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Currently Active LCDs124
Draft LCDs4
Retired LCDs1
Currently Active Articles309
Retired Articles37

Currently Active LCDs

LCD
Effective
Date
Revision
Effective
Date
Title
CPT Codes Covered in LCD
L32553 10/01/2015 11/02/2023 Allergy Immunotherapy
L33943 10/01/2015 12/07/2023 B-type Natriuretic Peptide (BNP) Testing
L33944 10/01/2015 11/02/2023 Blepharoplasty
L33945 10/01/2015 02/01/2024 Cerumen (Earwax) Removal
L33946 10/01/2015 11/02/2023 Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy
L33947 10/01/2015 10/03/2024 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
L33949 10/01/2015 12/07/2023 Botulinum Toxins
L33950 10/01/2015 12/07/2023 Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
L33952 10/01/2015 12/07/2023 Cardiac Event Detection
L33954 10/01/2015 01/04/2024 Cataract Extraction
L33959 10/01/2015 11/02/2023 Cardiac Catheterization and Coronary Angiography
L33960 10/01/2015 02/01/2024 Cardiovascular Nuclear Medicine
L33996 10/01/2015 08/08/2024 Vitamin D Assay Testing
L33999 10/01/2015 02/01/2024 Corneal Pachymetry
L34005 10/01/2015 02/01/2024 Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
L34008 10/01/2015 02/01/2024 Computerized Corneal Topography
L34032 10/01/2015 10/03/2024 Debridement Services
L34037 10/01/2015 03/07/2024 Flow Cytometry
L34045 10/01/2015 11/02/2023 Non-Invasive Vascular Studies
L34046 10/01/2015 08/08/2024 Speech-Language Pathology
L34049 10/01/2015 06/06/2024 Outpatient Physical and Occupational Therapy Services
L34055 10/01/2015 10/03/2024 Virtual Colonoscopy (CT Colonography)
L34056 10/01/2015 10/03/2024 Urodynamics
L34061 10/01/2015 08/08/2024 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
L34062 10/01/2015 02/01/2024 Dialysis Access Maintenance
L34063 10/01/2015 08/08/2024 RAST Type Tests
L34064 10/01/2015 04/04/2024 Panretinal (Scatter) Laser Photocoagulation
L34081 10/01/2015 03/07/2024 Endoscopy by Capsule
L34082 10/01/2015 10/03/2024 Varicose Veins of the Lower Extremity, Treatment of
L34084 10/01/2015 09/05/2024 Transcatheter Infusion Therapy
L34085 10/01/2015 04/04/2024 Post-Void Residual Urine and/or Bladder Capacity by Ultrasound
L34087 10/01/2015 09/05/2024 Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based
L34090 10/01/2015 04/04/2024 Laser Ablation of the Prostate
L34171 10/01/2015 06/06/2024 Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation
L34175 10/01/2015 06/06/2024 Ophthalmic Angiography (Fluorescein and Indocyanine Green)
L34181 10/01/2015 06/06/2024 Ophthalmic Biometry for Intraocular Lens Power Calculation
L34183 10/01/2015 04/04/2024 Psychiatric Inpatient Hospitalization
L34195 10/01/2015 05/09/2024 Mohs Micrographic Surgery
L34196 10/01/2015 04/04/2024 Psychiatric Partial Hospitalization Programs
L34200 10/01/2015 08/08/2024 Removal of Benign Skin Lesions
L34246 10/01/2015 08/08/2024 Routine Foot Care and Debridement of Nails
L34337 10/01/2015 09/05/2024 Transesophageal Echocardiography (TEE)
L34338 10/01/2015 10/03/2024 Transthoracic Echocardiography (TTE)
L34353 10/01/2015 06/06/2024 Outpatient Psychiatry and Psychology Services
L34356 10/01/2015 03/07/2024 Erythropoiesis Stimulating Agents (ESA)
L34393 10/01/2015 05/09/2024 Ocular Photography - External
L34394 10/01/2015 10/03/2024 Visual Fields Testing
L34399 10/01/2015 06/06/2024 Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
L34539 10/01/2015 04/04/2024 Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians
L34540 10/01/2015 09/05/2024 Stretta Procedure
L34541 10/01/2015 10/03/2024 Transtelephonic Spirometry
L35249 10/01/2015 05/09/2024 Nerve Blocks for Peripheral Neuropathy
L35442 10/01/2015 07/27/2023 MolDX: NRAS Genetic Testing
L35891 10/01/2015 04/04/2024 Intravenous Immune Globulin
L35897 10/01/2015 05/09/2024 Nerve Conduction Studies and Electromyography
L35906 10/01/2015 04/04/2024 Somatosensory Testing
L35984 10/01/2015 07/20/2023 MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)
L35986 10/01/2015 03/07/2024 Special Histochemical Stains and Immunohistochemical Stains
L36021 10/01/2015 08/22/2024 MolDX: Molecular Diagnostic Tests (MDT)
L36029 10/05/2015 03/07/2024 Urine Drug Testing
L36113 10/05/2015 08/22/2024 MolDX: MGMT Promoter Methylation Analysis
L36117 10/05/2015 05/16/2024 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
L36139 10/05/2015 03/02/2023 MolDX: Biomarkers in Cardiovascular Risk Assessment
