| LCD |
Effective
Date |
Revision
Effective
Date |
Title |
CPT Codes Covered in LCD |
|
L34833
|
10/01/2015
|
08/13/2020
|
Cardiac Rhythm Device Evaluation
|
|
|
L34834
|
10/01/2015
|
11/07/2019
|
Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)
|
|
|
L34856
|
10/01/2015
|
11/07/2019
|
C-Reactive Protein High Sensitivity Testing (hsCRP)
|
|
|
L34864
|
10/01/2015
|
11/14/2019
|
Loss-of-Heterozygosity Based Topographic Genotyping with PathfinderTG ®
|
|
|
L34865
|
10/01/2015
|
07/01/2020
|
Magnetic Resonance Angiography (MRA)
|
|
|
L34887
|
10/01/2015
|
01/30/2022
|
Surgical Treatment of Nails
|
|
|
L34892
|
10/01/2015
|
08/11/2024
|
Facet Joint Interventions for Pain Management
|
|
|
L34914
|
10/01/2015
|
07/01/2020
|
Assays for Vitamins and Metabolic Function
|
|
|
L34924
|
10/01/2015
|
12/27/2020
|
Treatment of Chronic Venous Insufficiency of the Lower Extremities
|
|
|
L34938
|
10/01/2015
|
09/26/2019
|
Removal of Benign Skin Lesions
|
|
|
L34961
|
10/01/2015
|
11/14/2019
|
Mohs Micrographic Surgery (MMS)
|
|
|
L34975
|
10/01/2015
|
10/17/2019
|
Neurophysiology Evoked Potentials (NEPs)
|
|
|
L34998
|
10/01/2015
|
12/11/2022
|
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder
|
|
|
L35003
|
10/01/2015
|
11/14/2019
|
Intraoperative Neurophysiological Testing
|
|
|
L35004
|
10/01/2015
|
03/21/2021
|
Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
|
|
|
L35006
|
10/01/2015
|
10/17/2019
|
Controlled Substance Monitoring and Drugs of Abuse Testing
|
|
|
L35007
|
10/01/2015
|
10/17/2019
|
Vestibular and Audiologic Function Studies
|
|
|
L35010
|
10/01/2015
|
09/01/2022
|
Trigger Point Injections
|
|
|
L35013
|
10/01/2015
|
09/12/2019
|
Debridement of Mycotic Nails
|
|
|
L35014
|
10/01/2015
|
09/26/2019
|
Frequency of Hemodialysis
|
|
|
L35016
|
10/01/2015
|
10/17/2019
|
Transesophageal Echocardiography (TEE)
|
|
|
L35022
|
10/01/2015
|
05/13/2021
|
Bariatric Surgical Management of Morbid Obesity
|
|
|
L35035
|
10/01/2015
|
11/21/2019
|
Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography
|
|
|
L35038
|
10/01/2015
|
10/31/2019
|
Scanning Computerized Ophthalmic Diagnostic Imaging
|
|
|
L35041
|
10/01/2015
|
09/26/2019
|
Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds
|
|
|
L35049
|
10/01/2015
|
10/17/2019
|
Monitored Anesthesia Care
|
|
|
L35050
|
10/01/2015
|
01/01/2021
|
Outpatient Sleep Studies
|
|
|
L35062
|
10/01/2015
|
12/12/2021
|
Biomarkers Overview
|
|
|
L35070
|
10/01/2015
|
08/13/2020
|
Speech - Language Pathology (SLP) Services: Communication Disorders
|
|
|
L35081
|
10/01/2015
|
12/10/2023
|
Nerve Conduction Studies and Electromyography
|
|
|
L35083
|
10/01/2015
|
04/25/2021
|
Cardiology Non-emergent Outpatient Stress Testing
|
|
|
L35089
|
10/01/2015
|
11/21/2019
|
Wireless Capsule Endoscopy
|
|
|
L35090
|
10/01/2015
|
07/11/2021
|
Cosmetic and Reconstructive Surgery
