| LCD | Title |
Effective Date |
| L38965 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Inherited Cancer Syndromes-Palmetto GBA |
|
| L38971 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Inherited Cancer Syndromes-Noridian Healthcare Solutions, LLC |
|
| L38973 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Inherited Cancer Syndromes-Noridian Healthcare Solutions, LLC |
|
| L38984 |
MolDX: Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Palmetto GBA |
|
| L38986 |
MolDX: Melanoma Risk Stratification Molecular Testing-Palmetto GBA |
|
| L38995 |
MolDX: Melanoma Risk Stratification Molecular Testing-CGS Administrators, LLC |
|
| L38996 |
MolDX: Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-CGS Administrators, LLC |
|
| L39000 |
MolDX: Multiplex Nucleic Acid Amplification Test (NAAT) Panels for Infectious Disease Testing-Noridian Healthcare Solutions, LLC |
|
| L39002 |
MolDX: Multiplex Nucleic Acid Amplification Test (NAAT) Panels for Infectious Disease Testing-Noridian Healthcare Solutions, LLC |
|
| L39004 |
MolDX: Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Noridian Healthcare Solutions, LLC |
|
| L39006 |
MolDX: Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Noridian Healthcare Solutions, LLC |
|
| L39010 |
MolDX: Melanoma Risk Stratification Molecular Testing-Noridian Healthcare Solutions, LLC |
|
| L39011 |
MolDX: Melanoma Risk Stratification Molecular Testing-Noridian Healthcare Solutions, LLC |
|
| L39016 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Inherited Cancer Syndromes-CGS Administrators, LLC |
|
| L39024 |
Minimally Invasive Surgical (MIS) Fusion of the Sacroiliac Joint (SIJ)-Palmetto GBA |
|
| L39039 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Inherited Cancer Syndromes-Wisconsin Physicians Service Insurance Corporation |
|
| L39041 |
MolDX: Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Wisconsin Physicians Service Insurance Corporation |
|
| L39043 |
MolDX: Multiplex Nucleic Acid Amplification Test (NAAT) Panels for Infectious Disease Testing-Wisconsin Physicians Service Insurance Corporation |
|
| L39045 |
MolDX: Melanoma Risk Stratification Molecular Testing-Wisconsin Physicians Service Insurance Corporation |
|
| L39122 |
Colon Capsule Endoscopy (CCE)-National Government Services, Inc. |
|
| L39127 |
Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound-Palmetto GBA |
|
| L39169 |
Pneumatic Compression Devices-Noridian Healthcare Solutions, LLC |
|
| L39170 |
Nebulizers-Noridian Healthcare Solutions, LLC |
|
| L39188 |
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)-National Government Services, Inc. |
|
| L39225 |
Multiplex Gastrointestinal Pathogen Panel (GPP) Tests for Acute Gastroenteritis (AGE)-National Government Services, Inc. |
|
| L39228 |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-CGS Administrators, LLC |
|
| L39229 |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Noridian Healthcare Solutions, LLC |
|
| L39231 |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Noridian Healthcare Solutions, LLC |
|
| L39234 |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-Noridian Healthcare Solutions, LLC |
|
| L39235 |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-Noridian Healthcare Solutions, LLC |
|
| L39236 |
Erythropoiesis Stimulating Agents-Palmetto GBA |
|
| L39238 |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-Palmetto GBA |
|
| L39239 |
Epidural Steroid Injections for Pain Management-Noridian Healthcare Solutions, LLC |
|
| L39241 |
Epidural Steroid Injections for Pain Management-Noridian Healthcare Solutions, LLC |
|
| L39243 |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-Wisconsin Physicians Service Insurance Corporation |
|
| L39246 |
Category III Codes-Wisconsin Physicians Service Insurance Corporation |
|
| L39248 |
Upper Gastrointestinal Endoscopy and Visualization-Palmetto GBA |
|
| L39251 |
CT of the Abdomen and Pelvis-Palmetto GBA |
|
| L39254 |
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-Palmetto GBA |
|
| L39255 |
MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia-Palmetto GBA |
|
| L39257 |
Surgical Treatment of Nails-Palmetto GBA |
|
| L39259 |
Hyaluronic Acid Injections for Knee Osteoarthritis-Palmetto GBA |
|
| L39261 |
MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia-Noridian Healthcare Solutions, LLC |
|
| L39263 |
MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia-Noridian Healthcare Solutions, LLC |
|
| L39265 |
Cognitive Assessment and Care Plan Service-Palmetto GBA |
|
| L39267 |
Bone Mass Measurement-Palmetto GBA |
|
| L39269 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Palmetto GBA |
|
| L39271 |
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)-Novitas Solutions, Inc. |
|
| L39274 |
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)-First Coast Service Options, Inc. |
|
| L39275 |
MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia-CGS Administrators, LLC |
|
| L39279 |
Nerve Blockade for Treatment of Chronic Pain and Neuropathy-Noridian Healthcare Solutions, LLC |
|
| L39280 |
Nerve Blockade for Treatment of Chronic Pain and Neuropathy-Noridian Healthcare Solutions, LLC |
|
| L39281 |
Transcranial Magnetic Stimulation (TMS)-CGS Administrators, LLC |
|
| L39282 |
Biomarker Testing for Prostate Cancer Diagnosis-National Government Services, Inc. |
|
| L39283 |
Prostate Cancer Detection with IsoPSA™-CGS Administrators, LLC |
|
| L39287 |
Lumbar Epidural Injections-Noridian Healthcare Solutions, LLC |
|
| L39288 |
Lumbar Epidural Injections-Noridian Healthcare Solutions, LLC |
|
| L39296 |
Off-label Use of Rituximab and Rituximab Biosimilars-National Government Services, Inc. |
|
| L39307 |
MolDX: 4Kscore® Assay-Noridian Healthcare Solutions, LLC |
|
| L39308 |
MolDX: 4Kscore® Assay-Noridian Healthcare Solutions, LLC |
|
| L39313 |
Off-Label Use of Intravenous Immune Globulin (IVIG)-National Government Services, Inc. |
|
| L39315 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Palmetto GBA |
|
| L39344 |
MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma-Palmetto GBA |
|
| L39346 |
Drugs and Biologicals, Coverage of, for Label and Off-Label Uses-National Government Services, Inc. |
|
| L39347 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-CGS Administrators, LLC |
|
| L39348 |
Special Histochemical Stains & Immunohistochemical Stains-First Coast Service Options, Inc. |
|
| L39355 |
MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia-Wisconsin Physicians Service Insurance Corporation |
|
| L39357 |
Transcranial Magnetic Stimulation (TMS)-Wisconsin Physicians Service Insurance Corporation |
|
| L39361 |
MolDX: CORUS® CAD ASSAY-Wisconsin Physicians Service Insurance Corporation |
|
| L39362 |
4Kscore® Assay-Wisconsin Physicians Service Insurance Corporation |
|
| L39364 |
Genetic Testing for Oncology-Novitas Solutions, Inc. |
|
| L39366 |
Genetic Testing for Oncology-First Coast Service Options, Inc. |
|
| L39368 |
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder-Novitas Solutions, Inc. |
|
| L39369 |
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder-First Coast Service Options, Inc. |
|
| L39370 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Noridian Healthcare Solutions, LLC |
|
| L39371 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Noridian Healthcare Solutions, LLC |
|
| L39372 |
MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma-Noridian Healthcare Solutions, LLC |
|
| L39374 |
MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma-Noridian Healthcare Solutions, LLC |
|
| L39380 |
Transcranial Magnetic Stimulation-National Government Services, Inc. |
|
| L39382 |
Sacroiliac Joint Injections and Procedures-CGS Administrators, LLC |
|
| L39384 |
Near-Infrared Spectroscopy in Wound and Flap Management-Palmetto GBA |
|
| L39386 |
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs-Palmetto GBA |
|
| L39388 |
MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma-CGS Administrators, LLC |
|
| L39390 |
Vitamin D Assay Testing-Palmetto GBA |
|
| L39394 |
Transurethral Waterjet Ablation of the Prostate-Palmetto GBA |
|
| L39395 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Noridian Healthcare Solutions, LLC |
|
| L39397 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Noridian Healthcare Solutions, LLC |
|
| L39399 |
Magnesium-Palmetto GBA |
|
| L39401 |
Sacroiliac Joint Injections and Procedures-Palmetto GBA |
|
| L39403 |
Nerve Stimulators for Chronic Intractable Pain-Novitas Solutions, Inc. |
|
| L39405 |
Nerve Stimulators for Chronic Intractable Pain-First Coast Service Options, Inc. |
|
| L39419 |
Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain-Palmetto GBA |
|
| L39423 |
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis-Palmetto GBA |
|
| L39425 |
White Cell Colony Stimulating Factors-Palmetto GBA |
|
| L39426 |
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis-CGS Administrators, LLC |
|
| L39430 |
Transtelephonic Spirometry-CGS Administrators, LLC |
|
| L39431 |
Immune Globulin-Novitas Solutions, Inc. |
|
| L39432 |
Immune Globulin-First Coast Service Options, Inc. |
|
| L39433 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-CGS Administrators, LLC |
|
| L39448 |
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-Novitas Solutions, Inc. |
|
| L39451 |
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-First Coast Service Options, Inc. |
|
| L39452 |
Urine Drug Testing-CGS Administrators, LLC |
|
| L39453 |
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL)-CGS Administrators, LLC |
|
| L39454 |
Sacroiliac Joint Injections and Procedures-National Government Services, Inc. |
|
| L39457 |
Pain Management-National Government Services, Inc. |
|
| L39460 |
Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-National Government Services, Inc. |
|
| L39461 |
Sacroiliac Joint Injections and Procedures-Noridian Healthcare Solutions, LLC |
|
| L39463 |
Sacroiliac Joint Injections and Procedures-Noridian Healthcare Solutions, LLC |
|
| L39465 |
Water Vapor Thermal Therapy for LUTS/BPH-National Government Services, Inc. |
|
| L39466 |
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis-Noridian Healthcare Solutions, LLC |
|
| L39468 |
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis-Noridian Healthcare Solutions, LLC |
|
| L39473 |
Glucose Monitors-Noridian Healthcare Solutions, LLC |
|
| L39474 |
Sacroiliac Joint Injections and Procedures-Wisconsin Physicians Service Insurance Corporation |
|
| L39476 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Wisconsin Physicians Service Insurance Corporation |
|
| L39478 |
MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma-Wisconsin Physicians Service Insurance Corporation |
|
| L39480 |
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis-Wisconsin Physicians Service Insurance Corporation |
|
| L39482 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Wisconsin Physicians Service Insurance Corporation |
|
| L39483 |
Urine Drug Testing-Wisconsin Physicians Service Insurance Corporation |
|
| L39484 |
Urine Drug Testing-Palmetto GBA |
|
| L39485 |
Controlled Substance Monitoring and Drugs of Abuse Testing-Novitas Solutions, Inc. |
|
| L39486 |
Controlled Substance Monitoring and Drugs of Abuse Testing-First Coast Service Options, Inc. |
|
| L39489 |
Ambulatory Electrocardiograph (AECG) Monitoring-Novitas Solutions, Inc. |
|
| L39491 |
Ambulatory Electrocardiograph (AECG) Monitoring-First Coast Service Options, Inc. |
|
| L39504 |
Special Histochemical Stains and Immunohistochemical Stains-CGS Administrators, LLC |
|
| L39505 |
Cosmetic and Reconstructive Surgery-CGS Administrators, LLC |
|
| L39510 |
Transthoracic Echocardiography (TTE)-CGS Administrators, LLC |
|
| L32553 |
Allergy Immunotherapy-CGS Administrators, LLC |
10/01/2015 |
| L33252 |
Psychiatric Diagnostic Evaluation and Psychotherapy Services-First Coast Service Options, Inc. |
10/01/2015 |
| L33256 |
3D Interpretation and Reporting of Imaging Studies-First Coast Service Options, Inc. |
10/01/2015 |
| L33261 |
Allergy Testing-First Coast Service Options, Inc. |
10/01/2015 |
| L33267 |
B-Type Natriuretic Peptide (BNP)-First Coast Service Options, Inc. |
10/01/2015 |
| L33270 |
Bisphosphonates (Intravenous [IV]) and Monoclonal Antibodies in the Treatment of Osteoporosis and Their Other Indications-First Coast Service Options, Inc. |
10/01/2015 |
| L33271 |
Biventricular Pacing/Cardiac Resynchronization Therapy-First Coast Service Options, Inc. |
10/01/2015 |
| L33274 |
Botulinum Toxins-First Coast Service Options, Inc. |
10/01/2015 |
| L33282 |
Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries-First Coast Service Options, Inc. |
10/01/2015 |
| L33312 |
Wheelchair Seating-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33317 |
External Breast Prostheses-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33318 |