L36425 02/01/2016 02/15/2024 MolDX: Breast Cancer Assay: Prosigna®
L36460 02/01/2016 01/04/2024 Bone Mass Measurement
L36469 02/08/2016 06/06/2024 Transcranial Magnetic Stimulation (TMS)
L36485 02/15/2016 09/19/2024 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy
L36494 02/01/2016 01/04/2024 Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint
L36658 10/24/2016 10/03/2024 Proton Beam Therapy
L36675 10/10/2016 12/07/2023 ProMark® Risk Score
L36690 10/10/2016 09/05/2024 Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities
L36902 03/06/2017 03/07/2024 Polysomnography and Other Sleep Studies
L36906 03/06/2017 04/04/2024 GlycoMark® Testing for Glycemic Control
L36951 03/06/2017 09/28/2023 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)
L36975 03/06/2017 02/01/2024 Bladder/Urothelial Tumor Markers
L37126 07/10/2017 02/01/2024 Coenzyme Q10 (CoQ10)
L37130 07/10/2017 05/18/2023 MolDX: DecisionDx-UM (Uveal Melanoma)
L37254 11/06/2017 02/01/2024 Chiropractic Services
L37352 11/06/2017 02/29/2024 MolDX: Prometheus IBD sgi Diagnostic® Policy
L37356 03/06/2018 04/11/2024 MolDX: EndoPredict Breast Cancer Gene Expression Test
L37364 01/07/2019 04/04/2024 Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)
L37575 04/01/2019 03/07/2024 Frequency of Hemodialysis
L37578 03/19/2018 11/17/2024 Micro-Invasive Glaucoma Surgery (MIGS)
L37598 12/17/2018 01/04/2024 Cystatin C Measurement
L37608 05/06/2019 08/08/2024 MDS FISH
L37790 10/01/2018 09/05/2024 Magnetic Resonance Guided Focused Ultrasound Surgery System (MRgFUS) for the treatment of neurologic conditions
L37832 04/01/2019 11/02/2023 MolDX: Breast Cancer Index® (BCI) Gene Expression Test
L37903 05/13/2019 06/27/2024 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer
L37905 05/20/2019 06/29/2023 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test
L38016 06/24/2019 05/18/2023 MolDX: Melanoma Risk Stratification Molecular Testing
L38065 07/27/2020 10/26/2023 MolDX: Plasma-Based Genomic Profiling in Solid Tumors
L38067 02/10/2020 08/22/2024 MolDX: Next-Generation Sequencing for Solid Tumors
L38070 02/10/2020 03/28/2024 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
L38111 03/30/2020 10/26/2023 MolDX: Pigmented Lesion Assay
L38201 11/18/2019 10/03/2024 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)
L38249 11/01/2020 05/23/2024 MolDX: Blood Product Molecular Antigen Typing
L38268 04/01/2020 03/07/2024 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 04/25/2024 MolDX: Repeat Germline Testing
L38303 11/09/2020 07/25/2024 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease
L38307 04/01/2020 03/07/2024 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
L38378 04/01/2020 04/04/2024 Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH)
L38394 08/03/2020 08/24/2023 MolDX: Pharmacogenomics Testing
L38582 06/06/2021 07/27/2023 MolDX: Molecular Testing for Solid Organ Allograft Rejection
L38584 07/25/2021 05/16/2024 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells
L38586 07/18/2021 03/21/2024 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer
L38662 11/02/2020 11/04/2024 Implantable Continuous Glucose Monitors (I-CGM)
L38694 11/02/2020 06/17/2021 Computed Tomography Cerebral Perfusion Analysis (CTP)
L38771 04/25/2021 09/05/2024 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease
L38773 05/02/2021 07/07/2024 Facet Joint Interventions for Pain Management
L38777 03/29/2021 01/30/2022 Colon Capsule Endoscopy (CCE)
L38822 12/26/2021 11/02/2023 MolDX: Minimal Residual Disease Testing for Cancer
L38920 08/08/2021 06/29/2023 Off-label Use of Rituximab and Rituximab Biosimilars
L38992 01/30/2022 01/12/2023 Electroretinography (ERG)
L38997 07/17/2022 03/14/2024 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
L39015 12/05/2021 11/09/2023 Epidural Steroid Injections for Pain Management
L39017 08/21/2022 04/18/2024 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 04/25/2024 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
L39276 06/04/2023 02/29/2024 MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia
L39284 11/20/2022 11/02/2023 Prostate Cancer Detection with IsoPSA®
L39383 03/19/2023 04/04/2024 Sacroiliac Joint Injections and Procedures
L39389 08/06/2023 05/16/2024 MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma
L39585 08/18/2024 MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma



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