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LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2023
2022

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CMS Transmittals



Important Notice: Change of Address

Future Revised LCD Policy Report for all Medicare Contractors.


Click here for the report of all New Future Effective LCD's.

LCDTitle Revision Effective Date
L34149 Respiratory Care-Noridian Healthcare Solutions, LLC 11/05/2023
L37293 Respiratory Care-Noridian Healthcare Solutions, LLC 11/05/2023
L33829 Pneumatic Compression Devices-Noridian Healthcare Solutions, LLC 10/22/2023
L38378 Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH)-CGS Administrators, LLC 10/22/2023
L36029 Urine Drug Testing-CGS Administrators, LLC 10/15/2023
L38682 Transurethral Waterjet Ablation of the Prostate-Wisconsin Physicians Service Insurance Corporation 10/15/2023
L35724 Urine Drug Testing-Palmetto GBA 10/08/2023
L36668 Urine Drug Testing-Noridian Healthcare Solutions, LLC 10/08/2023
L36707 Urine Drug Testing-Noridian Healthcare Solutions, LLC 10/08/2023
L35041 Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-Novitas Solutions, Inc. 10/01/2023
L36377 Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-First Coast Service Options, Inc. 10/01/2023
L36690 Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers-CGS Administrators, LLC 10/01/2023
L39015 Epidural Steroid Injections for Pain Management-CGS Administrators, LLC 09/21/2023
L38994 Epidural Steroid Injections for Pain Management-Palmetto GBA 09/14/2023
L34084 Transcatheter Infusion Therapy-CGS Administrators, LLC 09/07/2023
L37790 Magnetic Resonance Guided Focused Ultrasound Surgery System (MRgFUS) for the treatment of neurologic conditions-CGS Administrators, LLC 09/07/2023
L38771 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-CGS Administrators, LLC 09/07/2023
L34087 Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based-CGS Administrators, LLC 08/31/2023
L34337 Transesophageal Echocardiography (TEE)-CGS Administrators, LLC 08/31/2023
L34536 Treatment of Varicose Veins of the Lower Extremities-Wisconsin Physicians Service Insurance Corporation 08/31/2023
L34540 Stretta Procedure-CGS Administrators, LLC 08/31/2023
L34588 Trigger Points, Local Injections-Wisconsin Physicians Service Insurance Corporation 08/31/2023
L37001 MolDX: MGMT Promoter Methylation Analysis-Wisconsin Physicians Service Insurance Corporation 08/31/2023
L39051 Cosmetic and Reconstructive Surgery-Wisconsin Physicians Service Insurance Corporation 08/31/2023
L39475 Sacroiliac Joint Injections and Procedures-Wisconsin Physicians Service Insurance Corporation 08/31/2023
L36464 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Palmetto GBA 08/24/2023
L36485 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-CGS Administrators, LLC 08/24/2023
L37003 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Wisconsin Physicians Service Insurance Corporation 08/24/2023
L38294 MolDX: Pharmacogenomics Testing-Palmetto GBA 08/24/2023
L38335 MolDX: Pharmacogenomics Testing-Noridian Healthcare Solutions, LLC 08/24/2023
L38337 MolDX: Pharmacogenomics Testing-Noridian Healthcare Solutions, LLC 08/24/2023
L38394 MolDX: Pharmacogenomics Testing-CGS Administrators, LLC 08/24/2023
L38435 MolDX: Pharmacogenomics Testing-Wisconsin Physicians Service Insurance Corporation 08/24/2023
L37086 Transcranial Magnetic Stimulation (TMS)-Noridian Healthcare Solutions, LLC 08/20/2023
L37088 Transcranial Magnetic Stimulation (TMS)-Noridian Healthcare Solutions, LLC 08/20/2023
L38586 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-CGS Administrators, LLC 08/20/2023
L34417 CT of the Head-Palmetto GBA 08/17/2023
L34578 Surface Electrical Stimulation in the Treatment of Dysphagia-Palmetto GBA 08/17/2023
L38070 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-CGS Administrators, LLC 08/17/2023
L38684 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Wisconsin Physicians Service Insurance Corporation 08/13/2023
L34513 Lab: Flow Cytometry-Palmetto GBA 08/10/2023
L39036 Epidural Steroid Injections for Pain Management-National Government Services, Inc. 08/10/2023
L39455 Sacroiliac Joint Injections and Procedures-National Government Services, Inc. 08/10/2023
L35000 Molecular Pathology Procedures-National Government Services, Inc. 08/06/2023
L38576 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Palmetto GBA 08/06/2023
L38647 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Noridian Healthcare Solutions, LLC 08/06/2023
L38649 MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer-Noridian Healthcare Solutions, LLC 08/06/2023
L33996 Vitamin D Assay Testing-CGS Administrators, LLC 08/03/2023
L34046 Speech-Language Pathology-CGS Administrators, LLC 08/03/2023
L34063 RAST Type Tests-CGS Administrators, LLC 08/03/2023
L34200 Removal of Benign Skin Lesions-CGS Administrators, LLC 08/03/2023
L34246 Routine Foot Care and Debridement of Nails-CGS Administrators, LLC 08/03/2023
L34203 Cataract Surgery in Adults-Noridian Healthcare Solutions, LLC 07/30/2023
L37027 Cataract Surgery in Adults-Noridian Healthcare Solutions, LLC 07/30/2023
L37729 Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor and Tremor Dominant Parkinson's Disease-Noridian Healthcare Solutions, LLC 07/30/2023
L37738 Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor and Tremor Dominant Parkinson's Disease-Noridian Healthcare Solutions, LLC 07/30/2023
L34433 Somatosensory Testing-Palmetto GBA 07/27/2023