Knee Orthoses-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33369 |
Therapeutic Shoes for Persons with Diabetes-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33370 |
Nebulizers-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33380 |
Long-Term Wearable Electrocardiographic Monitoring (WEM)-First Coast Service Options, Inc. |
10/01/2015 |
| L33382 |
Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions-First Coast Service Options, Inc. |
10/01/2015 |
| L33393 |
Hospice - Determining Terminal Status-National Government Services, Inc. |
10/01/2015 |
| L33394 |
Drugs and Biologicals, Coverage of, for Label and Off-Label Uses-National Government Services, Inc. |
10/01/2015 |
| L33396 |
Posterior Tibial Nerve Stimulation for Voiding Dysfunction-National Government Services, Inc. |
10/01/2015 |
| L33398 |
Transcranial Magnetic Stimulation-National Government Services, Inc. |
10/01/2015 |
| L33399 |
EEG – Ambulatory Monitoring-National Government Services, Inc. |
10/01/2015 |
| L33405 |
Polysomnography and Sleep Testing-First Coast Service Options, Inc. |
10/01/2015 |
| L33406 |
Posterior Tibial Nerve Stimulation (PTNS)-First Coast Service Options, Inc. |
10/01/2015 |
| L33410 |
Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)-First Coast Service Options, Inc. |
10/01/2015 |
| L33411 |
Surgical Management of Morbid Obesity-First Coast Service Options, Inc. |
10/01/2015 |
| L33413 |
Therapy and Rehabilitation Services-First Coast Service Options, Inc. |
10/01/2015 |
| L33417 |
Allergy Skin Testing-Palmetto GBA |
10/01/2015 |
| L33418 |
Assays for Vitamins and Metabolic Function-Palmetto GBA |
10/01/2015 |
| L33420 |
Lab: Bladder/Urothelial Tumor Markers-Palmetto GBA |
10/01/2015 |
| L33422 |
Brain Natriuretic Peptide (BNP) Level-Palmetto GBA |
10/01/2015 |
| L33423 |
Cardiac Computed Tomography & Angiography (CCTA)-Palmetto GBA |
10/01/2015 |
| L33428 |
Cosmetic and Reconstructive Surgery-Palmetto GBA |
10/01/2015 |
| L33431 |
HbA1c-Palmetto GBA |
10/01/2015 |
| L33436 |
Mohs Micrographic Surgery (MMS)-Palmetto GBA |
10/01/2015 |
| L33438 |
Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)-Palmetto GBA |
10/01/2015 |
| L33443 |
Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control-Palmetto GBA |
10/01/2015 |
| L33444 |
Pulmonary Stress Testing-Palmetto GBA |
10/01/2015 |
| L33445 |
Removal of Benign and Malignant Skin Lesions-Palmetto GBA |
10/01/2015 |
| L33446 |
Respiratory Therapy and Oximetry Services-Palmetto GBA |
10/01/2015 |
| L33447 |
Special Electroencephalography-Palmetto GBA |
10/01/2015 |
| L33449 |
Swallowing Studies for Dysphagia-Palmetto GBA |
10/01/2015 |
| L33452 |
Virtual Colonoscopy (CT Colonography)-Palmetto GBA |
10/01/2015 |
| L33455 |
Wireless Gastrointestinal Motility Monitoring Systems-Palmetto GBA |
10/01/2015 |
| L33456 |
Total Joint Arthroplasty-Palmetto GBA |
10/01/2015 |
| L33457 |
Cardiac Radionuclide Imaging-Palmetto GBA |
10/01/2015 |
| L33458 |
Chemodenervation-Palmetto GBA |
10/01/2015 |
| L33459 |
Computerized Axial Tomography (CT), Thorax-Palmetto GBA |
10/01/2015 |
| L33461 |
Implantable Infusion Pump-Palmetto GBA |
10/01/2015 |
| L33467 |
Ophthalmology: Extended Ophthalmoscopy and Fundus Photography-Palmetto GBA |
10/01/2015 |
| L33557 |
Cardiac Catheterization and Coronary Angiography-National Government Services, Inc. |
10/01/2015 |
| L33558 |
Cataract Extraction-National Government Services, Inc. |
10/01/2015 |
| L33559 |
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)-National Government Services, Inc. |
10/01/2015 |
| L33560 |
Cardiovascular Nuclear Medicine-National Government Services, Inc. |
10/01/2015 |
| L33562 |
Computed Tomographic (CT) Colonography for Diagnostic Uses-National Government Services, Inc. |
10/01/2015 |
| L33563 |
Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures-National Government Services, Inc. |
10/01/2015 |
| L33567 |
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)-National Government Services, Inc. |
10/01/2015 |
| L33569 |
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)-National Government Services, Inc. |
10/01/2015 |
| L33573 |
B-type Natriuretic Peptide (BNP) Testing-National Government Services, Inc. |
10/01/2015 |
| L33574 |
Visual Fields Testing-National Government Services, Inc. |
10/01/2015 |
| L33575 |
Varicose Veins of the Lower Extremity, Treatment of-National Government Services, Inc. |
10/01/2015 |
| L33576 |
Urodynamics-National Government Services, Inc. |
10/01/2015 |
| L33577 |
Transthoracic Echocardiography (TTE)-National Government Services, Inc. |
10/01/2015 |
| L33578 |
Transrectal Ultrasound-National Government Services, Inc. |
10/01/2015 |
| L33579 |
Transesophageal Echocardiography (TEE)-National Government Services, Inc. |
10/01/2015 |
| L33580 |
Speech-Language Pathology-National Government Services, Inc. |
10/01/2015 |
| L33583 |
Diagnostic and Therapeutic Esophagogastroduodenoscopy-First Coast Service Options, Inc. |
10/01/2015 |
| L33584 |
Implantable Miniature Telescope (IMT)-National Government Services, Inc. |
10/01/2015 |
| L33585 |
Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography-National Government Services, Inc. |
10/01/2015 |
| L33591 |
RAST Type Tests-National Government Services, Inc. |
10/01/2015 |
| L33609 |
Autonomic Function Tests-First Coast Service Options, Inc. |
10/01/2015 |
| L33610 |
Intravenous Immune Globulin-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33611 |
Oral Appliances for Obstructive Sleep Apnea-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33612 |
Suction Pumps-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33614 |
Debridement Services-National Government Services, Inc. |
10/01/2015 |
| L33615 |
Biofeedback-First Coast Service Options, Inc. |
10/01/2015 |
| L33616 |
Osteopathic Manipulative Treatment-National Government Services, Inc. |
10/01/2015 |
| L33618 |
Major Joint Replacement (Hip and Knee)-First Coast Service Options, Inc. |
10/01/2015 |
| L33619 |
Nonvascular Extremity Ultrasound-National Government Services, Inc. |
10/01/2015 |
| L33621 |
Ophthalmic Biometry for Intraocular Lens Power Calculation-National Government Services, Inc. |
10/01/2015 |
| L33622 |
Pain Management-National Government Services, Inc. |
10/01/2015 |
| L33623 |
Percutaneous Coronary Intervention-National Government Services, Inc. |
10/01/2015 |
| L33624 |
Psychiatric Inpatient Hospitalization-National Government Services, Inc. |
10/01/2015 |
| L33626 |
Psychiatric Partial Hospitalization Programs-National Government Services, Inc. |
10/01/2015 |
| L33627 |
Non-Invasive Vascular Studies-National Government Services, Inc. |
10/01/2015 |
| L33628 |
Panretinal (Scatter) Laser Photocoagulation-National Government Services, Inc. |
10/01/2015 |
| L33630 |
Corneal Pachymetry-National Government Services, Inc. |
10/01/2015 |
| L33631 |
Outpatient Physical and Occupational Therapy Services-National Government Services, Inc. |
10/01/2015 |
| L33632 |
Psychiatry and Psychology Services-National Government Services, Inc. |
10/01/2015 |
| L33633 |
Magnetic Resonance Angiography (MRA)-National Government Services, Inc. |
10/01/2015 |
| L33636 |
Routine Foot Care and Debridement of Nails-National Government Services, Inc. |
10/01/2015 |
| L33641 |
Orthopedic Footwear-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33642 |
Pressure Reducing Support Surfaces - Group 2-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33646 |
Botulinum Toxins-National Government Services, Inc. |
10/01/2015 |
| L33661 |
Flow Cytometry-First Coast Service Options, Inc. |
10/01/2015 |
| L33667 |
Duplex Scan Of Lower Extremity Arteries-First Coast Service Options, Inc. |
10/01/2015 |
| L33669 |
Electrocardiography-First Coast Service Options, Inc. |
10/01/2015 |
| L33671 |
Diagnostic Colonoscopy-First Coast Service Options, Inc. |
10/01/2015 |
| L33674 |
Duplex Scanning-First Coast Service Options, Inc. |
10/01/2015 |
| L33684 |
Hemophilia Clotting Factors-First Coast Service Options, Inc. |
10/01/2015 |
| L33685 |
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs-First Coast Service Options, Inc. |
10/01/2015 |
| L33686 |
Ankle-Foot/Knee-Ankle-Foot Orthosis-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33689 |
Mohs Micrographic Surgery (MMS)-First Coast Service Options, Inc. |
10/01/2015 |
| L33690 |
Automatic External Defibrillators-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33692 |
Pressure Reducing Support Surfaces - Group 3-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33693 |
Non-Invasive Evaluation of Extremity Veins-First Coast Service Options, Inc. |
10/01/2015 |
| L33695 |
Non-invasive Extracranial Arterial Studies-First Coast Service Options, Inc. |
10/01/2015 |
| L33696 |
Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries-First Coast Service Options, Inc. |
10/01/2015 |
| L33707 |
Pulmonary Diagnostic Services-First Coast Service Options, Inc. |
10/01/2015 |
| L33718 |
Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33733 |
Canes and Crutches-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33735 |
Cold Therapy-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33736 |
Commodes-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33737 |
Eye Prostheses-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33738 |
Facial Prostheses-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33739 |
Speech Generating Devices (SGD)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33747 |
Pegfilgrastim-First Coast Service Options, Inc. |
10/01/2015 |
| L33751 |
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-First Coast Service Options, Inc. |
10/01/2015 |
| L33755 |
Susceptibility Studies-First Coast Service Options, Inc. |
10/01/2015 |
| L33756 |
Transesophageal Echocardiogram-First Coast Service Options, Inc. |
10/01/2015 |
| L33763 |
Vascular Stenting of Lower Extremity Arteries-First Coast Service Options, Inc. |
10/01/2015 |
| L33766 |
Visual Field Examination-First Coast Service Options, Inc. |
10/01/2015 |
| L33767 |
Viscosupplementation Therapy For Knee-First Coast Service Options, Inc. |
10/01/2015 |
| L33768 |
Transthoracic Echocardiography (TTE)-First Coast Service Options, Inc. |
10/01/2015 |
| L33771 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed-First Coast Service Options, Inc. |
10/01/2015 |
| L33774 |
Wireless Capsule Endoscopy-First Coast Service Options, Inc. |
10/01/2015 |
| L33784 |
Heating Pads and Heat Lamps-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33785 |
High Frequency Chest Wall Oscillation Devices-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33786 |
Intrapulmonary Percussive Ventilation System-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33787 |
Lower Limb Prostheses-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33788 |
Manual Wheelchair Bases-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33789 |
Power Mobility Devices-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33790 |
Spinal Orthoses: TLSO and LSO-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33791 |
Walkers-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33792 |
Wheelchair Options/Accessories-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33793 |
Refractive Lenses-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33794 |
External Infusion Pumps-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33795 |
Mechanical In-exsufflation Devices-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33796 |
Osteogenesis Stimulators-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33797 |
Oxygen and Oxygen Equipment-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33799 |
Patient Lifts-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33800 |
Respiratory Assist Devices-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33801 |
Seat Lift Mechanisms-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33802 |
Transcutaneous Electrical Nerve Stimulators (TENS)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33803 |
Urological Supplies-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33810 |
Computerized Corneal Topography-First Coast Service Options, Inc. |
10/01/2015 |
| L33813 |
Destruction of Malignant Skin Lesions-First Coast Service Options, Inc. |
10/01/2015 |
| L33818 |
Excision of Malignant Skin Lesions-First Coast Service Options, Inc. |
10/01/2015 |
| L33820 |
Hospital Beds And Accessories-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33821 |
Negative Pressure Wound Therapy Pumps-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33822 |
Glucose Monitors-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33823 |
Cervical Traction Devices-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33824 |
Immunosuppressive Drugs-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33825 |
Infrared Heating Pad Systems-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33826 |
Oral Anticancer Drugs-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33827 |
