CodeMap® 

150 North Wacker Drive
Suite 1870
Chicago, IL 60606
847-381-5465 Phone
847-381-4606 Fax
customerservice@codemap.com
      


User Information

Create New Account

Lost Password

Username:
Password:


Quick Links

LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2021
2020 (July)

Physician Fee Schedule

2021
2020

OPPS Fee Schedule

2021-April
2021-January

ASC Fee Schedule

2021-April
2021-January

APC Codes

2021-April
2021-January

DRG Codes

2021
2020

ASP Drug Pricing Files

April 2021
January 2021


CMS Transmittals




CodeMap® CodeMap® Contractor Policy Detail

List of All Medicare MAC Part A and MAC Part B Contractors

Wisconsin Physicians Service Insurance Corporation
Indiana
MAC A
08101


Currently Active LCDs99
Draft LCDs20
Retired LCDs12
Currently Active Articles275
Retired Articles19

Currently Active LCDs

LCD
Effective
Date
Revision
Effective
Date
Title
CPT Codes Covered in LCD
L34526 10/01/2015 07/29/2021 Surgical Treatment of Obstructive Sleep Apnea (OSA)
L34528 10/01/2015 05/27/2021 Blepharoplasty, Blepharoptosis and Brow Lift
L34536 10/01/2015 11/01/2019 Treatment of Varicose Veins of the Lower Extremities
L34588 10/01/2015 11/01/2019 Trigger Points, Local Injections
L34594 10/01/2015 10/31/2019 Nerve Conduction Studies and Electromyography
L34596 10/01/2015 11/01/2019 Immunizations
L34614 10/01/2015 10/01/2020 Colonoscopy and Sigmoidoscopy-Diagnostic
L34615 10/01/2015 10/31/2019 Visual Fields
L34616 10/01/2015 10/01/2020 Psychiatry and Psychology Services
L34623 10/01/2015 07/30/2020 Intraoperative Neurophysiological Testing
L34624 10/01/2015 11/01/2019 Somatosensory Testing
L34633 10/01/2015 07/01/2021 Erythropoiesis Stimulating Agents (ESAs)
L34635 10/01/2015 11/26/2020 Botulinum Toxin Type A & Type B
L34636 10/01/2015 01/01/2021 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)
L34641 10/01/2015 07/30/2020 Transcranial Magnetic Stimulation (TMS)
L34645 10/01/2015 05/10/2020 Drug Testing
L34646 10/01/2015 10/01/2020 Psychological and Neuropsychological Testing
L34648 10/01/2015 08/27/2020 Bisphosphonate Drug Therapy
L34658 10/01/2015 10/31/2019 Vitamin D Assay Testing
L34659 10/01/2015 02/14/2021 Endoscopic Treatment of GERD
L34698 10/01/2015 01/01/2021 Cosmetic and Reconstructive Surgery
L34760 10/01/2015 11/01/2019 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
L34761 10/01/2015 10/31/2019 Percutaneous Coronary Interventions
L34771 10/01/2015 10/01/2020 Immune Globulins
L35121 10/01/2015 08/27/2020 Coronary Computed Tomography Angiography (CCTA)
L35124 10/01/2015 11/01/2019 Autonomic Function Testing
L35222 10/01/2015 07/30/2020 Nerve Blocks for Peripheral Neuropathy
L35486 10/01/2015 11/01/2019 Pelvic Floor Dysfunction: Anorectal Manometry and EMG
L35490 10/01/2015 04/25/2021 Category III Codes
L35494 10/01/2015 12/31/2020 Mohs Micrographic Surgery
L35498 10/01/2015 10/31/2019 Removal of Benign Skin Lesions
L35751 10/01/2015 07/01/2021 Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies
L35753 10/01/2015 12/26/2019 Non-Invasive Cerebrovascular Studies
L35755 10/01/2015 12/26/2019 Non-Invasive Abdominal / Visceral Vascular Studies
L35761 10/01/2015 11/01/2019 Non-Invasive Peripheral Arterial Vascular Studies
L35998 10/01/2015 08/27/2020 Non-Coronary Vascular Stents
L36000 12/17/2015 06/25/2020 Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain
L36400 04/16/2016 08/12/2021 MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)
L36402 03/18/2016 11/26/2020 Allergy Testing
L36408 03/18/2016 05/28/2020 Allergy Immunotherapy
L36521 06/16/2016 11/01/2019 Lumbar Epidural Injections
L36523 06/16/2016 04/22/2021 MolDX: Biomarkers in Cardiovascular Risk Assessment
L36787 02/16/2017 11/01/2019 MolDX: Prolaris™ Prostate Cancer Genomic Assay
L36793 02/16/2017 02/25/2021 MolDX: Genetic Testing for Lynch Syndrome
L36797 02/16/2017 11/26/2020 MolDX: NRAS Genetic Testing