L34526 Surgical Treatment of Obstructive Sleep Apnea (OSA)-Wisconsin Physicians Service Insurance Corporation 07/27/2023
L35073 MolDX: NRAS Genetic Testing-Palmetto GBA 07/27/2023
L35442 MolDX: NRAS Genetic Testing-CGS Administrators, LLC 07/27/2023
L36761 GlycoMark® Testing for Glycemic Control-Palmetto GBA 07/27/2023
L36797 MolDX: NRAS Genetic Testing-Wisconsin Physicians Service Insurance Corporation 07/27/2023
L36839 Polysomnography and Other Sleep Studies-Wisconsin Physicians Service Insurance Corporation 07/27/2023
L38211 Corneal Hysteresis-Wisconsin Physicians Service Insurance Corporation 07/27/2023
L38568 MolDX: Molecular Testing for Solid Organ Allograft Rejection-Palmetto GBA 07/27/2023
L38582 MolDX: Molecular Testing for Solid Organ Allograft Rejection-CGS Administrators, LLC 07/27/2023
L38680 MolDx: Molecular Testing for Solid Organ Allograft Rejection-Wisconsin Physicians Service Insurance Corporation 07/27/2023
L38985 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Palmetto GBA 07/27/2023
L38997 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-CGS Administrators, LLC 07/27/2023
L39005 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Noridian Healthcare Solutions, LLC 07/27/2023
L39007 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Noridian Healthcare Solutions, LLC 07/27/2023
L39042 MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer-Wisconsin Physicians Service Insurance Corporation 07/27/2023
L39391 Vitamin D Assay Testing-Palmetto GBA 07/27/2023
L35984 MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-CGS Administrators, LLC 07/20/2023
L36089 MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Palmetto GBA 07/20/2023
L36113 MolDX: MGMT Promoter Methylation Analysis-CGS Administrators, LLC 07/20/2023
L36155 MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Noridian Healthcare Solutions, LLC 07/20/2023
L36159 MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Noridian Healthcare Solutions, LLC 07/20/2023
L36400 MolDX: Genetic Testing for Hypercoagulability/Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)-Wisconsin Physicians Service Insurance Corporation 07/20/2023
L38238 MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Palmetto GBA 07/20/2023
L38327 MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Noridian Healthcare Solutions, LLC 07/20/2023
L38329 MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Noridian Healthcare Solutions, LLC 07/20/2023
L38443 MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer-Wisconsin Physicians Service Insurance Corporation 07/20/2023
L38737 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-Palmetto GBA 07/20/2023
L36186 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Noridian Healthcare Solutions, LLC 07/16/2023
L37602 MDS FISH-Palmetto GBA 07/13/2023
L33942 Physical Therapy - Home Health-CGS Administrators, LLC 07/06/2023
L34422 Infrared Coagulation (IRC) of Hemorrhoids-Palmetto GBA 07/06/2023
L34538 Hospice Determining Terminal Status-CGS Administrators, LLC 07/06/2023
L36044 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Palmetto GBA 07/06/2023
L36117 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-CGS Administrators, LLC 07/06/2023
L36180 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Noridian Healthcare Solutions, LLC 07/06/2023
L36815 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease-Wisconsin Physicians Service Insurance Corporation 07/06/2023
L33796 Osteogenesis Stimulators-Noridian Healthcare Solutions, LLC 07/02/2023
L33801 Seat Lift Mechanisms-Noridian Healthcare Solutions, LLC 07/02/2023
L38953 Parenteral Nutrition-Noridian Healthcare Solutions, LLC 07/02/2023
L38955 Enteral Nutrition-Noridian Healthcare Solutions, LLC 07/02/2023
L33610 Intravenous Immune Globulin-Noridian Healthcare Solutions, LLC 07/01/2023
L33794 External Infusion Pumps-Noridian Healthcare Solutions, LLC 07/01/2023
L34615 Visual Fields-Wisconsin Physicians Service Insurance Corporation 06/29/2023
L34760 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-Wisconsin Physicians Service Insurance Corporation 06/29/2023
L35986 Special Histochemical Stains and Immunohistochemical Stains-CGS Administrators, LLC 06/29/2023
L37857 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Palmetto GBA 06/29/2023
L37887 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Noridian Healthcare Solutions, LLC 06/29/2023
L37891 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Noridian Healthcare Solutions, LLC 06/29/2023
L37919 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-Wisconsin Physicians Service Insurance Corporation 06/29/2023
L38920 Off-label Use of Rituximab and Rituximab Biosimilars-CGS Administrators, LLC 06/29/2023
L33456 Total Joint Arthroplasty-Palmetto GBA 06/15/2023
L34575 Frequency of Hemodialysis-Palmetto GBA 06/15/2023
L37903 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-CGS Administrators, LLC 06/15/2023
L38045 MolDX: Next-Generation Sequencing for Solid Tumors-Palmetto GBA 06/08/2023
L38067 MolDX: Next-Generation Sequencing for Solid Tumors-CGS Administrators, LLC 06/08/2023
L38119 MolDX: Next-Generation Sequencing for Solid Tumors-Noridian Healthcare Solutions, LLC 06/08/2023
L38121 MolDX: Next-Generation Sequencing for Solid Tumors-Noridian Healthcare Solutions, LLC 06/08/2023
L38158 MolDX: Next-Generation Sequencing for Solid Tumors-Wisconsin Physicians Service Insurance Corporation 06/08/2023