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33828 |
Ostomy Supplies-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33829 |
Pneumatic Compression Devices-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33830 |
Pressure Reducing Support Surfaces - Group 1-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33831 |
Surgical Dressings-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33832 |
Tracheostomy Care Supplies-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33833 |
Surgical Treatment of Nails-First Coast Service Options, Inc. |
10/01/2015 |
| L33834 |
Health and Behavior Assessment/Intervention-First Coast Service Options, Inc. |
10/01/2015 |
| L33906 |
Epidural Steroid Injections for Pain Management-First Coast Service Options, Inc. |
10/01/2015 |
| L33907 |
Hepatic (Liver) Function Panel-First Coast Service Options, Inc. |
10/01/2015 |
| L33908 |
High Sensitivity C-Reactive Protein (hsCRP)-First Coast Service Options, Inc. |
10/01/2015 |
| L33909 |
Incision and Drainage of Abscess of Skin, Subcutaneous and Accessory Structures-First Coast Service Options, Inc. |
10/01/2015 |
| L33910 |
Independent Diagnostic Testing Facility (IDTF)-First Coast Service Options, Inc. |
10/01/2015 |
| L33912 |
Injection of Trigger Points-First Coast Service Options, Inc. |
10/01/2015 |
| L33915 |
Label and Off-label Coverage of Outpatient Drugs and Biologicals-First Coast Service Options, Inc. |
10/01/2015 |
| L33922 |
Nail Debridement-First Coast Service Options, Inc. |
10/01/2015 |
| L33923 |
Noninvasive Ear or Pulse Oximetry For Oxygen Saturation-First Coast Service Options, Inc. |
10/01/2015 |
| L33924 |
Omalizumab-First Coast Service Options, Inc. |
10/01/2015 |
| L33929 |
Osteopathic Manipulative Treatment-First Coast Service Options, Inc. |
10/01/2015 |
| L33930 |
Facet Joint Interventions for Pain Management-First Coast Service Options, Inc. |
10/01/2015 |
| L33933 |
Peripheral Nerve Blocks-First Coast Service Options, Inc. |
10/01/2015 |
| L33937 |
Proton Beam Radiotherapy-First Coast Service Options, Inc. |
10/01/2015 |
| L33941 |
Routine Foot Care-First Coast Service Options, Inc. |
10/01/2015 |
| L33942 |
Physical Therapy - Home Health-CGS Administrators, LLC |
10/01/2015 |
| L33943 |
B-type Natriuretic Peptide (BNP) Testing-CGS Administrators, LLC |
10/01/2015 |
| L33944 |
Blepharoplasty-CGS Administrators, LLC |
10/01/2015 |
| L33945 |
Cerumen (Earwax) Removal-CGS Administrators, LLC |
10/01/2015 |
| L33946 |
Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy-CGS Administrators, LLC |
10/01/2015 |
| L33947 |
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)-CGS Administrators, LLC |
10/01/2015 |
| L33949 |
Botulinum Toxins-CGS Administrators, LLC |
10/01/2015 |
| L33950 |
Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography-CGS Administrators, LLC |
10/01/2015 |
| L33952 |
Cardiac Event Detection-CGS Administrators, LLC |
10/01/2015 |
| L33954 |
Cataract Extraction-CGS Administrators, LLC |
10/01/2015 |
| L33958 |
Somatosensory Testing-First Coast Service Options, Inc. |
10/01/2015 |
| L33959 |
Cardiac Catheterization and Coronary Angiography-CGS Administrators, LLC |
10/01/2015 |
| L33960 |
Cardiovascular Nuclear Medicine-CGS Administrators, LLC |
10/01/2015 |
| L33961 |
Therapy Services billed by Physicians/Nonphysician Practitioners -First Coast Service Options, Inc. |
10/01/2015 |
| L33966 |
Vestibular Function Tests-First Coast Service Options, Inc. |
10/01/2015 |
| L33967 |
Vitamin B12 Injections-First Coast Service Options, Inc. |
10/01/2015 |
| L33969 |
Diagnostic Aerosol or Vapor Inhalation-First Coast Service Options, Inc. |
10/01/2015 |
| L33974 |
Troponin-First Coast Service Options, Inc. |
10/01/2015 |
| L33975 |
Psychiatric Inpatient Hospitalization-First Coast Service Options, Inc. |
10/01/2015 |
| L33977 |
Transcranial Doppler Studies-First Coast Service Options, Inc. |
10/01/2015 |
| L33979 |
Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L33996 |
Vitamin D Assay Testing-CGS Administrators, LLC |
10/01/2015 |
| L33999 |
Corneal Pachymetry-CGS Administrators, LLC |
10/01/2015 |
| L34002 |
G-CSF Filgrastim-First Coast Service Options, Inc. |
10/01/2015 |
| L34005 |
Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy-CGS Administrators, LLC |
10/01/2015 |
| L34007 |
Immune Globulin-First Coast Service Options, Inc. |
10/01/2015 |
| L34008 |
Computerized Corneal Topography-CGS Administrators, LLC |
10/01/2015 |
| L34010 |
Treatment of Varicose Veins of the Lower Extremities-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34011 |
Ionized Calcium-First Coast Service Options, Inc. |
10/01/2015 |
| L34014 |
Magnesium-First Coast Service Options, Inc. |
10/01/2015 |
| L34018 |
Parathormone (Parathyroid Hormone)-First Coast Service Options, Inc. |
10/01/2015 |
| L34021 |
Sedimentation Rate, Erythrocyte-First Coast Service Options, Inc. |
10/01/2015 |
| L34022 |
Serum Phosphorus-First Coast Service Options, Inc. |
10/01/2015 |
| L34026 |
Trastuzumab – Trastuzumab Biologics-First Coast Service Options, Inc. |
10/01/2015 |
| L34027 |
Ultrasound, Soft Tissues of Head and Neck-First Coast Service Options, Inc. |
10/01/2015 |
| L34028 |
Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow-First Coast Service Options, Inc. |
10/01/2015 |
| L34032 |
Debridement Services-CGS Administrators, LLC |
10/01/2015 |
| L34037 |
Flow Cytometry-CGS Administrators, LLC |
10/01/2015 |
| L34038 |
B-type Natriuretic Peptide (BNP) Testing-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34040 |
Polysomnography and Other Sleep Studies-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34045 |
Non-Invasive Vascular Studies-CGS Administrators, LLC |
10/01/2015 |
| L34046 |
Speech-Language Pathology-CGS Administrators, LLC |
10/01/2015 |
| L34049 |
Outpatient Physical and Occupational Therapy Services-CGS Administrators, LLC |
10/01/2015 |
| L34051 |
Vitamin D Assay Testing-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34055 |
Virtual Colonoscopy (CT Colonography)-CGS Administrators, LLC |
10/01/2015 |
| L34056 |
Urodynamics-CGS Administrators, LLC |
10/01/2015 |
| L34061 |
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-CGS Administrators, LLC |
10/01/2015 |
| L34062 |
Dialysis Access Maintenance-CGS Administrators, LLC |
10/01/2015 |
| L34063 |
RAST Type Tests-CGS Administrators, LLC |
10/01/2015 |
| L34064 |
Panretinal (Scatter) Laser Photocoagulation-CGS Administrators, LLC |
10/01/2015 |
| L34074 |
Immune Globulin Intravenous (IVIg)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34076 |
Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34081 |
Endoscopy by Capsule-CGS Administrators, LLC |
10/01/2015 |
| L34082 |
Varicose Veins of the Lower Extremity, Treatment of-CGS Administrators, LLC |
10/01/2015 |
| L34084 |
Transcatheter Infusion Therapy-CGS Administrators, LLC |
10/01/2015 |
| L34085 |
Post-Void Residual Urine and/or Bladder Capacity by Ultrasound-CGS Administrators, LLC |
10/01/2015 |
| L34087 |
Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based-CGS Administrators, LLC |
10/01/2015 |
| L34090 |
Laser Ablation of the Prostate-CGS Administrators, LLC |
10/01/2015 |
| L34106 |
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34149 |
Respiratory Care (Respiratory Therapy)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34163 |
Total Hip Arthroplasty-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34171 |
Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation-CGS Administrators, LLC |
10/01/2015 |
| L34175 |
Ophthalmic Angiography (Fluorescein and Indocyanine Green)-CGS Administrators, LLC |
10/01/2015 |
| L34181 |
Ophthalmic Biometry for Intraocular Lens Power Calculation-CGS Administrators, LLC |
10/01/2015 |
| L34183 |
Psychiatric Inpatient Hospitalization-CGS Administrators, LLC |
10/01/2015 |
| L34194 |
Blepharoplasty, Eyelid Surgery, and Brow Lift-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34195 |
Mohs Micrographic Surgery-CGS Administrators, LLC |
10/01/2015 |
| L34196 |
Psychiatric Partial Hospitalization Programs-CGS Administrators, LLC |
10/01/2015 |
| L34200 |
Removal of Benign Skin Lesions-CGS Administrators, LLC |
10/01/2015 |
| L34203 |
Cataract Surgery in Adults-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34209 |
Treatment of Varicose Veins of the Lower Extremities-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34211 |
Trigger Point Injections-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34213 |
Diagnostic and Therapeutic Colonoscopy-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34215 |
Lab: Flow Cytometry-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34218 |
Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34220 |
Lumbar MRI-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34228 |
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34233 |
Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34246 |
Routine Foot Care and Debridement of Nails-CGS Administrators, LLC |
10/01/2015 |
| L34247 |
Pulmonary Function Testing-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34313 |
Allergy Testing-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34314 |
Immune Globulin Intravenous (IVIg)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34315 |
Electrocardiograms-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34324 |
Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34328 |
Peripheral Nerve Stimulation-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34337 |
Transesophageal Echocardiography (TEE)-CGS Administrators, LLC |
10/01/2015 |
| L34338 |
Transthoracic Echocardiography (TTE)-CGS Administrators, LLC |
10/01/2015 |
| L34353 |
Outpatient Psychiatry and Psychology Services-CGS Administrators, LLC |
10/01/2015 |
| L34356 |
Erythropoiesis Stimulating Agents (ESA)-CGS Administrators, LLC |
10/01/2015 |
| L34372 |
Magnetic Resonance Angiography (MRA)-First Coast Service Options, Inc. |
10/01/2015 |
| L34380 |
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-National Government Services, Inc. |
10/01/2015 |
| L34393 |
Ocular Photography - External-CGS Administrators, LLC |
10/01/2015 |
| L34394 |
Visual Fields Testing-CGS Administrators, LLC |
10/01/2015 |
| L34399 |
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)-CGS Administrators, LLC |
10/01/2015 |
| L34410 |
B-type Natriuretic Peptide (BNP) Testing-Palmetto GBA |
10/01/2015 |
| L34411 |
Blepharoplasty, Eyelid Surgery, and Brow Lift-Palmetto GBA |
10/01/2015 |
| L34413 |
Cataract Surgery-Palmetto GBA |
10/01/2015 |
| L34415 |
CT of the Abdomen and Pelvis-Palmetto GBA |
10/01/2015 |
| L34417 |
CT of the Head-Palmetto GBA |
10/01/2015 |
| L34419 |
Homocysteine Level, Serum-Palmetto GBA |
10/01/2015 |
| L34422 |
Infrared Coagulation (IRC) of Hemorrhoids-Palmetto GBA |
10/01/2015 |
| L34424 |
Magnetic Resonance Angiography-Palmetto GBA |
10/01/2015 |
| L34425 |
Magnetic Resonance Imaging of the Orbit, Face, and/or Neck-Palmetto GBA |
10/01/2015 |
| L34426 |
Ophthalmic Angiography (Fluorescein and Indocyanine Green)-Palmetto GBA |
10/01/2015 |
| L34427 |
Outpatient Occupational Therapy-Palmetto GBA |
10/01/2015 |
| L34428 |
Outpatient Physical Therapy-Palmetto GBA |
10/01/2015 |
| L34429 |
Outpatient Speech Language Pathology-Palmetto GBA |
10/01/2015 |
| L34430 |
Respiratory Therapy (Respiratory Care)-Palmetto GBA |
10/01/2015 |
| L34431 |
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-Palmetto GBA |
10/01/2015 |
| L34433 |
Somatosensory Testing-Palmetto GBA |
10/01/2015 |
| L34434 |
Upper Gastrointestinal Endoscopy and Visualization-Palmetto GBA |
10/01/2015 |
| L34454 |
Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy-Palmetto GBA |
10/01/2015 |
| L34512 |
Corneal Pachymetry-Palmetto GBA |
10/01/2015 |
| L34513 |
Lab: Flow Cytometry-Palmetto GBA |
10/01/2015 |
| L34518 |
Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing-First Coast Service Options, Inc. |
10/01/2015 |
| L34519 |
Molecular Pathology Procedures-First Coast Service Options, Inc. |
10/01/2015 |
| L34520 |
Psychological and Neuropsychological Tests-First Coast Service Options, Inc. |
10/01/2015 |
| L34521 |
Special EEG Tests-First Coast Service Options, Inc. |
10/01/2015 |
| L34522 |
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder-First Coast Service Options, Inc. |
10/01/2015 |
| L34526 |
Surgical Treatment of Obstructive Sleep Apnea (OSA)-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34528 |
Blepharoplasty, Blepharoptosis and Brow Lift-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34536 |
Treatment of Varicose Veins of the Lower Extremities-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34537 |
Vestibular Function Testing-Palmetto GBA |
10/01/2015 |
| L34538 |
Hospice Determining Terminal Status-CGS Administrators, LLC |
10/01/2015 |
| L34539 |
Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians-CGS Administrators, LLC |