L36805 02/16/2017 12/24/2020 Lab: Special Histochemical Stains and Immunohistochemical Stains
L36807 02/16/2017 01/01/2020 MolDX: Molecular Diagnostic Tests (MDT)
L36811 02/16/2017 04/22/2021 MolDX: Breast Cancer Assay: Prosigna®
L36813 02/16/2017 04/29/2021 MolDX: BRCA1 and BRCA2 Genetic Testing
L36815 02/16/2017 07/01/2021 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
L36839 02/16/2017 07/29/2021 Polysomnography and Other Sleep Studies
L37001 07/17/2017 10/29/2020 MolDX: MGMT Promoter Methylation Analysis
L37003 07/17/2017 07/08/2021 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy
L37005 07/17/2017 11/26/2020 MolDX: ConfirmMDx Epigenetic Molecular Assay
L37011 07/17/2017 10/29/2020 MolDX: ProMark Risk Score
L37013 07/17/2017 04/01/2021 MolDX: 4Kscore® Assay
L37015 07/17/2017 11/01/2019 Visual Electrophysiology Testing
L37195 09/16/2017 11/01/2019 MolDX: Percepta® Bronchial Genomic Classifier
L37199 09/16/2017 11/01/2019 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)
L37205 09/16/2017 11/28/2019 Chemotherapy Drugs and their Adjuncts
L37210 09/16/2017 07/08/2021 MolDX: Decision Dx-UM (Uveal Melanoma)
L37216 09/16/2017 04/22/2021 MolDX: BDX-XL2
L37224 09/16/2017 04/01/2021 MolDX: APC and MUTYH Gene Testing
L37226 09/16/2017 11/01/2019 MolDX: Prolaris™ Prostate Cancer Genomic Assay for Men with Favorable Intermediate Risk Disease
L37228 04/16/2018 01/28/2021 Wound Care
L37537 03/01/2019 10/01/2020 Frequency of Hemodialysis
L37539 03/19/2018 02/25/2021 MolDX: Prometheus IBD sgi Diagnostic® Policy
L37663 08/16/2018 07/04/2021 MolDX: EndoPredict® Breast Cancer Gene Expression Test
L37764 12/17/2018 10/29/2020 MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels
L37766 02/16/2019 08/05/2021 Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)
L37768 12/17/2018 05/27/2021 MolDX: CYSTATIN C Measurement
L37770 12/17/2018 06/03/2021 MolDX: CORUS® CAD ASSAY
L37772 05/13/2019 07/22/2021 MDS FISH
L37913 04/15/2019 05/02/2021 MolDX: Breast Cancer Index® (BCI) Gene Expression Test
L37919 05/13/2019 06/24/2021 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test
L37921 04/15/2019 02/25/2021 MolDX: Inivata, InVisionFirst, Liquid Biopsy for Patients with Lung Cancer
L37923 06/10/2019 07/01/2019 MolDX: myPath Melanoma Assay
L38018 08/12/2019 11/26/2020 MolDX: Melanoma Risk Stratification Molecular Testing
L38158 02/09/2020 06/24/2021 MolDX: Next-Generation Sequencing for Solid Tumors
L38168 03/15/2020 05/28/2020 MolDX: Plasma-Based Genomic Profiling in Solid Tumors
L38176 02/09/2020 07/08/2021 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
L38178 04/12/2020 MolDX: Pigmented Lesion Assay
L38211 10/14/2019 11/01/2019 Corneal Hysteresis
L38213 12/16/2019 07/01/2021 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)
L38429 06/14/2020 MolDX: Repeat Germline Testing
L38431 10/18/2020 MolDX: Minimal Residual Disease Testing for Colorectal Cancer
L38433 11/08/2020 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease
L38435 07/26/2020 08/06/2020 MolDX: Pharmacogenomics Testing
L38441 10/25/2020 12/31/2020 MolDX: Blood Product Molecular Antigen Typing
L38443 06/14/2020 MolDX: Predictive Classifiers for Early Stage Non-small Cell Lung Cancer
L38528 06/14/2020 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
L38678 07/25/2021 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells
L38680 06/06/2021 MolDx: Molecular Testing for Solid Organ Allograft Rejection
L38682 12/27/2020 Transurethral Waterjet Ablation of the Prostate
L38684 07/18/2021 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer
L38686 10/11/2020 Implantable Continuous Glucose Monitors (I-CGM)
L38837 03/28/2021 Colon Capsule Endoscopy (CCE)
L38839 04/25/2021 Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease
L38841 04/25/2021 04/25/2021 Facet Joint Interventions for Pain Management



CodeMap® is a Registered Trademark of Wheaton Partners, LLC.