L34594 Nerve Conduction Studies and Electromyography-Wisconsin Physicians Service Insurance Corporation 06/01/2023
L34633 Erythropoiesis Stimulating Agents (ESAs)-Wisconsin Physicians Service Insurance Corporation 06/01/2023
L37772 MDS FISH-Wisconsin Physicians Service Insurance Corporation 06/01/2023
L38176 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Wisconsin Physicians Service Insurance Corporation 06/01/2023
L34338 Transthoracic Echocardiography (TTE)-CGS Administrators, LLC 05/28/2023
L34049 Outpatient Physical and Occupational Therapy Services-CGS Administrators, LLC 05/25/2023
L34171 Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation-CGS Administrators, LLC 05/25/2023
L34181 Ophthalmic Biometry for Intraocular Lens Power Calculation-CGS Administrators, LLC 05/25/2023
L34353 Outpatient Psychiatry and Psychology Services-CGS Administrators, LLC 05/25/2023
L34399 Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)-CGS Administrators, LLC 05/25/2023
L34428 Outpatient Physical Therapy-Palmetto GBA 05/18/2023
L34580 Intravenous Immunoglobulin (IVIG)-Palmetto GBA 05/18/2023
L37130 MolDX: DecisionDx-UM (Uveal Melanoma)-CGS Administrators, LLC 05/18/2023
L38016 MolDX: Melanoma Risk Stratification Molecular Testing-CGS Administrators, LLC 05/18/2023
L38765 Facet Joint Interventions for Pain Management-Palmetto GBA 05/18/2023
L33789 Power Mobility Devices-Noridian Healthcare Solutions, LLC 05/16/2023
L33792 Wheelchair Options/Accessories-Noridian Healthcare Solutions, LLC 05/16/2023
L33467 Ophthalmology: Extended Ophthalmoscopy and Fundus Photography-Palmetto GBA 05/11/2023
L34563 Home Health Speech-Language Pathology-Palmetto GBA 05/11/2023
L35025 MolDX: Molecular Diagnostic Tests (MDT)-Palmetto GBA 05/04/2023
L35160 MolDX: Molecular Diagnostic Tests (MDT)-Noridian Healthcare Solutions, LLC 05/04/2023
L36021 MolDX: Molecular Diagnostic Tests (MDT)-CGS Administrators, LLC 05/04/2023
L36256 MolDX: Molecular Diagnostic Tests (MDT)-Noridian Healthcare Solutions, LLC 05/04/2023
L37873 Topical Oxygen Therapy-Palmetto GBA 05/04/2023
L39038 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-CGS Administrators, LLC 05/04/2023
L34195 Mohs Micrographic Surgery-CGS Administrators, LLC 04/27/2023
L34393 Ocular Photography - External-CGS Administrators, LLC 04/27/2023
L34564 Home Health Physical Therapy-Palmetto GBA 04/27/2023
L35249 Nerve Blocks for Peripheral Neuropathy-CGS Administrators, LLC 04/27/2023
L35490 Category III Codes-Wisconsin Physicians Service Insurance Corporation 04/27/2023
L35897 Nerve Conduction Studies and Electromyography-CGS Administrators, LLC 04/27/2023
L36807 MolDX: Molecular Diagnostic Tests (MDT)-Wisconsin Physicians Service Insurance Corporation 04/27/2023
L37228 Wound Care-Wisconsin Physicians Service Insurance Corporation 04/27/2023
L37356 MolDX: EndoPredict Breast Cancer Gene Expression Test-CGS Administrators, LLC 04/27/2023
L37663 MolDX: EndoPredict® Breast Cancer Gene Expression Test-Wisconsin Physicians Service Insurance Corporation 04/27/2023
L38033 Cervical Disc Replacement-Palmetto GBA 04/27/2023
L38249 MolDX: Blood Product Molecular Antigen Typing-CGS Administrators, LLC 04/27/2023
L38584 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-CGS Administrators, LLC 04/27/2023
L37863 Voretigene Neparvovec-rzyl (Luxturna®)-Palmetto GBA 04/20/2023
L33822 Glucose Monitors-Noridian Healthcare Solutions, LLC 04/16/2023
L34427 Outpatient Occupational Therapy-Palmetto GBA 04/13/2023
L38276 Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea-Palmetto GBA 04/13/2023
L33423 Cardiac Computed Tomography & Angiography (CCTA)-Palmetto GBA 04/06/2023
L33398 Transcranial Magnetic Stimulation-National Government Services, Inc. 04/01/2023
L33612 Suction Pumps-Noridian Healthcare Solutions, LLC 04/01/2023
L33797 Oxygen and Oxygen Equipment-Noridian Healthcare Solutions, LLC 04/01/2023
L33803 Urological Supplies-Noridian Healthcare Solutions, LLC 04/01/2023
L37808 Water Vapor Thermal Therapy for LUTS/BPH-National Government Services, Inc. 04/01/2023
L39075 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-National Government Services, Inc. 04/01/2023
L36523 MolDX: Biomarkers in Cardiovascular Risk Assessment-Wisconsin Physicians Service Insurance Corporation 03/30/2023
L36811 MolDX: Breast Cancer Assay: Prosigna®-Wisconsin Physicians Service Insurance Corporation 03/30/2023
L37216 BDX-XL2-Wisconsin Physicians Service Insurance Corporation 03/30/2023
L38841 Facet Joint Interventions for Pain Management-Wisconsin Physicians Service Insurance Corporation 03/30/2023
L39017 MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer-CGS Administrators, LLC 03/30/2023
L35906 Somatosensory Testing-CGS Administrators, LLC 03/24/2023
L33457 Cardiac Radionuclide Imaging-Palmetto GBA 03/23/2023
L34090 Laser Ablation of the Prostate-CGS Administrators, LLC 03/23/2023
L35891 Intravenous Immune Globulin-CGS Administrators, LLC 03/23/2023
L37578 Micro-Invasive Glaucoma Surgery (MIGS)-CGS Administrators, LLC 03/23/2023
L38745 Platelet Rich Plasma-Palmetto GBA 03/23/2023
L33622 Pain Management-National Government Services, Inc. 03/19/2023
L33447 Special Electroencephalography-Palmetto GBA 03/16/2023
L36593 Polysomnography-Palmetto GBA 03/16/2023
L38769 Computed Tomography Cerebral Perfusion Analysis (CTP)-Palmetto GBA 03/16/2023
L34037 Flow Cytometry-CGS Administrators, LLC 03/02/2023
L34064 Panretinal (Scatter) Laser Photocoagulation-CGS Administrators, LLC 03/02/2023