10/01/2015 |
| L34540 |
Stretta Procedure-CGS Administrators, LLC |
10/01/2015 |
| L34541 |
Transtelephonic Spirometry-CGS Administrators, LLC |
10/01/2015 |
| L34544 |
Hospice - Liver Disease-Palmetto GBA |
10/01/2015 |
| L34547 |
Hospice - Neurological Conditions-Palmetto GBA |
10/01/2015 |
| L34548 |
Hospice Cardiopulmonary Conditions-Palmetto GBA |
10/01/2015 |
| L34549 |
Ambulance Services-Palmetto GBA |
10/01/2015 |
| L34551 |
One Day Stays for Chest Pain-Palmetto GBA |
10/01/2015 |
| L34552 |
Outpatient Observation Bed/Room Services-Palmetto GBA |
10/01/2015 |
| L34553 |
Stretta Procedure-Palmetto GBA |
10/01/2015 |
| L34554 |
In Vitro Chemosensitivity & Chemoresistance Assays-Palmetto GBA |
10/01/2015 |
| L34558 |
Hospice The Adult Failure To Thrive Syndrome-Palmetto GBA |
10/01/2015 |
| L34559 |
Hospice - Renal Care-Palmetto GBA |
10/01/2015 |
| L34560 |
Home Health Occupational Therapy-Palmetto GBA |
10/01/2015 |
| L34561 |
Home Health - Psychiatric Care-Palmetto GBA |
10/01/2015 |
| L34562 |
Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances-Palmetto GBA |
10/01/2015 |
| L34563 |
Home Health Speech-Language Pathology-Palmetto GBA |
10/01/2015 |
| L34564 |
Home Health Physical Therapy-Palmetto GBA |
10/01/2015 |
| L34565 |
Home Health-Surface Electrical Stimulation in the Treatment of Dysphagia-Palmetto GBA |
10/01/2015 |
| L34566 |
Hospice - HIV Disease-Palmetto GBA |
10/01/2015 |
| L34567 |
Hospice Alzheimer's Disease & Related Disorders-Palmetto GBA |
10/01/2015 |
| L34570 |
Psychiatric Inpatient Hospitalization-Palmetto GBA |
10/01/2015 |
| L34573 |
Cardiac Event Detection-Palmetto GBA |
10/01/2015 |
| L34574 |
Dental Services-Palmetto GBA |
10/01/2015 |
| L34575 |
Frequency of Hemodialysis-Palmetto GBA |
10/01/2015 |
| L34576 |
Laparoscopic Sleeve Gastrectomy for Severe Obesity-Palmetto GBA |
10/01/2015 |
| L34577 |
Retroperitoneal Ultrasound-Palmetto GBA |
10/01/2015 |
| L34578 |
Surface Electrical Stimulation in the Treatment of Dysphagia-Palmetto GBA |
10/01/2015 |
| L34580 |
Intravenous Immunoglobulin (IVIG)-Palmetto GBA |
10/01/2015 |
| L34588 |
Trigger Points, Local Injections-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34594 |
Nerve Conduction Studies and Electromyography-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34596 |
Immunizations-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34614 |
Colonoscopy and Sigmoidoscopy-Diagnostic-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34615 |
Visual Fields-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34616 |
Psychiatry and Psychology Services-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34623 |
Intraoperative Neurophysiological Testing-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34624 |
Somatosensory Testing-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34633 |
Erythropoiesis Stimulating Agents (ESAs)-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34635 |
Botulinum Toxin Type A & Type B-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34636 |
Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34641 |
Transcranial Magnetic Stimulation (TMS)-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34645 |
Drug Testing-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34646 |
Psychological and Neuropsychological Testing-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34648 |
Bisphosphonate Drug Therapy-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34658 |
Vitamin D Assay Testing-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34659 |
Endoscopic Treatment of GERD-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34760 |
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34761 |
Percutaneous Coronary Interventions-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34771 |
Immune Globulins-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L34821 |
Transcutaneous Electrical Joint Stimulation Devices (TEJSD)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34822 |
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs-Novitas Solutions, Inc. |
10/01/2015 |
| L34823 |
Tumor Treatment Field Therapy (TTFT)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34824 |
Vacuum Erection Devices (VED)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34833 |
Cardiac Rhythm Device Evaluation-Novitas Solutions, Inc. |
10/01/2015 |
| L34834 |
Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)-Novitas Solutions, Inc. |
10/01/2015 |
| L34856 |
C-Reactive Protein High Sensitivity Testing (hsCRP)-Novitas Solutions, Inc. |
10/01/2015 |
| L34859 |
Nerve Conduction Studies and Electromyography-First Coast Service Options, Inc. |
10/01/2015 |
| L34864 |
Loss-of-Heterozygosity Based Topographic Genotyping with PathfinderTG ®-Novitas Solutions, Inc. |
10/01/2015 |
| L34865 |
Magnetic Resonance Angiography (MRA)-Novitas Solutions, Inc. |
10/01/2015 |
| L34869 |
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults-Palmetto GBA |
10/01/2015 |
| L34887 |
Surgical Treatment of Nails-Novitas Solutions, Inc. |
10/01/2015 |
| L34892 |
Facet Joint Interventions for Pain Management-Novitas Solutions, Inc. |
10/01/2015 |
| L34912 |
Genetic Testing for Lynch Syndrome-First Coast Service Options, Inc. |
10/01/2015 |
| L34914 |
Assays for Vitamins and Metabolic Function-Novitas Solutions, Inc. |
10/01/2015 |
| L34924 |
Treatment of Chronic Venous Insufficiency of the Lower Extremities-Novitas Solutions, Inc. |
10/01/2015 |
| L34938 |
Removal of Benign Skin Lesions-Novitas Solutions, Inc. |
10/01/2015 |
| L34953 |
Cardiac Event Detection Monitoring-Novitas Solutions, Inc. |
10/01/2015 |
| L34960 |
Hydration Therapy-Novitas Solutions, Inc. |
10/01/2015 |
| L34961 |
Mohs Micrographic Surgery (MMS)-Novitas Solutions, Inc. |
10/01/2015 |
| L34975 |
Neurophysiology Evoked Potentials (NEPs)-Novitas Solutions, Inc. |
10/01/2015 |
| L34976 |
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-First Coast Service Options, Inc. |
10/01/2015 |
| L34977 |
Anorectal Manometry, Anal Electromyography, and Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters-Novitas Solutions, Inc. |
10/01/2015 |
| L34980 |
Lumbar Epidural Injections-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34982 |
Lumbar Epidural Injections-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L34996 |
Neuromuscular Junction Testing-Novitas Solutions, Inc. |
10/01/2015 |
| L34997 |
Real-Time, Outpatient Cardiac Telemetry-Novitas Solutions, Inc. |
10/01/2015 |
| L34998 |
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder-Novitas Solutions, Inc. |
10/01/2015 |
| L35000 |
Molecular Pathology Procedures-National Government Services, Inc. |
10/01/2015 |
| L35001 |
Reduction Mammaplasty-National Government Services, Inc. |
10/01/2015 |
| L35003 |
Intraoperative Neurophysiological Testing-Novitas Solutions, Inc. |
10/01/2015 |
| L35004 |
Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow-Novitas Solutions, Inc. |
10/01/2015 |
| L35006 |
Controlled Substance Monitoring and Drugs of Abuse Testing-Novitas Solutions, Inc. |
10/01/2015 |
| L35007 |
Vestibular and Audiologic Function Studies-Novitas Solutions, Inc. |
10/01/2015 |
| L35010 |
Trigger Point Injections-Novitas Solutions, Inc. |
10/01/2015 |
| L35011 |
Surgery: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control-Novitas Solutions, Inc. |
10/01/2015 |
| L35013 |
Debridement of Mycotic Nails-Novitas Solutions, Inc. |
10/01/2015 |
| L35014 |
Frequency of Hemodialysis-Novitas Solutions, Inc. |
10/01/2015 |
| L35016 |
Transesophageal Echocardiography (TEE)-Novitas Solutions, Inc. |
10/01/2015 |
| L35022 |
Bariatric Surgical Management of Morbid Obesity-Novitas Solutions, Inc. |
10/01/2015 |
| L35024 |
MolDX: Genetic Testing for Lynch Syndrome-Palmetto GBA |
10/01/2015 |
| L35025 |
MolDX: Molecular Diagnostic Tests (MDT)-Palmetto GBA |
10/01/2015 |
| L35026 |
Rituximab-Palmetto GBA |
10/01/2015 |
| L35028 |
Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency-National Government Services, Inc. |
10/01/2015 |
| L35032 |
Flow Cytometry-Novitas Solutions, Inc. |
10/01/2015 |
| L35035 |
Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography-Novitas Solutions, Inc. |
10/01/2015 |
| L35036 |
Therapy and Rehabilitation Services (PT, OT)-Novitas Solutions, Inc. |
10/01/2015 |
| L35038 |
Scanning Computerized Ophthalmic Diagnostic Imaging-Novitas Solutions, Inc. |
10/01/2015 |
| L35041 |
Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds-Novitas Solutions, Inc. |
10/01/2015 |
| L35048 |
Nerve Conduction Studies and Electromyography-Palmetto GBA |
10/01/2015 |
| L35049 |
Monitored Anesthesia Care-Novitas Solutions, Inc. |
10/01/2015 |
| L35050 |
Outpatient Sleep Studies-Novitas Solutions, Inc. |
10/01/2015 |
| L35062 |
Biomarkers Overview-Novitas Solutions, Inc. |
10/01/2015 |
| L35068 |
Evaluation and Management Services Provided in a Nursing Facility-Novitas Solutions, Inc. |
10/01/2015 |
| L35070 |
Speech - Language Pathology (SLP) Services: Communication Disorders-Novitas Solutions, Inc. |
10/01/2015 |
| L35073 |
MolDX: NRAS Genetic Testing-Palmetto GBA |
10/01/2015 |
| L35074 |
Heavy Metal Testing-National Government Services, Inc. |
10/01/2015 |
| L35075 |
Proton Beam Therapy-National Government Services, Inc. |
10/01/2015 |
| L35076 |
Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)-National Government Services, Inc. |
10/01/2015 |
| L35080 |
Select Minimally Invasive GERD Procedures-National Government Services, Inc. |
10/01/2015 |
| L35081 |
Nerve Conduction Studies and Electromyography-Novitas Solutions, Inc. |
10/01/2015 |
| L35083 |
Cardiology Non-emergent Outpatient Stress Testing-Novitas Solutions, Inc. |
10/01/2015 |
| L35084 |
Non-Coronary Vascular Stents-Novitas Solutions, Inc. |
10/01/2015 |
| L35089 |
Wireless Capsule Endoscopy-Novitas Solutions, Inc. |
10/01/2015 |
| L35090 |
Cosmetic and Reconstructive Surgery-Novitas Solutions, Inc. |
10/01/2015 |
| L35091 |
Cataract Extraction (including Complex Cataract Surgery)-Novitas Solutions, Inc. |
10/01/2015 |
| L35092 |
Diagnostic Abdominal Aortography and Renal Angiography-Novitas Solutions, Inc. |
10/01/2015 |
| L35093 |
Immune Globulin-Novitas Solutions, Inc. |
10/01/2015 |
| L35098 |
Nerve Conduction Studies and Electromyography-National Government Services, Inc. |
10/01/2015 |
| L35099 |
Frequency of Laboratory Tests-Novitas Solutions, Inc. |
10/01/2015 |
| L35101 |
Psychiatric Codes-Novitas Solutions, Inc. |
10/01/2015 |
| L35111 |
Hemophilia Factor Products-Novitas Solutions, Inc. |
10/01/2015 |
| L35112 |
Implantable Infusion Pump-Novitas Solutions, Inc. |
10/01/2015 |
| L35121 |
Coronary Computed Tomography Angiography (CCTA)-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35124 |
Autonomic Function Testing-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35125 |
Wound Care-Novitas Solutions, Inc. |
10/01/2015 |
| L35130 |
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-Novitas Solutions, Inc. |
10/01/2015 |
| L35132 |
Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus-Palmetto GBA |
10/01/2015 |
| L35136 |
Spinal Cord Stimulators for Chronic Pain-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35138 |
Routine Foot Care-Novitas Solutions, Inc. |
10/01/2015 |
| L35160 |
MolDX: Molecular Diagnostic Tests (MDT)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35162 |
Ambulance Services (Ground Ambulance)-Novitas Solutions, Inc. |
10/01/2015 |
| L35163 |
Plastic Surgery-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35170 |
Botulinum Toxin Types A and B Policy-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35172 |
Botulinum Toxin Types A and B-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35175 |
MRI and CT Scans of the Head and Neck-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35222 |
Nerve Blocks for Peripheral Neuropathy-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35249 |
Nerve Blocks for Peripheral Neuropathy-CGS Administrators, LLC |
10/01/2015 |
| L35349 |
MolDX: Genetic Testing for Lynch Syndrome-CGS Administrators, LLC |
10/01/2015 |
| L35350 |
Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)-Novitas Solutions, Inc. |
10/01/2015 |
| L35360 |
Pulmonary Function Testing-Novitas Solutions, Inc. |
10/01/2015 |
| L35391 |
Multiple Imaging in Oncology-Novitas Solutions, Inc. |
10/01/2015 |
| L35395 |
Autonomic Function Tests-Novitas Solutions, Inc. |
10/01/2015 |
| L35396 |
Biomarkers for Oncology-Novitas Solutions, Inc. |
10/01/2015 |
| L35397 |
Non-Invasive Cerebrovascular Arterial Studies-Novitas Solutions, Inc. |
10/01/2015 |
| L35408 |
3D Interpretation and Reporting of Imaging Studies-Novitas Solutions, Inc. |
10/01/2015 |
| L35409 |
Non-Vascular Extremity Ultrasound-Novitas Solutions, Inc. |
10/01/2015 |
| L35427 |
Hyaluronan Acid Therapies for Osteoarthritis of the Knee-Novitas Solutions, Inc. |
10/01/2015 |
| L35428 |
Thrombolytic Agents-Novitas Solutions, Inc. |