|
|
|
L35091
|
10/01/2015
|
07/11/2021
|
Cataract Extraction (including Complex Cataract Surgery)
|
|
|
L35092
|
10/01/2015
|
11/07/2019
|
Diagnostic Abdominal Aortography and Renal Angiography
|
|
|
L35093
|
10/01/2015
|
02/05/2023
|
Immune Globulin
|
|
|
L35099
|
10/01/2015
|
11/07/2019
|
Frequency of Laboratory Tests
|
|
|
L35101
|
10/01/2015
|
01/01/2024
|
Psychiatric Codes
|
|
|
L35125
|
10/01/2015
|
07/23/2020
|
Wound Care
|
|
|
L35130
|
10/01/2015
|
07/11/2021
|
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)
|
|
|
L35138
|
10/01/2015
|
10/17/2019
|
Routine Foot Care
|
|
|
L35350
|
10/01/2015
|
10/17/2019
|
Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
|
|
|
L35391
|
10/01/2015
|
11/14/2019
|
Multiple Imaging in Oncology
|
|
|
L35395
|
10/01/2015
|
11/14/2019
|
Autonomic Function Tests
|
|
|
L35396
|
10/01/2015
|
12/13/2020
|
Biomarkers for Oncology
|
|
|
L35397
|
10/01/2015
|
10/17/2019
|
Non-Invasive Cerebrovascular Arterial Studies
|
|
|
L35434
|
10/01/2015
|
10/17/2019
|
Oximetry Services
|
|
|
L35451
|
10/01/2015
|
01/28/2024
|
Peripheral Venous Ultrasound
|
|
|
L36007
|
10/01/2015
|
11/14/2019
|
Lower Extremity Major Joint Replacement (Hip and Knee)
|
|
|
L36240
|
10/01/2015
|
03/31/2024
|
Allergen Immunotherapy
|
|
|
L36241
|
10/01/2015
|
07/11/2021
|
Allergy Testing
|
|
|
L36711
|
12/01/2016
|
01/01/2021
|
Intensity Modulated Radiation Therapy (IMRT)
|
|
|
L36715
|
12/01/2016
|
12/10/2020
|
BRCA1 and BRCA2 Genetic Testing
|
|
|
L36920
|
05/04/2017
|
12/12/2021
|
Epidural Steroid Injections for Pain Management
|
|
|
L37371
|
01/25/2018
|
11/21/2019
|
Electroretinography (ERG)
|
|
|
L37792
|
03/21/2019
|
12/30/2019
|
4Kscore Test Algorithm
|
|
|
L37893
|
05/20/2019
|
12/27/2020
|
Endovenous Stenting
|
|
|
L38223
|
12/30/2019
|
|
Micro-Invasive Glaucoma Surgery (MIGS)
|
|
|
L38229
|
12/30/2019
|
10/26/2023
|
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)
|
|
|
L38385
|
03/15/2020
|
|
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
|
|
|
L38495
|
07/12/2020
|
|
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor
|
|
|
L38617
|
10/11/2020
|
08/11/2024
|
Implantable Continuous Glucose Monitors (I-CGM)
|
|
|
L38712
|
12/27/2020
|
|
Transurethral Waterjet Ablation of the Prostate
|
|
|
L38807
|
03/28/2021
|
|
Colon Capsule Endoscopy (CCE)
|
|
|
L38809
|
03/21/2021
|
|
Botulinum Toxins
|
|
|
L38812
|
03/21/2021
|
|
Diagnostic Colonoscopy
|
|
|
L38916
|
07/11/2021
|
|
Respiratory Pathogen Panel Testing
|
|
|
L39063
|
12/12/2021
|
|
Pharmacogenomics Testing
|
|
|
L39068
|
12/12/2021
|
12/12/2021
|
Platelet Rich Plasma
|
|
|
L39082
|
01/30/2022
|
01/30/2022
|
Genetic Testing for Cardiovascular Disease
|
|
|
L39365
|
07/17/2023
|
|
Genetic Testing for Oncology
|
|
|
L39490
|
06/11/2023
|
|
Ambulatory Electrocardiograph (AECG) Monitoring
|
|