L34081 Endoscopy by Capsule-CGS Administrators, LLC 03/02/2023
L34085 Post-Void Residual Urine and/or Bladder Capacity by Ultrasound-CGS Administrators, LLC 03/02/2023
L34183 Psychiatric Inpatient Hospitalization-CGS Administrators, LLC 03/02/2023
L34196 Psychiatric Partial Hospitalization Programs-CGS Administrators, LLC 03/02/2023
L34356 Erythropoiesis Stimulating Agents (ESA)-CGS Administrators, LLC 03/02/2023
L34539 Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians-CGS Administrators, LLC 03/02/2023
L36139 MolDX: Biomarkers in Cardiovascular Risk Assessment-CGS Administrators, LLC 03/02/2023
L36425 MolDX: Breast Cancer Assay: Prosigna®-CGS Administrators, LLC 03/02/2023
L38268 Immune Thrombocytopenia (ITP) Therapy-CGS Administrators, LLC 03/02/2023
L38307 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-CGS Administrators, LLC 03/02/2023
L37733 Biomarker Testing for Prostate Cancer Diagnosis-National Government Services, Inc. 03/01/2023
L37913 MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Wisconsin Physicians Service Insurance Corporation 02/23/2023
L38837 Colon Capsule Endoscopy (CCE)-Wisconsin Physicians Service Insurance Corporation 02/23/2023
L34541 Transtelephonic Spirometry-CGS Administrators, LLC 02/19/2023
L34062 Dialysis Access Maintenance-CGS Administrators, LLC 02/09/2023
L34007 Immune Globulin-First Coast Service Options, Inc. 02/05/2023
L35093 Immune Globulin-Novitas Solutions, Inc. 02/05/2023
L37176 White Cell Colony Stimulating Factors-Palmetto GBA 02/05/2023
L37364 Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs)-CGS Administrators, LLC 02/02/2023
L38549 Transurethral Waterjet Ablation of the Prostate-Palmetto GBA 01/29/2023
L33945 Cerumen (Earwax) Removal-CGS Administrators, LLC 01/26/2023
L33960 Cardiovascular Nuclear Medicine-CGS Administrators, LLC 01/26/2023
L33999 Corneal Pachymetry-CGS Administrators, LLC 01/26/2023
L34005 Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy-CGS Administrators, LLC 01/26/2023
L34008 Computerized Corneal Topography-CGS Administrators, LLC 01/26/2023
L36902 Polysomnography and Other Sleep Studies-CGS Administrators, LLC 01/26/2023
L36975 Bladder/Urothelial Tumor Markers-CGS Administrators, LLC 01/26/2023
L37126 Coenzyme Q10 (CoQ10)-CGS Administrators, LLC 01/26/2023
L37254 Chiropractic Services-CGS Administrators, LLC 01/26/2023
L37575 Frequency of Hemodialysis-CGS Administrators, LLC 01/26/2023
L38992 Electroretinography (ERG)-CGS Administrators, LLC 01/12/2023
L33954 Cataract Extraction-CGS Administrators, LLC 01/05/2023
L36460 Bone Mass Measurement-CGS Administrators, LLC 01/05/2023
L36469 Transcranial Magnetic Stimulation (TMS)-CGS Administrators, LLC 01/05/2023
L36494 Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint-CGS Administrators, LLC 01/05/2023
L33370 Nebulizers-Noridian Healthcare Solutions, LLC 01/01/2023
L33626 Psychiatric Partial Hospitalization Programs-National Government Services, Inc. 01/01/2023
L35998 Non-Coronary Vascular Stents-Wisconsin Physicians Service Insurance Corporation 01/01/2023
L37539 MolDX: Prometheus IBD sgi Diagnostic® Policy-Wisconsin Physicians Service Insurance Corporation 12/29/2022
L38303 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-CGS Administrators, LLC 12/29/2022
L35922 Lab: Special Histochemical Stains and Immunohistochemical Stains-Palmetto GBA 12/15/2022
L34522 Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder-First Coast Service Options, Inc. 12/11/2022
L34998 Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder-Novitas Solutions, Inc. 12/11/2022
L36234 Special Histochemical Stains & Immunohistochemical Stains-First Coast Service Options, Inc. 12/11/2022
L34429 Outpatient Speech Language Pathology-Palmetto GBA 12/08/2022
L33943 B-type Natriuretic Peptide (BNP) Testing-CGS Administrators, LLC 12/01/2022
L33949 Botulinum Toxins-CGS Administrators, LLC 12/01/2022
L33950 Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography-CGS Administrators, LLC 12/01/2022
L33952 Cardiac Event Detection-CGS Administrators, LLC 12/01/2022
L34771 Immune Globulins-Wisconsin Physicians Service Insurance Corporation 12/01/2022
L35494 Mohs Micrographic Surgery-Wisconsin Physicians Service Insurance Corporation 12/01/2022
L36675 ProMark® Risk Score-CGS Administrators, LLC 11/24/2022
L38288 MolDX: Repeat Germline Testing-CGS Administrators, LLC 11/24/2022
L37352 MolDX: Prometheus IBD sgi Diagnostic® Policy-CGS Administrators, LLC 11/17/2022
L33394 Drugs and Biologicals, Coverage of, for Label and Off-Label Uses-National Government Services, Inc. 11/01/2022
L32553 Allergy Immunotherapy-CGS Administrators, LLC 10/27/2022
L33944 Blepharoplasty-CGS Administrators, LLC 10/27/2022
L33946 Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy-CGS Administrators, LLC 10/27/2022
L33959 Cardiac Catheterization and Coronary Angiography-CGS Administrators, LLC 10/27/2022
L34045 Non-Invasive Vascular Studies-CGS Administrators, LLC 10/27/2022
L38284 MolDX: Predictive Classifiers for Early Stage Non-small Cell Lung Cancer-CGS Administrators, LLC 10/20/2022
L34641 Transcranial Magnetic Stimulation (TMS)-Wisconsin Physicians Service Insurance Corporation 10/17/2022
L37013 4Kscore® Assay-Wisconsin Physicians Service Insurance Corporation 10/17/2022
L37770 MolDX: CORUS® CAD ASSAY-Wisconsin Physicians Service Insurance Corporation 10/17/2022
L38227 Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Amplification Techniques (NAATs)-First Coast Service Options, Inc. 10/16/2022
