150 North Wacker Drive
Suite 2360
Chicago, IL 60606
847-381-5465 Phone
847-381-4606 Fax

User Information

Create New Account

Lost Password


Quick Links

LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule


Physician Fee Schedule


OPPS Fee Schedule


ASC Fee Schedule


APC Codes


DRG Codes


ASP Drug Pricing Files


CMS Transmittals

CodeMap® CodeMap® Contractor Policy Detail

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

Noridian Healthcare Solutions, LLC
California - Entire State

Currently Active LCDs97
Draft LCDs9
Retired LCDs1
Currently Active Articles289
Retired Articles50

Currently Active LCDs

CPT Codes Covered in LCD
L34149 10/01/2015 11/05/2023 Respiratory Care
L34163 10/01/2015 12/01/2019 Total Hip Arthroplasty
L34194 10/01/2015 10/01/2019 Blepharoplasty, Eyelid Surgery, and Brow Lift
L34203 10/01/2015 07/30/2023 Cataract Surgery in Adults
L34209 10/01/2015 12/01/2019 Treatment of Varicose Veins of the Lower Extremities
L34211 10/01/2015 04/01/2024 Trigger Point Injections (TPI)
L34213 10/01/2015 10/01/2019 Diagnostic and Therapeutic Colonoscopy
L34215 10/01/2015 04/08/2021 Lab: Flow Cytometry
L34218 10/01/2015 10/01/2019 Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
L34220 10/01/2015 08/18/2022 Lumbar MRI
L34228 10/01/2015 01/10/2021 Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)
L34233 10/01/2015 10/01/2019 Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)
L34314 10/01/2015 02/01/2020 Immune Globulin Intravenous (IVIg)
L34315 10/01/2015 10/01/2019 Electrocardiograms
L34324 10/01/2015 10/01/2019 Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography
L34328 10/01/2015 12/01/2019 Peripheral Nerve Stimulation
L35136 10/01/2015 12/01/2019 Spinal Cord Stimulators for Chronic Pain
L35160 10/01/2015 05/04/2023 MolDX: Molecular Diagnostic Tests (MDT)
L35163 10/01/2015 10/01/2019 Plastic Surgery
L35170 10/01/2015 10/01/2019 Botulinum Toxin Types A and B Policy
L35456 10/01/2015 09/04/2022 Nerve Blockade for Treatment of Chronic Pain and Neuropathy
L35526 10/01/2015 10/01/2019 B-type Natriuretic Peptide (BNP) Testing
L35702 10/01/2015 12/01/2019 Mohs Micrographic Surgery
L36155 06/16/2016 07/20/2023 MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)
L36180 04/19/2016 07/06/2023 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
L36188 04/15/2016 10/14/2021 MolDX: MGMT Promoter Methylation Analysis
L36335 07/05/2016 07/27/2023 MolDX: NRAS Genetic Testing
L36351 10/15/2015 12/24/2020 Lab: Special Histochemical Stains and Immunohistochemical Stains
L36358 06/01/2016 03/21/2024 MolDX: Biomarkers in Cardiovascular Risk Assessment
L36380 05/03/2016 04/22/2021 MolDX: Breast Cancer Assay: Prosigna®
L36524 06/01/2016 12/01/2019 Nerve Conduction Studies and Electromyography
L36538 07/12/2016 11/01/2019 Treatment of Males with Low Testosterone
L36551 09/15/2016 07/08/2021 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy
L36575 09/07/2016 12/01/2019 Total Knee Arthroplasty
L36668 06/28/2016 10/08/2023 Urine Drug Testing
L36678 05/16/2017 03/04/2021 Lab: Bladder/Urothelial Tumor Markers
L36692 02/03/2017 12/01/2019 Vitamin D Assay Testing
L36702 03/13/2017 10/01/2019 Serum Magnesium
L36704 06/01/2017 12/30/2021 ProMark® Risk Score
L36846 07/21/2017 11/01/2019 Measurement of Salivary Hormones
L36861 06/05/2017 12/01/2019 Polysomnography and Other Sleep Studies
L36864 08/01/2017 03/04/2021 GlycoMark® Testing for Glycemic Control
L36886 05/15/2017 12/01/2019 MolDX: Percepta© Bronchial Genomic Classifier
L36941 03/27/2017 11/25/2021 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)
L37054 09/29/2017 04/28/2022 BDX-XL2
L37066 10/02/2017 02/25/2021 Lab: Coenzyme Q10 (CoQ10)
L37070 09/22/2017 06/30/2022 MolDX: DecisionDx-UM (Uveal Melanoma)