10/01/2015 |
| L35433 |
Barium Swallow Studies, Modified-Novitas Solutions, Inc. |
10/01/2015 |
| L35434 |
Oximetry Services-Novitas Solutions, Inc. |
10/01/2015 |
| L35442 |
MolDX: NRAS Genetic Testing-CGS Administrators, LLC |
10/01/2015 |
| L35448 |
Independent Diagnostic Testing Facility (IDTF)-Novitas Solutions, Inc. |
10/01/2015 |
| L35450 |
Spinal Cord Stimulation (Dorsal Column Stimulation)-Novitas Solutions, Inc. |
10/01/2015 |
| L35451 |
Non-Invasive Peripheral Venous Studies-Novitas Solutions, Inc. |
10/01/2015 |
| L35456 |
Nerve Blockade for Treatment of Chronic Pain and Neuropathy-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35457 |
Nerve Blockade for Treatment of Chronic Pain and Neuropathy-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35486 |
Pelvic Floor Dysfunction: Anorectal Manometry and EMG-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35490 |
Category III Codes-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35494 |
Mohs Micrographic Surgery-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35498 |
Removal of Benign Skin Lesions-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35526 |
B-type Natriuretic Peptide (BNP) Testing-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35632 |
MolDX: ConfirmMDx Epigenetic Molecular Assay-Palmetto GBA |
10/01/2015 |
| L35677 |
Infliximab-Palmetto GBA |
10/01/2015 |
| L35702 |
Mohs Micrographic Surgery-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35704 |
Mohs Micrographic Surgery-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L35724 |
Lab: Controlled Substance Monitoring and Drugs of Abuse Testing-Palmetto GBA |
10/01/2015 |
| L35751 |
Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35753 |
Non-Invasive Cerebrovascular Studies-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35755 |
Non-Invasive Abdominal / Visceral Vascular Studies-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35761 |
Non-Invasive Peripheral Arterial Vascular Studies-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L35891 |
Intravenous Immune Globulin-CGS Administrators, LLC |
10/01/2015 |
| L35897 |
Nerve Conduction Studies and Electromyography-CGS Administrators, LLC |
10/01/2015 |
| L35906 |
Somatosensory Testing-CGS Administrators, LLC |
10/01/2015 |
| L35922 |
Lab: Special Histochemical Stains and Immunohistochemical Stains-Palmetto GBA |
10/01/2015 |
| L35936 |
Facet Joint Interventions for Pain Management-National Government Services, Inc. |
10/01/2015 |
| L35974 |
MolDX: MGMT Promoter Methylation Analysis-Palmetto GBA |
10/01/2015 |
| L35984 |
MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-CGS Administrators, LLC |
10/01/2015 |
| L35986 |
Special Histochemical Stains and Immunohistochemical Stains-CGS Administrators, LLC |
10/01/2015 |
| L35998 |
Non-Coronary Vascular Stents-Wisconsin Physicians Service Insurance Corporation |
10/01/2015 |
| L36007 |
Lower Extremity Major Joint Replacement (Hip and Knee)-Novitas Solutions, Inc. |
10/01/2015 |
| L36021 |
MolDX: Molecular Diagnostic Tests (MDT)-CGS Administrators, LLC |
10/01/2015 |
| L36035 |
Spinal Cord Stimulation for Chronic Pain-First Coast Service Options, Inc. |
10/01/2015 |
| L36089 |
MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Palmetto GBA |
10/01/2015 |
| L36094 |
Lab: Flow Cytometry-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L36125 |
MolDX: Breast Cancer Assay: Prosigna®-Palmetto GBA |
10/01/2015 |
| L36236 |
Autonomic Function Testing-National Government Services, Inc. |
10/01/2015 |
| L36237 |
Amniotic Membrane- Sutureless Placement on the Ocular Surface -First Coast Service Options, Inc. |
10/01/2015 |
| L36238 |
Humanitarian Use Device (HUD) and Humanitarian Device Exemption (HDE) process-First Coast Service Options, Inc. |
10/01/2015 |
| L36240 |
Allergen Immunotherapy-Novitas Solutions, Inc. |
10/01/2015 |
| L36241 |
Allergy Testing-Novitas Solutions, Inc. |
10/01/2015 |
| L36256 |
MolDX: Molecular Diagnostic Tests (MDT)-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L36276 |
Erythropoiesis Stimulating Agents-First Coast Service Options, Inc. |
10/01/2015 |
| L36286 |
Blepharoplasty, Eyelid Surgery, and Brow Lift-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L36327 |
MolDX: ConfirmMDx Epigenetic Molecular Assay-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L36329 |
MolDX: ConfirmMDx Epigenetic Molecular Assay-Noridian Healthcare Solutions, LLC |
10/01/2015 |
| L36356 |
Bone Mineral Density Studies-First Coast Service Options, Inc. |
10/01/2015 |
| L36377 |
Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities-First Coast Service Options, Inc. |
10/01/2015 |
| L36006 |
MolDX: ConfirmMDx Epigenetic Molecular Assay-CGS Administrators, LLC |
10/05/2015 |
| L36029 |
Controlled Substance Monitoring and Drugs of Abuse Testing-CGS Administrators, LLC |
10/05/2015 |
| L36044 |
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Palmetto GBA |
10/05/2015 |
| L36082 |
MolDX: BRCA1 and BRCA2 Genetic Testing-Palmetto GBA |
10/05/2015 |
| L36113 |
MolDX: MGMT Promoter Methylation Analysis-CGS Administrators, LLC |
10/05/2015 |
| L36117 |
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-CGS Administrators, LLC |
10/05/2015 |
| L36129 |
MolDX: Biomarkers in Cardiovascular Risk Assessment-Palmetto GBA |
10/05/2015 |
| L36139 |
MolDX: Biomarkers in Cardiovascular Risk Assessment-CGS Administrators, LLC |
10/05/2015 |
| L36393 |
Controlled Substance Monitoring and Drugs of Abuse Testing-First Coast Service Options, Inc. |
10/11/2015 |
| L36351 |
Lab: Special Histochemical Stains and Immunohistochemical Stains-Noridian Healthcare Solutions, LLC |
10/15/2015 |
| L36353 |
Lab: Special Histochemical Stains and Immunohistochemical Stains-Noridian Healthcare Solutions, LLC |
10/15/2015 |
| L36230 |
Evaluation and Management Services in a Nursing Facility -First Coast Service Options, Inc. |
11/15/2015 |
| L36037 |
Urine Drug Testing-National Government Services, Inc. |
12/01/2015 |
| L36039 |
Total Joint Arthroplasty-National Government Services, Inc. |
12/01/2015 |
| L36267 |
Bowel Management Devices-Noridian Healthcare Solutions, LLC |
12/01/2015 |
| L36234 |
Special Histochemical Stains & Immunohistochemical Stains-First Coast Service Options, Inc. |
12/06/2015 |
| L36000 |
Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain-Wisconsin Physicians Service Insurance Corporation |
12/17/2015 |
| L36427 |
Wireless Capsule Endoscopy-Palmetto GBA |
01/25/2016 |
| L36425 |
MolDX: Breast Cancer Assay: Prosigna®-CGS Administrators, LLC |
02/01/2016 |
| L36460 |
Bone Mass Measurement-CGS Administrators, LLC |
02/01/2016 |
| L36494 |
Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint-CGS Administrators, LLC |
02/01/2016 |
| L36469 |
Transcranial Magnetic Stimulation (TMS)-CGS Administrators, LLC |
02/08/2016 |
| L36456 |
MolDX: BRCA1 and BRCA2 Genetic Testing-CGS Administrators, LLC |
02/15/2016 |
| L36464 |
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Palmetto GBA |
02/15/2016 |
| L36485 |
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-CGS Administrators, LLC |
02/15/2016 |
| L36402 |
Allergy Testing-Wisconsin Physicians Service Insurance Corporation |
03/18/2016 |
| L36408 |
Allergy Immunotherapy-Wisconsin Physicians Service Insurance Corporation |
03/18/2016 |
| L36406 |
Minimally-invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint-National Government Services, Inc. |
04/01/2016 |
| L36499 |
BRCA1 and BRCA2 Genetic Testing-First Coast Service Options, Inc. |
04/11/2016 |
| L36161 |
MolDX: BRCA1 and BRCA2 Genetic Testing-Noridian Healthcare Solutions, LLC |
04/15/2016 |
| L36163 |
MolDX: BRCA1 and BRCA2 Genetic Testing-Noridian Healthcare Solutions, LLC |
04/15/2016 |
| L36188 |
MolDX: MGMT Promoter Methylation Analysis-Noridian Healthcare Solutions, LLC |
04/15/2016 |
| L36192 |
MolDX: MGMT Promoter Methylation Analysis-Noridian Healthcare Solutions, LLC |
04/15/2016 |
| L36400 |
MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Wisconsin Physicians Service Insurance Corporation |
04/16/2016 |
| L36180 |
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Noridian Healthcare Solutions, LLC |
04/19/2016 |
| L36186 |
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Noridian Healthcare Solutions, LLC |
04/19/2016 |
| L36380 |
MolDX: Breast Cancer Assay: Prosigna®-Noridian Healthcare Solutions, LLC |
05/03/2016 |
| L36386 |
MolDX: Breast Cancer Assay: Prosigna®-Noridian Healthcare Solutions, LLC |
05/03/2016 |
| L36204 |
Spinal Cord Stimulators for Chronic Pain-Noridian Healthcare Solutions, LLC |
06/01/2016 |
| L36358 |
MolDX: Biomarkers in Cardiovascular Risk Assessment-Noridian Healthcare Solutions, LLC |
06/01/2016 |
| L36362 |
MolDX: Biomarkers in Cardiovascular Risk Assessment-Noridian Healthcare Solutions, LLC |
06/01/2016 |
| L36370 |
MolDX: Genetic Testing for Lynch Syndrome-Noridian Healthcare Solutions, LLC |
06/01/2016 |
| L36374 |
MolDX: Genetic Testing for Lynch Syndrome-Noridian Healthcare Solutions, LLC |
06/01/2016 |
| L36524 |
Nerve Conduction Studies and Electromyography-Noridian Healthcare Solutions, LLC |
06/01/2016 |
| L36526 |
Nerve Conduction Studies and Electromyography-Noridian Healthcare Solutions, LLC |
06/01/2016 |
| L36593 |
Polysomnography-Palmetto GBA |
06/13/2016 |
| L36155 |
MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Noridian Healthcare Solutions, LLC |
06/16/2016 |
| L36159 |
MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Noridian Healthcare Solutions, LLC |
06/16/2016 |
| L36523 |
MolDX: Biomarkers in Cardiovascular Risk Assessment-Wisconsin Physicians Service Insurance Corporation |
06/16/2016 |
| L36668 |
Lab: Controlled Substance Monitoring and Drugs of Abuse Testing-Noridian Healthcare Solutions, LLC |
06/28/2016 |
| L36707 |
Lab: Controlled Substance Monitoring and Drugs of Abuse Testing-Noridian Healthcare Solutions, LLC |
06/28/2016 |
| L36335 |
MolDX: NRAS Genetic Testing-Noridian Healthcare Solutions, LLC |
07/05/2016 |
| L36339 |
MolDX: NRAS Genetic Testing-Noridian Healthcare Solutions, LLC |
07/05/2016 |
| L36538 |
Treatment of Males with Low Testosterone-Noridian Healthcare Solutions, LLC |
07/12/2016 |
| L36569 |
Treatment of Males with Low Testosterone-Noridian Healthcare Solutions, LLC |
07/12/2016 |
| L36573 |
Total Hip Arthroplasty-Noridian Healthcare Solutions, LLC |
09/07/2016 |
| L36575 |
Total Knee Arthroplasty-Noridian Healthcare Solutions, LLC |
09/07/2016 |
| L36577 |
Total Knee Arthroplasty-Noridian Healthcare Solutions, LLC |
09/07/2016 |
| L36544 |
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Noridian Healthcare Solutions, LLC |
09/15/2016 |
| L36551 |
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Noridian Healthcare Solutions, LLC |
09/15/2016 |
| L36665 |
ProMark® Risk Score-Palmetto GBA |
10/10/2016 |
| L36675 |
ProMark® Risk Score-CGS Administrators, LLC |
10/10/2016 |
| L36690 |
Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities-CGS Administrators, LLC |
10/10/2016 |
| L36761 |
GlycoMark® Testing for Glycemic Control-Palmetto GBA |
10/17/2016 |
| L36658 |
Proton Beam Therapy-CGS Administrators, LLC |
10/24/2016 |
| L36767 |
Aortography and peripheral angiography-First Coast Service Options, Inc. |
10/31/2016 |
| L36773 |
Intensity Modulated Radiation Therapy (IMRT) -First Coast Service Options, Inc. |
11/07/2016 |
| L36763 |
4Kscore® Assay-Palmetto GBA |
11/21/2016 |
| L36711 |
Intensity Modulated Radiation Therapy (IMRT)-Novitas Solutions, Inc. |
12/01/2016 |
| L36715 |
BRCA1 and BRCA2 Genetic Testing-Novitas Solutions, Inc. |
12/01/2016 |
| L36692 |
Vitamin D Assay Testing-Noridian Healthcare Solutions, LLC |
02/03/2017 |
| L36793 |
MolDX: Genetic Testing for Lynch Syndrome-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36797 |
MolDX: NRAS Genetic Testing-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36805 |
Lab: Special Histochemical Stains and Immunohistochemical Stains-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36807 |
MolDX: Molecular Diagnostic Tests (MDT)-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36811 |
MolDX: Breast Cancer Assay: Prosigna®-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36813 |
MolDX: BRCA1 and BRCA2 Genetic Testing-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36815 |
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36839 |
Polysomnography and Other Sleep Studies-Wisconsin Physicians Service Insurance Corporation |
02/16/2017 |
| L36902 |
Polysomnography and Other Sleep Studies-CGS Administrators, LLC |
03/06/2017 |
| L36906 |
GlycoMark® Testing for Glycemic Control-CGS Administrators, LLC |
03/06/2017 |
| L36912 |
MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Palmetto GBA |
03/06/2017 |
| L36951 |
MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-CGS Administrators, LLC |
03/06/2017 |
| L36975 |
Bladder/Urothelial Tumor Markers-CGS Administrators, LLC |
03/06/2017 |