L38229 Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Amplification Techniques (NAATs)-Novitas Solutions, Inc. 10/16/2022
L38065 MolDX: Plasma-Based Genomic Profiling in Solid Tumors-CGS Administrators, LLC 10/13/2022
L38623 Implantable Continuous Glucose Monitors (I-CGM)-National Government Services, Inc. 10/13/2022
L33947 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)-CGS Administrators, LLC 10/06/2022
L34032 Debridement Services-CGS Administrators, LLC 10/06/2022
L34055 Virtual Colonoscopy (CT Colonography)-CGS Administrators, LLC 10/06/2022
L34056 Urodynamics-CGS Administrators, LLC 10/06/2022
L34082 Varicose Veins of the Lower Extremity, Treatment of-CGS Administrators, LLC 10/06/2022
L34394 Visual Fields Testing-CGS Administrators, LLC 10/06/2022
L36658 Proton Beam Therapy-CGS Administrators, LLC 10/06/2022
L36908 MolDX: Percepta® Bronchial Genomic Classifier-CGS Administrators, LLC 10/06/2022
L36951 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-CGS Administrators, LLC 10/06/2022
L38111 MolDX: Pigmented Lesion Assay-CGS Administrators, LLC 10/06/2022
L38201 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-CGS Administrators, LLC 10/06/2022
L38822 MolDX: Minimal Residual Disease Testing for Cancer-CGS Administrators, LLC 10/06/2022
L33785 High Frequency Chest Wall Oscillation Devices-Noridian Healthcare Solutions, LLC 10/01/2022
L34614 Colonoscopy and Sigmoidoscopy-Diagnostic-Wisconsin Physicians Service Insurance Corporation 10/01/2022
L34616 Psychiatry and Psychology Services-Wisconsin Physicians Service Insurance Corporation 10/01/2022
L36402 Allergy Testing-Wisconsin Physicians Service Insurance Corporation 10/01/2022
L34646 Psychological and Neuropsychological Testing-Wisconsin Physicians Service Insurance Corporation 09/29/2022
L34659 Endoscopic Treatment of GERD-Wisconsin Physicians Service Insurance Corporation 09/29/2022
L36805 Lab: Special Histochemical Stains and Immunohistochemical Stains-Wisconsin Physicians Service Insurance Corporation 09/29/2022
L37832 MolDX: Breast Cancer Index® (BCI) Gene Expression Test-CGS Administrators, LLC 09/22/2022
L38613 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-Noridian Healthcare Solutions, LLC 09/18/2022
L38615 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-Noridian Healthcare Solutions, LLC 09/18/2022
L34576 Laparoscopic Sleeve Gastrectomy for Severe Obesity-Palmetto GBA 09/08/2022
L35456 Nerve Blockade for Treatment of Chronic Pain and Neuropathy-Noridian Healthcare Solutions, LLC 09/04/2022
L35457 Nerve Blockade for Treatment of Chronic Pain and Neuropathy-Noridian Healthcare Solutions, LLC 09/04/2022
L35010 Trigger Point Injections-Novitas Solutions, Inc. 09/01/2022
L38213 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-Wisconsin Physicians Service Insurance Corporation 09/01/2022
L34415 CT of the Abdomen and Pelvis-Palmetto GBA 08/28/2022
L33636 Routine Foot Care and Debridement of Nails-National Government Services, Inc. 08/18/2022
L34220 Lumbar MRI-Noridian Healthcare Solutions, LLC 08/18/2022
L37281 Lumbar MRI-Noridian Healthcare Solutions, LLC 08/18/2022
L34434 Upper Gastrointestinal Endoscopy and Visualization-Palmetto GBA 08/14/2022
L38278 Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease-Palmetto GBA 08/14/2022
L38839 Non-Invasive Fractional Flow Reserve (FFR) for Ischemic Heart Disease-Wisconsin Physicians Service Insurance Corporation 08/14/2022
L37748 MolDX: Melanoma Risk Stratification Molecular Testing-Noridian Healthcare Solutions, LLC 08/08/2022
L37750 MolDX: Melanoma Risk Stratification Molecular Testing-Noridian Healthcare Solutions, LLC 08/08/2022
L34061 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-CGS Administrators, LLC 08/04/2022
L34623 Intraoperative Neurophysiological Testing-Wisconsin Physicians Service Insurance Corporation 07/28/2022
L37537 Frequency of Hemodialysis-Wisconsin Physicians Service Insurance Corporation 07/28/2022
L39023 Platelet Rich Plasma Injections for Non-Wound Injections-CGS Administrators, LLC 07/21/2022
L37907 MolDX: myPath Melanoma Assay-CGS Administrators, LLC 07/14/2022
L37725 MolDX: Melanoma Risk Stratification Molecular Testing-Palmetto GBA 07/03/2022
L38018 MolDX: Melanoma Risk Stratification Molecular Testing-Wisconsin Physicians Service Insurance Corporation 07/03/2022
L39040 MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer-Wisconsin Physicians Service Insurance Corporation 07/03/2022
L36000 Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain-Wisconsin Physicians Service Insurance Corporation 06/30/2022
L37033 MolDX: DecisionDx-UM (Uveal Melanoma)-Palmetto GBA 06/30/2022
L37070 MolDX: DecisionDx-UM (Uveal Melanoma)-Noridian Healthcare Solutions, LLC 06/30/2022
L37072 MolDX: DecisionDx-UM (Uveal Melanoma)-Noridian Healthcare Solutions, LLC 06/30/2022
L37210 MolDX: Decision Dx-UM (Uveal Melanoma)-Wisconsin Physicians Service Insurance Corporation 06/30/2022
L37608 MDS FISH-CGS Administrators, LLC 06/30/2022
L37620 MDS FISH-Noridian Healthcare Solutions, LLC 06/30/2022
L37622 MDS FISH-Noridian Healthcare Solutions, LLC 06/30/2022
L39054 Epidural Steroid Injections for Pain Management-Wisconsin Physicians Service Insurance Corporation 06/30/2022
L37531 Micro-Invasive Glaucoma Surgery (MIGS)-Palmetto GBA 06/23/2022
L37641 Continuous Peripheral Nerve Blocks (CPNB)-Palmetto GBA 06/23/2022
L34512 Corneal Pachymetry-Palmetto GBA 06/09/2022
L34560 Home Health Occupational Therapy-Palmetto GBA 06/09/2022