L37086 05/14/2018 08/20/2023 Transcranial Magnetic Stimulation (TMS)
L37295 01/30/2018 07/11/2021 MolDX: EndoPredict® Breast Cancer Gene Expression Test
L37299 01/30/2018 02/29/2024 MolDX: Prometheus® IBD sgi Diagnostic® Policy
L37373 10/08/2018 10/01/2019 MRI and CT Scans of the Head and Neck
L37502 02/18/2019 10/01/2019 Frequency of Hemodialysis
L37547 06/22/2018 11/01/2019 Chest X-Ray Policy
L37616 02/11/2019 06/09/2022 Lab: Cystatin C Measurement
L37620 06/03/2019 06/30/2022 MDS FISH
L37628 10/01/2018 02/25/2021 In Vitro Chemosensitivity & Chemoresistance Assays
L37729 04/01/2019 07/30/2023 Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor and Tremor Dominant Parkinson's Disease
L37750 02/10/2019 06/20/2024 MolDX: Melanoma Risk Stratification Molecular Testing
L37822 04/16/2019 10/28/2021 MolDX: Breast Cancer Index® (BCI) Gene Expression Test
L37887 05/27/2019 06/29/2023 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test
L37897 06/03/2019 10/14/2021 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer
L38119 05/17/2020 06/08/2023 MolDX: Next-Generation Sequencing for Solid Tumors
L38123 05/17/2020 03/28/2024 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies
L38151 06/07/2020 06/20/2024 MolDX: Pigmented Lesion Assay
L38299 03/23/2020 10/03/2021 Micro-Invasive Glaucoma Surgery (MIGS)
L38310 03/15/2020 03/15/2020 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
L38327 08/24/2020 07/20/2023 MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer
L38331 12/06/2020 05/23/2024 MolDX: Blood Product Molecular Antigen Typing
L38335 08/17/2020 08/24/2023 MolDX: Pharmacogenomics Testing
L38339 12/06/2020 02/03/2022 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease
L38351 08/03/2020 04/25/2024 MolDX: Repeat Germline Testing
L38613 04/26/2021 09/18/2022 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease
L38629 07/04/2021 MolDX: Molecular Testing for Solid Organ Allograft Rejection
L38643 07/04/2021 06/02/2022 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells
L38647 07/25/2021 08/06/2023 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer
L38657 11/02/2020 02/25/2024 Implantable Continuous Glucose Monitors (I-CGM)
L38705 12/27/2020 01/28/2024 Transurethral Waterjet Ablation of the Prostate
L38709 12/13/2020 Computed Tomography Cerebral Perfusion Analysis (CTP)
L38801 04/25/2021 07/07/2024 Facet Joint Interventions for Pain Management
L38814 01/02/2022 MolDX: Minimal Residual Disease Testing for Cancer
L38824 03/28/2021 12/19/2021 Colon Capsule Endoscopy (CCE)
L38902 11/28/2021 11/28/2021 Wound and Ulcer Care
L38972 08/08/2022 04/18/2024 MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer
L39001 04/17/2022 06/02/2022 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
L39005 08/08/2022 07/27/2023 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
L39058 01/23/2022 01/23/2022 Platelet Rich Plasma Injections for Non-Wound Injections
L39116 11/12/2023 Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound
L39230 12/26/2022 MolDX: Plasma-Based Genomic Profiling in Solid Tumors
L39240 06/19/2022 06/19/2022 Epidural Steroid Injections for Pain Management
L39262 05/28/2023 MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia
L39373 08/06/2023 MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma
L39396 03/05/2023 Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin
L39462 03/19/2023 Sacroiliac Joint Injections and Procedures
L39467 10/15/2023 MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis
L39589 08/18/2024 MolDX: Molecular Biomarker Testing for Risk Stratification of Cutaneous Squamous Cell Carcinoma
L39642 01/28/2024 Intraosseous Basivertebral Nerve Ablation
L39758 07/07/2024 Cervical Fusion

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