| L36700 |
Serum Magnesium-Noridian Healthcare Solutions, LLC |
03/13/2017 |
| L36702 |
Serum Magnesium-Noridian Healthcare Solutions, LLC |
03/13/2017 |
| L36827 |
MolDX: APC and MUTYH Gene Testing-Palmetto GBA |
03/13/2017 |
| L36854 |
MolDX: Percepta® Bronchial Genomic Classifier-Palmetto GBA |
03/13/2017 |
| L36908 |
MolDX: Percepta® Bronchial Genomic Classifier-CGS Administrators, LLC |
03/13/2017 |
| L36910 |
MolDX: APC and MUTYH Gene Testing-CGS Administrators, LLC |
03/13/2017 |
| L36979 |
4Kscore® Assay-CGS Administrators, LLC |
03/13/2017 |
| L36831 |
Visual Electrophysiology Testing -National Government Services, Inc. |
03/16/2017 |
| L36941 |
MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Noridian Healthcare Solutions, LLC |
03/27/2017 |
| L36947 |
MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Noridian Healthcare Solutions, LLC |
03/27/2017 |
| L36850 |
Peripheral Nerve Blocks-National Government Services, Inc. |
05/01/2017 |
| L36920 |
Epidural Steroid Injections for Pain Management-Novitas Solutions, Inc. |
05/04/2017 |
| L36882 |
MolDX: APC and MUTYH Gene Testing-Noridian Healthcare Solutions, LLC |
05/15/2017 |
| L36884 |
MolDX: APC and MUTYH Gene Testing-Noridian Healthcare Solutions, LLC |
05/15/2017 |
| L36886 |
MolDX: Percepta© Bronchial Genomic Classifier-Noridian Healthcare Solutions, LLC |
05/15/2017 |
| L36891 |
MolDX: Percepta© Bronchial Genomic Classifier-Noridian Healthcare Solutions, LLC |
05/15/2017 |
| L36678 |
Lab: Bladder/Urothelial Tumor Markers-Noridian Healthcare Solutions, LLC |
05/16/2017 |
| L36680 |
Lab: Bladder/Urothelial Tumor Markers-Noridian Healthcare Solutions, LLC |
05/16/2017 |
| L36859 |
Trigger Point Injections-Noridian Healthcare Solutions, LLC |
05/26/2017 |
| L36704 |
ProMark® Risk Score-Noridian Healthcare Solutions, LLC |
06/01/2017 |
| L36706 |
ProMark® Risk Score-Noridian Healthcare Solutions, LLC |
06/01/2017 |
| L36861 |
Polysomnography and Other Sleep Studies-Noridian Healthcare Solutions, LLC |
06/05/2017 |
| L37176 |
White Cell Colony Stimulating Factors-Palmetto GBA |
06/12/2017 |
| L37022 |
Lab: Coenzyme Q10 (CoQ10)-Palmetto GBA |
07/10/2017 |
| L37031 |
BDX-XL2-Palmetto GBA |
07/10/2017 |
| L37033 |
MolDX: DecisionDx-UM (Uveal Melanoma)-Palmetto GBA |
07/10/2017 |
| L37126 |
Coenzyme Q10 (CoQ10)-CGS Administrators, LLC |
07/10/2017 |
| L37130 |
MolDX: DecisionDx-UM (Uveal Melanoma)-CGS Administrators, LLC |
07/10/2017 |
| L37134 |
BDX-XL2-CGS Administrators, LLC |
07/10/2017 |
| L36868 |
Diagnostic and Therapeutic Colonoscopy-Noridian Healthcare Solutions, LLC |
07/17/2017 |
| L36889 |
Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography-Noridian Healthcare Solutions, LLC |
07/17/2017 |
| L37001 |
MolDX: MGMT Promoter Methylation Analysis-Wisconsin Physicians Service Insurance Corporation |
07/17/2017 |
| L37003 |
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Wisconsin Physicians Service Insurance Corporation |
07/17/2017 |
| L37005 |
MolDX: ConfirmMDx Epigenetic Molecular Assay-Wisconsin Physicians Service Insurance Corporation |
07/17/2017 |
| L37011 |
ProMark® Risk Score-Wisconsin Physicians Service Insurance Corporation |
07/17/2017 |
| L37013 |
4Kscore® Assay-Wisconsin Physicians Service Insurance Corporation |
07/17/2017 |
| L37015 |
Visual Electrophysiology Testing-Wisconsin Physicians Service Insurance Corporation |
07/17/2017 |
| L36846 |
Measurement of Salivary Hormones-Noridian Healthcare Solutions, LLC |
07/21/2017 |
| L36857 |
Measurement of Salivary Hormones-Noridian Healthcare Solutions, LLC |
07/21/2017 |
| L36962 |
Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases -First Coast Service Options, Inc. |
07/24/2017 |
| L36864 |
GlycoMark® Testing for Glycemic Control-Noridian Healthcare Solutions, LLC |
08/01/2017 |
| L36866 |
GlycoMark® Testing for Glycemic Control-Noridian Healthcare Solutions, LLC |
08/01/2017 |
| L37195 |
MolDX: Percepta® Bronchial Genomic Classifier-Wisconsin Physicians Service Insurance Corporation |
09/16/2017 |
| L37199 |
MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Wisconsin Physicians Service Insurance Corporation |
09/16/2017 |
| L37205 |
Chemotherapy Drugs and their Adjuncts-Wisconsin Physicians Service Insurance Corporation |
09/16/2017 |
| L37210 |
MolDX: Decision Dx-UM (Uveal Melanoma)-Wisconsin Physicians Service Insurance Corporation |
09/16/2017 |
| L37216 |
BDX-XL2-Wisconsin Physicians Service Insurance Corporation |
09/16/2017 |
| L37224 |
MolDX: APC and MUTYH Gene Testing-Wisconsin Physicians Service Insurance Corporation |
09/16/2017 |
| L37379 |
Echocardiography-Palmetto GBA |
09/18/2017 |
| L37070 |
MolDX: DecisionDx-UM (Uveal Melanoma)-Noridian Healthcare Solutions, LLC |
09/22/2017 |
| L37072 |
MolDX: DecisionDx-UM (Uveal Melanoma)-Noridian Healthcare Solutions, LLC |
09/22/2017 |
| L37387 |
Chiropractic Services-Palmetto GBA |
09/25/2017 |
| L37260 |
MolDX: Prometheus IBD sgi Diagnostic® Policy-Palmetto GBA |
09/26/2017 |
| L37054 |
BDX-XL2-Noridian Healthcare Solutions, LLC |
09/29/2017 |
| L37062 |
BDX-XL2-Noridian Healthcare Solutions, LLC |
09/29/2017 |
| L37066 |
Lab: Coenzyme Q10 (CoQ10)-Noridian Healthcare Solutions, LLC |
10/02/2017 |
| L37068 |
Lab: Coenzyme Q10 (CoQ10)-Noridian Healthcare Solutions, LLC |
10/02/2017 |
| L37264 |
MolDX: EndoPredict Breast Cancer Gene Expression Test-Palmetto GBA |
10/02/2017 |
| L37020 |
Plastic Surgery-Noridian Healthcare Solutions, LLC |
10/10/2017 |
| L37027 |
Cataract Surgery in Adults-Noridian Healthcare Solutions, LLC |
10/10/2017 |
| L37254 |
Chiropractic Services-CGS Administrators, LLC |
11/06/2017 |
| L37352 |
MolDX: Prometheus IBD sgi Diagnostic® Policy-CGS Administrators, LLC |
11/06/2017 |
| L37244 |
Micro-Invasive Glaucoma Surgery (MIGS)-National Government Services, Inc. |
12/01/2017 |
| L37166 |
Wound Care-First Coast Service Options, Inc. |
12/07/2017 |
| L37371 |
Electroretinography (ERG)-Novitas Solutions, Inc. |
01/25/2018 |
| L37632 |
Spinal Cord Stimulators for Chronic Pain-Palmetto GBA |
01/29/2018 |
| L37633 |
Partial Hospitalization Programs-Palmetto GBA |
01/29/2018 |
| L37638 |
Health and Behavior Assessment/Intervention-Palmetto GBA |
01/29/2018 |
| L37641 |
Continuous Peripheral Nerve Blocks (CPNB)-Palmetto GBA |
01/29/2018 |
| L37642 |
Nerve Blocks and Electrostimulation for Peripheral Neuropathy-Palmetto GBA |
01/29/2018 |
| L37643 |
Routine Foot Care-Palmetto GBA |
01/29/2018 |
| L37644 |
YAG Capsulotomy-Palmetto GBA |
01/29/2018 |
| L37295 |
MolDX: EndoPredict® Breast Cancer Gene Expression Test-Noridian Healthcare Solutions, LLC |
01/30/2018 |
| L37299 |
MolDX: Prometheus IBD sgi Diagnostic® Policy-Noridian Healthcare Solutions, LLC |
01/30/2018 |
| L37311 |
MolDX: EndoPredict® Breast Cancer Gene Expression Test-Noridian Healthcare Solutions, LLC |
01/30/2018 |
| L37313 |
MolDX: Prometheus IBD sgi Diagnostic® Policy-Noridian Healthcare Solutions, LLC |
01/30/2018 |
| L37398 |
Electroretinography (ERG)-First Coast Service Options, Inc. |
02/02/2018 |
| L37561 |
Cystatin C Measurement-First Coast Service Options, Inc. |
02/02/2018 |
| L37635 |
Trigger Point Injections-Palmetto GBA |
02/26/2018 |
| L37636 |
Nonobstetric Pelvic Ultrasound-Palmetto GBA |
02/26/2018 |
| L37356 |
MolDX: EndoPredict Breast Cancer Gene Expression Test-CGS Administrators, LLC |
03/06/2018 |
| L37539 |
MolDX: Prometheus IBD sgi Diagnostic® Policy-Wisconsin Physicians Service Insurance Corporation |
03/19/2018 |
| L37578 |
Micro-Invasive Glaucoma Surgery (MIGS)-CGS Administrators, LLC |
03/19/2018 |
| L37283 |
Electrocardiograms-Noridian Healthcare Solutions, LLC |
03/26/2018 |
| L37421 |
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor-National Government Services, Inc. |
04/01/2018 |
| L37535 |
Vitamin D Assay Testing-National Government Services, Inc. |
04/01/2018 |
| L37228 |
Wound Care-Wisconsin Physicians Service Insurance Corporation |
04/16/2018 |
| L37086 |
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder-Noridian Healthcare Solutions, LLC |
05/14/2018 |
| L37088 |
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder-Noridian Healthcare Solutions, LLC |
05/14/2018 |
| L37547 |
Chest X-Ray Policy-Noridian Healthcare Solutions, LLC |
06/22/2018 |
| L37549 |
Chest X-Ray Policy-Noridian Healthcare Solutions, LLC |
06/22/2018 |
| L37697 |
Emergency and Non-Emergency Ground Ambulance Services-First Coast Service Options, Inc. |
06/28/2018 |
| L37485 |
Prostate Rectal Spacers-National Government Services, Inc. |
07/02/2018 |
| L37293 |
Respiratory Care (Respiratory Therapy)-Noridian Healthcare Solutions, LLC |
07/09/2018 |
| L37606 |
Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases-National Government Services, Inc. |
08/01/2018 |
| L37663 |
MolDX: EndoPredict® Breast Cancer Gene Expression Test-Wisconsin Physicians Service Insurance Corporation |
08/16/2018 |
| L37281 |
Lumbar MRI-Noridian Healthcare Solutions, LLC |
08/27/2018 |
| L37360 |
Peripheral Nerve Stimulation-Noridian Healthcare Solutions, LLC |
08/27/2018 |
| L37761 |
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor-Palmetto GBA |
09/24/2018 |
| L37779 |
Intraoperative Radiation Therapy-Palmetto GBA |
09/24/2018 |
| L37628 |
In Vitro Chemosensitivity & Chemoresistance Assays-Noridian Healthcare Solutions, LLC |
10/01/2018 |
| L37630 |
In Vitro Chemosensitivity & Chemoresistance Assays-Noridian Healthcare Solutions, LLC |
10/01/2018 |
| L37790 |
Magnetic Resonance Guided Focused Ultrasound Surgery System (MRgFUS) for the treatment of neurologic conditions-CGS Administrators, LLC |
10/01/2018 |
| L37373 |
MRI and CT Scans of the Head and Neck-Noridian Healthcare Solutions, LLC |
10/08/2018 |
| L37800 |
Allergen Immunotherapy-First Coast Service Options, Inc. |
10/18/2018 |
| L37612 |
MolDX: Corus® CAD Assay-Palmetto GBA |
11/05/2018 |
| L37713 |
MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels-Palmetto GBA |
11/12/2018 |
| L37787 |
MolDX: Corus® CAD Assay-CGS Administrators, LLC |
11/12/2018 |
| L37774 |
Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication-Palmetto GBA |
11/19/2018 |
| L37733 |
Biomarker Testing for Prostate Cancer Diagnosis-National Government Services, Inc. |
12/01/2018 |
| L37808 |
Water Vapor Thermal Therapy for LUTS/BPH-National Government Services, Inc. |
12/01/2018 |
| L37348 |
MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels-CGS Administrators, LLC |
12/03/2018 |
| L37581 |
Lab: Cystatin C Measurement-Palmetto GBA |
12/03/2018 |
| L37725 |
MolDX: Melanoma Risk Stratification Molecular Testing-Palmetto GBA |
12/03/2018 |
| L37709 |
Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification (NAATs)-Palmetto GBA |
12/10/2018 |
| L37598 |
Cystatin C Measurement-CGS Administrators, LLC |
12/17/2018 |
| L37764 |
MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels-Wisconsin Physicians Service Insurance Corporation |
12/17/2018 |
| L37768 |
MolDX: CYSTATIN C Measurement-Wisconsin Physicians Service Insurance Corporation |
12/17/2018 |
| L37770 |
MolDX: CORUS® CAD ASSAY-Wisconsin Physicians Service Insurance Corporation |
12/17/2018 |
| L37531 |
Micro-Invasive Glaucoma Surgery (MIGS)-Palmetto GBA |
12/24/2018 |
| L37364 |
Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)-CGS Administrators, LLC |
01/07/2019 |
| L37120 |
MolDX: 4Kscore Assay-Noridian Healthcare Solutions, LLC |
01/13/2019 |
| L37122 |
MolDX: 4Kscore Assay-Noridian Healthcare Solutions, LLC |
01/13/2019 |
| L37673 |
MolDX: Corus® CAD Assay-Noridian Healthcare Solutions, LLC |
02/10/2019 |
| L37675 |
MolDX: Corus® CAD Assay-Noridian Healthcare Solutions, LLC |
02/10/2019 |
| L37748 |
MolDX: Melanoma Risk Stratification Molecular Testing-Noridian Healthcare Solutions, LLC |
02/10/2019 |
| L37750 |
MolDX: Melanoma Risk Stratification Molecular Testing-Noridian Healthcare Solutions, LLC |
02/10/2019 |
| L37350 |
Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)-Noridian Healthcare Solutions, LLC |
02/11/2019 |
| L37368 |
Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)-Noridian Healthcare Solutions, LLC |
02/11/2019 |
| L37616 |
Lab: Cystatin C Measurement-Noridian Healthcare Solutions, LLC |
02/11/2019 |
| L37618 |
Lab: Cystatin C Measurement-Noridian Healthcare Solutions, LLC |
02/11/2019 |
| L37766 |
Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)-Wisconsin Physicians Service Insurance Corporation |
02/16/2019 |
| L37502 |
Frequency of Hemodialysis-Noridian Healthcare Solutions, LLC |
02/18/2019 |
| L37504 |
Frequency of Hemodialysis-Noridian Healthcare Solutions, LLC |
02/18/2019 |
| L37475 |
Frequency of Hemodialysis-National Government Services, Inc. |
03/01/2019 |
| L37537 |
Frequency of Hemodialysis-Wisconsin Physicians Service Insurance Corporation |
03/01/2019 |
| L37564 |
Frequency of Hemodialysis-First Coast Service Options, Inc. |
03/01/2019 |
| L37794 |
MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Palmetto GBA |
03/11/2019 |
| L37798 |