L34869 Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults-Palmetto GBA 06/09/2022
L37581 Lab: Cystatin C Measurement-Palmetto GBA 06/09/2022
L37598 Cystatin C Measurement-CGS Administrators, LLC 06/09/2022
L37616 Lab: Cystatin C Measurement-Noridian Healthcare Solutions, LLC 06/09/2022
L37618 Lab: Cystatin C Measurement-Noridian Healthcare Solutions, LLC 06/09/2022
L38988 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Palmetto GBA 06/09/2022
L38566 MolDX: Phenotypic Biomarker Detection in Circulating Tumor Cells-Palmetto GBA 06/02/2022
L38643 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-Noridian Healthcare Solutions, LLC 06/02/2022
L38645 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-Noridian Healthcare Solutions, LLC 06/02/2022
L39001 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Noridian Healthcare Solutions, LLC 06/02/2022
L39003 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Noridian Healthcare Solutions, LLC 06/02/2022
L34413 Cataract Surgery-Palmetto GBA 05/26/2022
L37015 Visual Electrophysiology Testing-Wisconsin Physicians Service Insurance Corporation 05/26/2022
L37205 Chemotherapy Drugs and their Adjuncts-Wisconsin Physicians Service Insurance Corporation 05/26/2022
L38240 MolDX: Blood Product Molecular Antigen Typing-Palmetto GBA 05/26/2022
L38331 MolDX: Blood Product Molecular Antigen Typing-Noridian Healthcare Solutions, LLC 05/26/2022
L38333 MolDX: Blood Product Molecular Antigen Typing-Noridian Healthcare Solutions, LLC 05/26/2022
L38441 MolDX: Blood Product Molecular Antigen Typing-Wisconsin Physicians Service Insurance Corporation 05/26/2022
L38551 Transanal Endoscopic Surgery (TES)-Palmetto GBA 05/26/2022
L38678 MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells-Wisconsin Physicians Service Insurance Corporation 05/26/2022
L38743 Implantable Continuous Glucose Monitors (I-CGM)-Palmetto GBA 05/26/2022
L38792 Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®)-Palmetto GBA 05/26/2022
L37905 MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test-CGS Administrators, LLC 05/19/2022
L34551 One Day Stays for Chest Pain-Palmetto GBA 05/05/2022
L38662 Implantable Continuous Glucose Monitors (I-CGM)-CGS Administrators, LLC 05/05/2022
L39086 Treatment of Males with Low Testosterone-Palmetto GBA 05/05/2022
L34528 Blepharoplasty, Blepharoptosis and Brow Lift-Wisconsin Physicians Service Insurance Corporation 04/28/2022
L37031 BDX-XL2-Palmetto GBA 04/28/2022
L37054 BDX-XL2-Noridian Healthcare Solutions, LLC 04/28/2022
L37062 BDX-XL2-Noridian Healthcare Solutions, LLC 04/28/2022
L38528 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-Wisconsin Physicians Service Insurance Corporation 04/28/2022
L36006 MolDX: ConfirmMDx Epigenetic Molecular Assay-CGS Administrators, LLC 04/21/2022
L37421 Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor-National Government Services, Inc. 04/21/2022
L38617 Implantable Continuous Glucose Monitors (I-CGM)-Novitas Solutions, Inc. 04/21/2022
L38664 Implantable Continuous Glucose Monitors (I-CGM)-First Coast Service Options, Inc. 04/21/2022
L39044 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing-Wisconsin Physicians Service Insurance Corporation 04/17/2022
L39121 Treatment of Varicose Veins of the Lower Extremities-Palmetto GBA 04/03/2022
L33559 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)-National Government Services, Inc. 04/01/2022
L37810 Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms-National Government Services, Inc. 04/01/2022
L36763 4Kscore® Assay-Palmetto GBA 03/24/2022
L38026 Corneal Hysteresis-Palmetto GBA 03/17/2022
L38773 Facet Joint Interventions for Pain Management-CGS Administrators, LLC 03/17/2022
L33431 HbA1c-Palmetto GBA 03/10/2022
L37644 YAG Capsulotomy-Palmetto GBA 03/10/2022
L35036 Therapy and Rehabilitation Services (PT, OT)-Novitas Solutions, Inc. 03/09/2022
L36906 GlycoMark® Testing for Glycemic Control-CGS Administrators, LLC 03/02/2022
L38686 Implantable Continuous Glucose Monitors (I-CGM)-Wisconsin Physicians Service Insurance Corporation 02/28/2022
L37011 ProMark® Risk Score-Wisconsin Physicians Service Insurance Corporation 02/24/2022
L38571 Colon Capsule Endoscopy (CCE)-National Government Services, Inc. 02/15/2022
L35080 Select Minimally Invasive GERD Procedures-National Government Services, Inc. 02/10/2022
L35936 Facet Joint Interventions for Pain Management-National Government Services, Inc. 02/10/2022
L37851 Biomarker Testing for Neuroendocrine Tumors/Neoplasms-National Government Services, Inc. 02/10/2022
L38937 Platelet Rich Plasma-National Government Services, Inc. 02/10/2022
L38292 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Palmetto GBA 02/03/2022
L38339 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Noridian Healthcare Solutions, LLC 02/03/2022
L38341 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Noridian Healthcare Solutions, LLC 02/03/2022
L38801 Facet Joint Interventions for Pain Management-Noridian Healthcare Solutions, LLC 02/03/2022
L38803 Facet Joint Interventions for Pain Management-Noridian Healthcare Solutions, LLC 02/03/2022
L33833 Surgical Treatment of Nails-First Coast Service Options, Inc. 01/30/2022
L34887 Surgical Treatment of Nails-Novitas Solutions, Inc. 01/30/2022
L38777 Colon Capsule Endoscopy (CCE)-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
L35751 Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies-Wisconsin Physicians Service Insurance Corporation 01/27/2022
