrasound Surgery System (MRgFUS) for the treatment of neurologic conditions
L37832 04/01/2019 09/22/2022 MolDX: Breast Cancer Index® (BCI) Gene Expression Test
L37903 05/13/2019 06/16/2022 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer
L37905 05/20/2019 05/19/2022 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test
L37907 06/03/2019 07/14/2022 MolDX: myPath Melanoma Assay
L38016 06/24/2019 07/03/2022 MolDX: Melanoma Risk Stratification Molecular Testing
L38065 07/27/2020 10/13/2022 MolDX: Plasma-Based Genomic Profiling in Solid Tumors
L38067 02/10/2020 08/25/2022 MolDX: Next-Generation Sequencing for Solid Tumors
L38070 02/10/2020 08/25/2022 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
L38111 03/30/2020 10/06/2022 MolDX: Pigmented Lesion Assay
L38201 11/18/2019 10/06/2022 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)
L38249 11/01/2020 05/26/2022 MolDX: Blood Product Molecular Antigen Typing
L38268 04/01/2020 03/17/2022 Immune Thrombocytopenia (ITP) Therapy
L38284 07/27/2020 10/20/2022 MolDX: Predictive Classifiers for Early Stage Non-small Cell Lung Cancer
L38288 06/07/2020 11/24/2022 MolDX: Repeat Germline Testing
L38303 11/09/2020 02/03/2022 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease
L38307 04/01/2020 03/17/2022 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
L38378 04/01/2020 04/07/2022 Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH)
L38394 08/03/2020 09/29/2022 MolDX: Pharmacogenomics Testing
L38582 06/06/2021 06/23/2022 MolDX: Molecular Testing for Solid Organ Allograft Rejection
L38584 07/25/2021 07/21/2022 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells
L38586 07/18/2021 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer
L38662 11/02/2020 05/05/2022 Implantable Continuous Glucose Monitors (I-CGM)
L38694 11/02/2020 Computed Tomography Cerebral Perfusion Analysis (CTP)
L38771 04/25/2021 08/21/2022 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease
L38773 05/02/2021 03/17/2022 Facet Joint Interventions for Pain Management
L38777 03/29/2021 01/30/2022 Colon Capsule Endoscopy (CCE)
L38822 12/26/2021 10/06/2022 MolDX: Minimal Residual Disease Testing for Cancer
L38920 08/08/2021 06/30/2022 Off-label Use of Rituximab and Rituximab Biosimilars
L38992 01/30/2022 07/21/2022 Electroretinography (ERG)
L38997 07/17/2022 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
L39015 12/05/2021 Epidural Steroid Injections for Pain Management
L39017 08/21/2022 MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
L39023 01/03/2022 07/21/2022 Platelet Rich Plasma Injections for Non-Wound Injections
L39038 04/17/2022 06/02/2022 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
L39284 11/20/2022 Prostate Cancer Detection with IsoPSA®



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