4Kscore Test Algorithm-First Coast Service Options, Inc. |
03/18/2019 |
| L37792 |
4Kscore Test Algorithm-Novitas Solutions, Inc. |
03/21/2019 |
| L37575 |
Frequency of Hemodialysis-CGS Administrators, LLC |
04/01/2019 |
| L37729 |
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor-Noridian Healthcare Solutions, LLC |
04/01/2019 |
| L37738 |
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor-Noridian Healthcare Solutions, LLC |
04/01/2019 |
| L37810 |
Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms-National Government Services, Inc. |
04/01/2019 |
| L37832 |
MolDX: Breast Cancer Index® (BCI) Gene Expression Test-CGS Administrators, LLC |
04/01/2019 |
| L37851 |
Biomarker Testing for Neuroendocrine Tumors/Neoplasms-National Government Services, Inc. |
04/01/2019 |
| L37857 |
MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Palmetto GBA |
04/01/2019 |
| L37929 |
Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea-National Government Services, Inc. |
04/01/2019 |
| L37602 |
MDS FISH-Palmetto GBA |
04/08/2019 |
| L37870 |
MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Palmetto GBA |
04/08/2019 |
| L37913 |
MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Wisconsin Physicians Service Insurance Corporation |
04/15/2019 |
| L37921 |
MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Wisconsin Physicians Service Insurance Corporation |
04/15/2019 |
| L37822 |
MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Noridian Healthcare Solutions, LLC |
04/16/2019 |
| L37824 |
MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Noridian Healthcare Solutions, LLC |
04/16/2019 |
| L37859 |
MolDX: myPath® Melanoma Assay-Palmetto GBA |
04/29/2019 |
| L37608 |
MDS FISH-CGS Administrators, LLC |
05/06/2019 |
| L37826 |
Lumbar Artificial Disc Replacement-Palmetto GBA |
05/06/2019 |
| L37848 |
Lumbar Spinal Fusion-Palmetto GBA |
05/06/2019 |
| L37863 |
Voretigene Neparvovec-rzyl (Luxturna®)-Palmetto GBA |
05/06/2019 |
| L37873 |
Topical Oxygen Therapy-Palmetto GBA |
05/06/2019 |
| L37301 |
MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels-Noridian Healthcare Solutions, LLC |
05/13/2019 |
| L37315 |
MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels-Noridian Healthcare Solutions, LLC |
05/13/2019 |
| L37772 |
MDS FISH-Wisconsin Physicians Service Insurance Corporation |
05/13/2019 |
| L37903 |
MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-CGS Administrators, LLC |
05/13/2019 |
| L37919 |
MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Wisconsin Physicians Service Insurance Corporation |
05/13/2019 |
| L37893 |
Endovenous Stenting-Novitas Solutions, Inc. |
05/20/2019 |
| L37905 |
MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-CGS Administrators, LLC |
05/20/2019 |
| L37887 |
MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Noridian Healthcare Solutions, LLC |
05/27/2019 |
| L37891 |
MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Noridian Healthcare Solutions, LLC |
05/27/2019 |
| L37620 |
MDS FISH-Noridian Healthcare Solutions, LLC |
06/03/2019 |
| L37622 |
MDS FISH-Noridian Healthcare Solutions, LLC |
06/03/2019 |
| L37879 |
MolDX: myPath® Melanoma Assay-Noridian Healthcare Solutions, LLC |
06/03/2019 |
| L37881 |
MolDX: myPath® Melanoma Assay-Noridian Healthcare Solutions, LLC |
06/03/2019 |
| L37897 |
MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Noridian Healthcare Solutions, LLC |
06/03/2019 |
| L37899 |
MolDX: Inivata™, InvisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Noridian Healthcare Solutions, LLC |
06/03/2019 |
| L37907 |
MolDX: myPath Melanoma Assay-CGS Administrators, LLC |
06/03/2019 |
| L37923 |
MolDX: myPath® Melanoma Assay-Wisconsin Physicians Service Insurance Corporation |
06/10/2019 |
| L38016 |
MolDX: Melanoma Risk Stratification Molecular Testing-CGS Administrators, LLC |
06/24/2019 |
| L38014 |
Corneal Hysteresis-National Government Services, Inc. |
08/01/2019 |
| L37943 |
Anorectal Manometry and Electromyography (EMG) of the Urinary and Anal Sphincters-First Coast Service Options, Inc. |
08/12/2019 |
| L38018 |
MolDX: Melanoma Risk Stratification Molecular Testing-Wisconsin Physicians Service Insurance Corporation |
08/12/2019 |
| L38211 |
Corneal Hysteresis-Wisconsin Physicians Service Insurance Corporation |
10/14/2019 |
| L38026 |
Corneal Hysteresis-Palmetto GBA |
10/21/2019 |
| L38033 |
Cervical Disc Replacement-Palmetto GBA |
10/28/2019 |
| L38201 |
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-CGS Administrators, LLC |
11/18/2019 |
| L38213 |
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-Wisconsin Physicians Service Insurance Corporation |
12/16/2019 |
| L38223 |
Micro-Invasive Glaucoma Surgery (MIGS)-Novitas Solutions, Inc. |
12/30/2019 |
| L38227 |
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Amplification Techniques (NAATs)-First Coast Service Options, Inc. |
12/30/2019 |
| L38229 |
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Amplification Techniques (NAATs)-Novitas Solutions, Inc. |
12/30/2019 |
| L38231 |
Endovenous Stenting-First Coast Service Options, Inc. |
12/30/2019 |
| L38233 |
Micro-Invasive Glaucoma Surgery (MIGS)-First Coast Service Options, Inc. |
12/30/2019 |
| L38043 |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Palmetto GBA |
02/03/2020 |
| L38158 |
MolDX: Next-Generation Sequencing for Solid Tumors-Wisconsin Physicians Service Insurance Corporation |
02/09/2020 |
| L38176 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Wisconsin Physicians Service Insurance Corporation |
02/09/2020 |
| L38045 |
MolDX: Next-Generation Sequencing for Solid Tumors-Palmetto GBA |
02/10/2020 |
| L38047 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Palmetto GBA |
02/10/2020 |
| L38051 |
MolDX: Pigmented Lesion Assay-Palmetto GBA |
02/10/2020 |
| L38067 |
MolDX: Next-Generation Sequencing for Solid Tumors-CGS Administrators, LLC |
02/10/2020 |
| L38070 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-CGS Administrators, LLC |
02/10/2020 |
| L38168 |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Wisconsin Physicians Service Insurance Corporation |
03/15/2020 |
| L38310 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-Noridian Healthcare Solutions, LLC |
03/15/2020 |
| L38312 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-Noridian Healthcare Solutions, LLC |
03/15/2020 |
| L38385 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-Novitas Solutions, Inc. |
03/15/2020 |
| L38396 |
Cardiology Non-emergent Outpatient Stress Testing-First Coast Service Options, Inc. |
03/15/2020 |
| L38398 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-First Coast Service Options, Inc. |
03/15/2020 |
| L38299 |
Micro-Invasive Glaucoma Surgery (MIGS)-Noridian Healthcare Solutions, LLC |
03/23/2020 |
| L38301 |
Micro-Invasive Glaucoma Surgery (MIGS)-Noridian Healthcare Solutions, LLC |
03/23/2020 |
| L38111 |
MolDX: Pigmented Lesion Assay-CGS Administrators, LLC |
03/30/2020 |
| L38262 |
Salvage High-intensity Focused Ultrasound (HIFU) Treatment in Prostate Cancer (PCa)-National Government Services, Inc. |
04/01/2020 |
| L38268 |
Immune Thrombocytopenia (ITP) Therapy-CGS Administrators, LLC |
04/01/2020 |
| L38307 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-CGS Administrators, LLC |
04/01/2020 |
| L38367 |
Fluid Jet System Treatment for LUTS/BPH-National Government Services, Inc. |
04/01/2020 |
| L38378 |
Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH)-CGS Administrators, LLC |
04/01/2020 |
| L38387 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-National Government Services, Inc. |
04/01/2020 |
| L38178 |
MolDX: Pigmented Lesion Assay-Wisconsin Physicians Service Insurance Corporation |
04/12/2020 |
| L38119 |
MolDX: Next-Generation Sequencing for Solid Tumors-Noridian Healthcare Solutions, LLC |
05/17/2020 |
| L38121 |
MolDX: Next-Generation Sequencing for Solid Tumors-Noridian Healthcare Solutions, LLC |
05/17/2020 |
| L38123 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Noridian Healthcare Solutions, LLC |
05/17/2020 |
| L38125 |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Noridian Healthcare Solutions, LLC |
05/17/2020 |
| L38274 |
MolDX: Repeat Germline Testing-Palmetto GBA |
05/31/2020 |
| L38151 |
MolDX: Pigmented Lesion Assay-Noridian Healthcare Solutions, LLC |
06/07/2020 |
| L38153 |
MolDX: Pigmented Lesion Assay-Noridian Healthcare Solutions, LLC |
06/07/2020 |
| L38288 |
MolDX: Repeat Germline Testing-CGS Administrators, LLC |
06/07/2020 |
| L38238 |
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Palmetto GBA |
06/14/2020 |
| L38429 |
MolDX: Repeat Germline Testing-Wisconsin Physicians Service Insurance Corporation |
06/14/2020 |
| L38443 |
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Wisconsin Physicians Service Insurance Corporation |
06/14/2020 |
| L38528 |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-Wisconsin Physicians Service Insurance Corporation |
06/14/2020 |
| L38276 |
Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea-Palmetto GBA |
06/21/2020 |
| L38371 |
Multimarker Serum Tests Related to Ovarian Cancer Testing-National Government Services, Inc. |
07/01/2020 |
| L38495 |
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor-Novitas Solutions, Inc. |
07/12/2020 |
| L38506 |
Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor-First Coast Service Options, Inc. |
07/12/2020 |
| L38294 |
MolDX: Pharmacogenomics Testing-Palmetto GBA |
07/26/2020 |
| L38435 |
MolDX: Pharmacogenomics Testing-Wisconsin Physicians Service Insurance Corporation |
07/26/2020 |
| L38065 |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors-CGS Administrators, LLC |
07/27/2020 |
| L38284 |
MolDX: Predictive Classifiers for Early Stage Non-small Cell Lung Cancer-CGS Administrators, LLC |
07/27/2020 |
| L38351 |
MolDX: Repeat Germline Testing-Noridian Healthcare Solutions, LLC |
08/03/2020 |
| L38353 |
MolDX: Repeat Germline Testing-Noridian Healthcare Solutions, LLC |
08/03/2020 |
| L38394 |
MolDX: Pharmacogenomics Testing-CGS Administrators, LLC |
08/03/2020 |
| L38335 |
MolDX: Pharmacogenomics Testing-Noridian Healthcare Solutions, LLC |
08/17/2020 |
| L38337 |
MolDX: Pharmacogenomics Testing-Noridian Healthcare Solutions, LLC |
08/17/2020 |
| L38327 |
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Noridian Healthcare Solutions, LLC |
08/24/2020 |
| L38329 |
MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Noridian Healthcare Solutions, LLC |
08/24/2020 |
| L38551 |
Transanal Endoscopic Surgery (TES)-Palmetto GBA |
10/11/2020 |
| L38617 |
Implantable Continuous Glucose Monitors (I-CGM)-Novitas Solutions, Inc. |
10/11/2020 |
| L38664 |
Implantable Continuous Glucose Monitors (I-CGM)-First Coast Service Options, Inc. |
10/11/2020 |
| L38686 |
Implantable Continuous Glucose Monitors (I-CGM)-Wisconsin Physicians Service Insurance Corporation |
10/11/2020 |
| L38240 |
MolDX: Blood Product Molecular Antigen Typing-Palmetto GBA |
10/25/2020 |
| L38441 |
MolDX: Blood Product Molecular Antigen Typing-Wisconsin Physicians Service Insurance Corporation |
10/25/2020 |
| L38249 |
MolDX: Blood Product Molecular Antigen Typing-CGS Administrators, LLC |
11/01/2020 |
| L38667 |
Computed Tomography Cerebral Perfusion Analysis (CTP)-National Government Services, Inc. |
11/01/2020 |
| L38657 |
Implantable Continuous Glucose Monitors (I-CGM)-Noridian Healthcare Solutions, LLC |
11/02/2020 |
| L38659 |
Implantable Continuous Glucose Monitors (I-CGM)-Noridian Healthcare Solutions, LLC |
11/02/2020 |
| L38662 |
Implantable Continuous Glucose Monitors (I-CGM)-CGS Administrators, LLC |
11/02/2020 |
| L38694 |
Computed Tomography Cerebral Perfusion Analysis (CTP)-CGS Administrators, LLC |
11/02/2020 |
| L38292 |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Palmetto GBA |
11/08/2020 |
| L38433 |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Wisconsin Physicians Service Insurance Corporation |
11/08/2020 |
| L38303 |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-CGS Administrators, LLC |
11/09/2020 |
| L38278 |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-Palmetto GBA |
11/22/2020 |
| L38623 |
Implantable Continuous Glucose Monitors (I-CGM)-National Government Services, Inc. |
12/01/2020 |
| L38331 |
MolDX: Blood Product Molecular Antigen Typing-Noridian Healthcare Solutions, LLC |
12/06/2020 |
| L38333 |
MolDX: Blood Product Molecular Antigen Typing-Noridian Healthcare Solutions, LLC |
12/06/2020 |
| L38339 |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Noridian Healthcare Solutions, LLC |
12/06/2020 |
| L38341 |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Noridian Healthcare Solutions, LLC |
12/06/2020 |
| L38355 |
MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts-Noridian Healthcare Solutions, LLC |
12/06/2020 |
| L38380 |
MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts-Noridian Healthcare Solutions, LLC |
12/06/2020 |