L38433 MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease-Wisconsin Physicians Service Insurance Corporation 01/27/2022
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
L33828 Ostomy Supplies-Noridian Healthcare Solutions, LLC 01/01/2022
L34761 Percutaneous Coronary Interventions-Wisconsin Physicians Service Insurance Corporation 12/30/2021
L35222 Nerve Blocks for Peripheral Neuropathy-Wisconsin Physicians Service Insurance Corporation 12/30/2021
L36665 ProMark® Risk Score-Palmetto GBA 12/30/2021
L36704 ProMark® Risk Score-Noridian Healthcare Solutions, LLC 12/30/2021
L36706 ProMark® Risk Score-Noridian Healthcare Solutions, LLC 12/30/2021
L37923 MolDX: myPath® Melanoma Assay-Wisconsin Physicians Service Insurance Corporation 12/30/2021
L38043 MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Palmetto GBA 12/30/2021
L38168 MolDX: Plasma-Based Genomic Profiling in Solid Tumors-Wisconsin Physicians Service Insurance Corporation 12/30/2021
L38178 MolDX: Pigmented Lesion Assay-Wisconsin Physicians Service Insurance Corporation 12/30/2021
L38274 MolDX: Repeat Germline Testing-Palmetto GBA 12/30/2021
L38351 MolDX: Repeat Germline Testing-Noridian Healthcare Solutions, LLC 12/30/2021
L38353 MolDX: Repeat Germline Testing-Noridian Healthcare Solutions, LLC 12/30/2021
L38429 MolDX: Repeat Germline Testing-Wisconsin Physicians Service Insurance Corporation 12/30/2021
L38835 MolDX: Minimal Residual Disease Testing for Cancer-Wisconsin Physicians Service Insurance Corporation 12/26/2021
L38051 MolDX: Pigmented Lesion Assay-Palmetto GBA 12/23/2021
L38824 Colon Capsule Endoscopy (CCE)-Noridian Healthcare Solutions, LLC 12/19/2021
L38826 Colon Capsule Endoscopy (CCE)-Noridian Healthcare Solutions, LLC 12/19/2021
L33906 Epidural Steroid Injections for Pain Management-First Coast Service Options, Inc. 12/12/2021
L34518 Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing-First Coast Service Options, Inc. 12/12/2021
L34519 Molecular Pathology Procedures-First Coast Service Options, Inc. 12/12/2021
L35062 Biomarkers Overview-Novitas Solutions, Inc. 12/12/2021
L36920 Epidural Steroid Injections for Pain Management-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
L36912 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Palmetto GBA 11/25/2021
L36941 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Noridian Healthcare Solutions, LLC 11/25/2021
L36947 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Noridian Healthcare Solutions, LLC 11/25/2021
L33802 Transcutaneous Electrical Nerve Stimulators (TENS)-Noridian Healthcare Solutions, LLC 11/20/2021
L34635 Botulinum Toxin Type A & Type B-Wisconsin Physicians Service Insurance Corporation 11/14/2021
L34022 Serum Phosphorus-First Coast Service Options, Inc. 11/11/2021
L34558 Hospice The Adult Failure To Thrive Syndrome-Palmetto GBA 11/11/2021
L34567 Hospice Alzheimer's Disease & Related Disorders-Palmetto GBA 11/11/2021
L34548 Hospice Cardiopulmonary Conditions-Palmetto GBA 11/04/2021
L34566 Hospice - HIV Disease-Palmetto GBA 11/04/2021
L37859 MolDX: myPath® Melanoma Assay-Palmetto GBA 11/04/2021
L37879 MolDX: myPath® Melanoma Assay-Noridian Healthcare Solutions, LLC 11/04/2021
L37881 MolDX: myPath® Melanoma Assay-Noridian Healthcare Solutions, LLC 11/04/2021
L34624 Somatosensory Testing-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L34636 Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L35121 Coronary Computed Tomography Angiography (CCTA)-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L35124 Autonomic Function Testing-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L35486 Pelvic Floor Dysfunction: Anorectal Manometry and EMG-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L35498 Removal of Benign Skin Lesions-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L35755 Non-Invasive Abdominal / Visceral Vascular Studies-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L36427 Wireless Capsule Endoscopy-Palmetto GBA 10/28/2021
L37195 MolDX: Percepta® Bronchial Genomic Classifier-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L37199 MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)-Wisconsin Physicians Service Insurance Corporation 10/28/2021
L37794 MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Palmetto GBA 10/28/2021
L37822 MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Noridian Healthcare Solutions, LLC 10/28/2021
L37824 MolDX: Breast Cancer Index® (BCI) Gene Expression Test-Noridian Healthcare Solutions, LLC 10/28/2021
L35974 MolDX: MGMT Promoter Methylation Analysis-Palmetto GBA 10/14/2021
L36188 MolDX: MGMT Promoter Methylation Analysis-Noridian Healthcare Solutions, LLC 10/14/2021
L36192 MolDX: MGMT Promoter Methylation Analysis-Noridian Healthcare Solutions, LLC 10/14/2021
L37870 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Palmetto GBA 10/14/2021
L37897 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Noridian Healthcare Solutions, LLC 10/14/2021
L37899 MolDX: Inivata™, InvisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Noridian Healthcare Solutions, LLC 10/14/2021
L37921 MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer-Wisconsin Physicians Service Insurance Corporation 10/14/2021
L34553 Stretta Procedure-Palmetto GBA 10/07/2021
L36335 MolDX: NRAS Genetic Testing-Noridian Healthcare Solutions, LLC 10/07/2021
L36339 MolDX: NRAS Genetic Testing-Noridian Healthcare Solutions, LLC 10/07/2021
L38299 Micro-Invasive Glaucoma Surgery (MIGS)-Noridian Healthcare Solutions, LLC 10/03/2021