| L38700 |
Computed Tomography Cerebral Perfusion Analysis (CTP)-Noridian Healthcare Solutions, LLC |
12/13/2020 |
| L38709 |
Computed Tomography Cerebral Perfusion Analysis (CTP)-Noridian Healthcare Solutions, LLC |
12/13/2020 |
| L38549 |
Transurethral Waterjet Ablation of the Prostate-Palmetto GBA |
12/27/2020 |
| L38682 |
Transurethral Waterjet Ablation of the Prostate-Wisconsin Physicians Service Insurance Corporation |
12/27/2020 |
| L38705 |
Transurethral Waterjet Ablation of the Prostate-Noridian Healthcare Solutions, LLC |
12/27/2020 |
| L38707 |
Transurethral Waterjet Ablation of the Prostate-Noridian Healthcare Solutions, LLC |
12/27/2020 |
| L38712 |
Transurethral Waterjet Ablation of the Prostate-Novitas Solutions, Inc. |
12/27/2020 |
| L38720 |
Treatment of Chronic Venous Insufficiency of the Lower Extremities-First Coast Service Options, Inc. |
12/27/2020 |
| L38726 |
Transurethral Waterjet Ablation of the Prostate-First Coast Service Options, Inc. |
12/27/2020 |
| L38573 |
Percutaneous Arteriovenous Fistula (pAVF) for Hemodialysis-National Government Services, Inc. |
01/18/2021 |
| L38745 |
Platelet Rich Plasma-Palmetto GBA |
02/07/2021 |
| L38769 |
Computed Tomography Cerebral Perfusion Analysis (CTP)-Palmetto GBA |
02/07/2021 |
| L38786 |
Echocardiography for Myocardial Perfusion-Palmetto GBA |
02/07/2021 |
| L38792 |
Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®)-Palmetto GBA |
02/07/2021 |
| L38775 |
Extracorporeal Shock Wave Therapy (ESWT)-Palmetto GBA |
02/14/2021 |
| L38747 |
Peroral Endoscopic Myotomy (POEM)-Palmetto GBA |
02/28/2021 |
| L38809 |
Botulinum Toxins-Novitas Solutions, Inc. |
03/21/2021 |
| L38812 |
Diagnostic Colonoscopy-Novitas Solutions, Inc. |
03/21/2021 |
| L38805 |
Colon Capsule Endoscopy (CCE)-First Coast Service Options, Inc. |
03/28/2021 |
| L38807 |
Colon Capsule Endoscopy (CCE)-Novitas Solutions, Inc. |
03/28/2021 |
| L38824 |
Colon Capsule Endoscopy (CCE)-Noridian Healthcare Solutions, LLC |
03/28/2021 |
| L38826 |
Colon Capsule Endoscopy (CCE)-Noridian Healthcare Solutions, LLC |
03/28/2021 |
| L38837 |
Colon Capsule Endoscopy (CCE)-Wisconsin Physicians Service Insurance Corporation |
03/28/2021 |
| L38777 |
Colon Capsule Endoscopy (CCE)-CGS Administrators, LLC |
03/29/2021 |
| L38755 |
Colon Capsule Endoscopy (CCE)-Palmetto GBA |
04/12/2021 |
| L38571 |
Colon Capsule Endoscopy (CCE)-National Government Services, Inc. |
04/15/2021 |
| L38743 |
Implantable Continuous Glucose Monitors (I-CGM)-Palmetto GBA |
04/18/2021 |
| L38765 |
Facet Joint Interventions for Pain Management-Palmetto GBA |
04/25/2021 |
| L38771 |
Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-CGS Administrators, LLC |
04/25/2021 |
| L38801 |
Facet Joint Interventions for Pain Management-Noridian Healthcare Solutions, LLC |
04/25/2021 |
| L38803 |
Facet Joint Interventions for Pain Management-Noridian Healthcare Solutions, LLC |
04/25/2021 |
| L38839 |
Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-Wisconsin Physicians Service Insurance Corporation |
04/25/2021 |
| L38841 |
Facet Joint Interventions for Pain Management-Wisconsin Physicians Service Insurance Corporation |
04/25/2021 |
| L38613 |
Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-Noridian Healthcare Solutions, LLC |
04/26/2021 |
| L38615 |
Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-Noridian Healthcare Solutions, LLC |
04/26/2021 |
| L38773 |
Facet Joint Interventions for Pain Management-CGS Administrators, LLC |
05/02/2021 |
| L38568 |
MolDX: Molecular Testing for Solid Organ Allograft Rejection-Palmetto GBA |
06/06/2021 |
| L38582 |
MolDX: Molecular Testing for Solid Organ Allograft Rejection-CGS Administrators, LLC |
06/06/2021 |
| L38680 |
MolDx: Molecular Testing for Solid Organ Allograft Rejection-Wisconsin Physicians Service Insurance Corporation |
06/06/2021 |
| L38629 |
MolDX: Molecular Testing for Solid Organ Allograft Rejection-Noridian Healthcare Solutions, LLC |
07/04/2021 |
| L38643 |
MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-Noridian Healthcare Solutions, LLC |
07/04/2021 |
| L38645 |
MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-Noridian Healthcare Solutions, LLC |
07/04/2021 |
| L38671 |
MolDX: Molecular Testing for Solid Organ Allograft Rejection-Noridian Healthcare Solutions, LLC |
07/04/2021 |
| L38914 |
Cosmetic and Reconstructive Surgery-First Coast Service Options, Inc. |
07/11/2021 |
| L38916 |
Respiratory Pathogen Panel Testing-Novitas Solutions, Inc. |
07/11/2021 |
| L38918 |
Respiratory Pathogen Panel Testing-First Coast Service Options, Inc. |
07/11/2021 |
| L38926 |
Cataract Extraction (including Complex Cataract Surgery)-First Coast Service Options, Inc. |
07/11/2021 |
| L38576 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Palmetto GBA |
07/18/2021 |
| L38586 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-CGS Administrators, LLC |
07/18/2021 |
| L38684 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Wisconsin Physicians Service Insurance Corporation |
07/18/2021 |
| L38566 |
MolDX: Phenotypic Biomarker Detection in Circulating Tumor Cells-Palmetto GBA |
07/25/2021 |
| L38584 |
MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-CGS Administrators, LLC |
07/25/2021 |
| L38647 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Noridian Healthcare Solutions, LLC |
07/25/2021 |
| L38649 |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Noridian Healthcare Solutions, LLC |
07/25/2021 |
| L38678 |
MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-Wisconsin Physicians Service Insurance Corporation |
07/25/2021 |
| L38937 |
Platelet Rich Plasma-National Government Services, Inc. |
08/01/2021 |
| L38920 |
Off-label Use of Rituximab and Rituximab Biosimilars-CGS Administrators, LLC |
08/08/2021 |
| L38953 |
Parenteral Nutrition-Noridian Healthcare Solutions, LLC |
09/05/2021 |
| L38955 |
Enteral Nutrition-Noridian Healthcare Solutions, LLC |
09/05/2021 |
| L39051 |
Cosmetic and Reconstructive Surgery-Wisconsin Physicians Service Insurance Corporation |
11/14/2021 |
| L38737 |
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-Palmetto GBA |
11/28/2021 |
| L38902 |
Wound and Ulcer Care-Noridian Healthcare Solutions, LLC |
11/28/2021 |
| L38904 |
Wound and Ulcer Care-Noridian Healthcare Solutions, LLC |
11/28/2021 |
| L38968 |
Thyroid Nodule Molecular Testing-National Government Services, Inc. |
12/01/2021 |
| L39027 |
Respiratory Pathogen Panel Testing-National Government Services, Inc. |
12/01/2021 |
| L38970 |
Advance Care Planning-Palmetto GBA |
12/05/2021 |
| L38994 |
Epidural Steroid Injections for Pain Management-Palmetto GBA |
12/05/2021 |
| L39015 |
Epidural Steroid Injections for Pain Management-CGS Administrators, LLC |
12/05/2021 |
| L39036 |
Epidural Steroid Injections for Pain Management-National Government Services, Inc. |
12/05/2021 |
| L39054 |
Epidural Steroid Injections for Pain Management-Wisconsin Physicians Service Insurance Corporation |
12/05/2021 |
| L39063 |
Pharmacogenomics Testing-Novitas Solutions, Inc. |
12/12/2021 |
| L39068 |
Platelet Rich Plasma-Novitas Solutions, Inc. |
12/12/2021 |
| L39071 |
Platelet Rich Plasma-First Coast Service Options, Inc. |
12/12/2021 |
| L39073 |
Pharmacogenomics Testing-First Coast Service Options, Inc. |
12/12/2021 |
| L39080 |
Cardiac Resynchronization Therapy (CRT)-Palmetto GBA |
12/12/2021 |
| L38779 |
MolDX: Minimal Residual Disease Testing for Cancer-Palmetto GBA |
12/26/2021 |
| L38822 |
MolDX: Minimal Residual Disease Testing for Cancer-CGS Administrators, LLC |
12/26/2021 |
| L38835 |
MolDX: Minimal Residual Disease Testing for Cancer-Wisconsin Physicians Service Insurance Corporation |
12/26/2021 |
| L38814 |
MolDX: Minimal Residual Disease Testing for Cancer-Noridian Healthcare Solutions, LLC |
01/02/2022 |
| L38816 |
MolDX: Minimal Residual Disease Testing for Cancer-Noridian Healthcare Solutions, LLC |
01/02/2022 |
| L39023 |
Platelet Rich Plasma Injections for Non-Wound Injections-CGS Administrators, LLC |
01/03/2022 |
| L39058 |
Platelet Rich Plasma Injections for Non-Wound Injections-Noridian Healthcare Solutions, LLC |
01/23/2022 |
| L39060 |
Platelet Rich Plasma Injections for Non-Wound Injections-Noridian Healthcare Solutions, LLC |
01/23/2022 |
| L38992 |
Electroretinography (ERG)-CGS Administrators, LLC |
01/30/2022 |
| L39082 |
Genetic Testing for Cardiovascular Disease-Novitas Solutions, Inc. |
01/30/2022 |
| L39084 |
Genetic Testing for Cardiovascular Disease-First Coast Service Options, Inc. |
01/30/2022 |
| L39086 |
Treatment of Males with Low Testosterone-Palmetto GBA |
02/13/2022 |
| L39075 |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-National Government Services, Inc. |
04/01/2022 |
| L39121 |
Treatment of Varicose Veins of the Lower Extremities-Palmetto GBA |
04/03/2022 |
| L38988 |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Palmetto GBA |
04/17/2022 |
| L39001 |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Noridian Healthcare Solutions, LLC |
04/17/2022 |
| L39003 |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Noridian Healthcare Solutions, LLC |
04/17/2022 |
| L39038 |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-CGS Administrators, LLC |
04/17/2022 |
| L39044 |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Wisconsin Physicians Service Insurance Corporation |
04/17/2022 |
| L39240 |
Epidural Steroid Injections for Pain Management-Noridian Healthcare Solutions, LLC |
06/19/2022 |
| L39242 |
Epidural Steroid Injections for Pain Management-Noridian Healthcare Solutions, LLC |
06/19/2022 |
| L38966 |
MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer-Palmetto GBA |
07/03/2022 |
| L38985 |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Palmetto GBA |
07/03/2022 |
| L39040 |
MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer-Wisconsin Physicians Service Insurance Corporation |
07/03/2022 |
| L39042 |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Wisconsin Physicians Service Insurance Corporation |
07/03/2022 |
| L38997 |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-CGS Administrators, LLC |
07/17/2022 |
| L39025 |
Minimally Invasive Surgical (MIS) Fusion of the Sacroiliac Joint (SIJ)-Palmetto GBA |
07/17/2022 |
| L39237 |
Erythropoiesis Stimulating Agents-Palmetto GBA |
07/24/2022 |
| L39189 |
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)-National Government Services, Inc. |
08/01/2022 |
| L39226 |
Multiplex Gastrointestinal Pathogen Panel (GPP) Tests for Acute Gastroenteritis (AGE)-National Government Services, Inc. |
08/01/2022 |
| L38972 |
MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer-Noridian Healthcare Solutions, LLC |
08/08/2022 |
| L38974 |
MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer-Noridian Healthcare Solutions, LLC |
08/08/2022 |
| L39005 |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Noridian Healthcare Solutions, LLC |
08/08/2022 |
| L39007 |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Noridian Healthcare Solutions, LLC |
08/08/2022 |
| L39017 |
MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer-CGS Administrators, LLC |
08/21/2022 |
| L39260 |
Hyaluronic Acid Injections for Knee Osteoarthritis-Palmetto GBA |
08/21/2022 |
| L39266 |
Cognitive Assessment and Care Plan Service-Palmetto GBA |
08/28/2022 |
| L39270 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Palmetto GBA |
09/04/2022 |
| L39268 |
Bone Mass Measurement-Palmetto GBA |
09/18/2022 |
| L39297 |
Off-label Use of Rituximab and Rituximab Biosimilars-National Government Services, Inc. |
11/01/2022 |
| L39314 |
Off-Label Use of Intravenous Immune Globulin (IVIG)-National Government Services, Inc. |
11/01/2022 |
| L39284 |
Prostate Cancer Detection with IsoPSA®-CGS Administrators, LLC |
11/20/2022 |
| L39230 |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Noridian Healthcare Solutions, LLC |
12/26/2022 |
| L39232 |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Noridian Healthcare Solutions, LLC |
12/26/2022 |
| L39400 |
Magnesium-Palmetto GBA |
01/22/2023 |
| L39391 |
Vitamin D Assay Testing-Palmetto GBA |
01/29/2023 |
| L39385 |
Near-Infrared Spectroscopy in Wound and Flap Management-Palmetto GBA |
02/12/2023 |
| L39477 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Wisconsin Physicians Service Insurance Corporation |
02/12/2023 |
| L39387 |
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs-Palmetto GBA |
02/19/2023 |
| L39434 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-CGS Administrators, LLC |
02/19/2023 |
| L39258 |
Surgical Treatment of Nails-Palmetto GBA |
03/05/2023 |
| L39396 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Noridian Healthcare Solutions, LLC |
03/05/2023 |
| L39398 |
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin-Noridian Healthcare Solutions, LLC |
03/05/2023 |
| L39420 |
Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain-Palmetto GBA |
03/05/2023 |