L38301 Micro-Invasive Glaucoma Surgery (MIGS)-Noridian Healthcare Solutions, LLC 10/03/2021
L34645 Drug Testing-Wisconsin Physicians Service Insurance Corporation 10/01/2021
L34658 Vitamin D Assay Testing-Wisconsin Physicians Service Insurance Corporation 10/01/2021
L35753 Non-Invasive Cerebrovascular Studies-Wisconsin Physicians Service Insurance Corporation 10/01/2021
L35761 Non-Invasive Peripheral Arterial Vascular Studies-Wisconsin Physicians Service Insurance Corporation 10/01/2021
L36267 Bowel Management Devices-Noridian Healthcare Solutions, LLC 10/01/2021
L36408 Allergy Immunotherapy-Wisconsin Physicians Service Insurance Corporation 10/01/2021
L37535 Vitamin D Assay Testing-National Government Services, Inc. 10/01/2021
L34596 Immunizations-Wisconsin Physicians Service Insurance Corporation 09/30/2021
L35132 Home Health Plans of Care: Monitoring Glucose Control in the Medicare Home Health Population with Type II Diabetes Mellitus-Palmetto GBA 09/30/2021
L33718 Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea-Noridian Healthcare Solutions, LLC 09/27/2021
L33455 Wireless Gastrointestinal Motility Monitoring Systems-Palmetto GBA 09/09/2021
L34425 Magnetic Resonance Imaging of the Orbit, Face, and/or Neck-Palmetto GBA 09/09/2021
L34537 Vestibular Function Testing-Palmetto GBA 09/09/2021
L37387 Chiropractic Services-Palmetto GBA 09/09/2021
L37848 Lumbar Spinal Fusion-Palmetto GBA 09/09/2021
L33907 Hepatic (Liver) Function Panel-First Coast Service Options, Inc. 09/07/2021
L34018 Parathormone (Parathyroid Hormone)-First Coast Service Options, Inc. 09/07/2021
L36276 Erythropoiesis Stimulating Agents-First Coast Service Options, Inc. 09/07/2021
L35084 Non-Coronary Vascular Stents-Novitas Solutions, Inc. 08/23/2021
L34431 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-Palmetto GBA 08/12/2021
L33611 Oral Appliances for Obstructive Sleep Apnea-Noridian Healthcare Solutions, LLC 08/08/2021
L33800 Respiratory Assist Devices-Noridian Healthcare Solutions, LLC 08/08/2021
L35677 Infliximab-Palmetto GBA 08/05/2021
L33428 Cosmetic and Reconstructive Surgery-Palmetto GBA 07/29/2021
L34549 Ambulance Services-Palmetto GBA 07/29/2021
L37642 Nerve Blocks and Electrostimulation for Peripheral Neuropathy-Palmetto GBA 07/29/2021
L37779 Intraoperative Radiation Therapy-Palmetto GBA 07/29/2021
L34430 Respiratory Therapy (Respiratory Care)-Palmetto GBA 07/22/2021
L34574 Dental Services-Palmetto GBA 07/22/2021
L33444 Pulmonary Stress Testing-Palmetto GBA 07/15/2021
L33461 Implantable Infusion Pump-Palmetto GBA 07/15/2021
L34426 Ophthalmic Angiography (Fluorescein and Indocyanine Green)-Palmetto GBA 07/15/2021
L35048 Nerve Conduction Studies and Electromyography-Palmetto GBA 07/15/2021
L33261 Allergy Testing-First Coast Service Options, Inc. 07/11/2021
L34976 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-First Coast Service Options, Inc. 07/11/2021
L35090 Cosmetic and Reconstructive Surgery-Novitas Solutions, Inc. 07/11/2021
L35091 Cataract Extraction (including Complex Cataract Surgery)-Novitas Solutions, Inc. 07/11/2021
L35130 Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)-Novitas Solutions, Inc. 07/11/2021
L36240 Allergen Immunotherapy-Novitas Solutions, Inc. 07/11/2021
L36241 Allergy Testing-Novitas Solutions, Inc. 07/11/2021
L37295 MolDX: EndoPredict® Breast Cancer Gene Expression Test-Noridian Healthcare Solutions, LLC 07/11/2021
L37311 MolDX: EndoPredict® Breast Cancer Gene Expression Test-Noridian Healthcare Solutions, LLC 07/11/2021
L37800 Allergen Immunotherapy-First Coast Service Options, Inc. 07/11/2021
L38914 Cosmetic and Reconstructive Surgery-First Coast Service Options, Inc. 07/11/2021
L38926 Cataract Extraction (including Complex Cataract Surgery)-First Coast Service Options, Inc. 07/11/2021
L36544 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Noridian Healthcare Solutions, LLC 07/08/2021
L36551 MolDX: HLA-DQB1*06:02 Testing for Narcolepsy-Noridian Healthcare Solutions, LLC 07/08/2021
L38047 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Palmetto GBA 07/08/2021
L38123 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Noridian Healthcare Solutions, LLC 07/08/2021
L38125 MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies-Noridian Healthcare Solutions, LLC 07/08/2021
L37264 MolDX: EndoPredict Breast Cancer Gene Expression Test-Palmetto GBA 07/04/2021
L33436 Mohs Micrographic Surgery (MMS)-Palmetto GBA 07/01/2021
L33438 Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)-Palmetto GBA 06/24/2021
L33446 Respiratory Therapy and Oximetry Services-Palmetto GBA 06/24/2021
L37826 Lumbar Artificial Disc Replacement-Palmetto GBA 06/17/2021
L33422 Brain Natriuretic Peptide (BNP) Level-Palmetto GBA 06/10/2021
L34410 B-type Natriuretic Peptide (BNP) Testing-Palmetto GBA 06/10/2021
L34419 Homocysteine Level, Serum-Palmetto GBA 06/10/2021
L37379 Echocardiography-Palmetto GBA 06/10/2021
L34175 Ophthalmic Angiography (Fluorescein and Indocyanine Green)-CGS Administrators, LLC 06/03/2021
L33458 Chemodenervation-Palmetto GBA 05/27/2021
L34411 Blepharoplasty, Eyelid Surgery, and Brow Lift-Palmetto GBA 05/20/2021
L33910 Independent Diagnostic Testing Facility (IDTF)-First Coast Service Options, Inc. 05/13/2021
L34960 Hydration Therapy-Novitas Solutions, Inc. 05/13/2021
L35022 Bariatric Surgical Management of Morbid Obesity-Novitas Solutions, Inc. 05/13/2021
L35448 Independent Diagnostic Testing Facility (IDTF)-Novitas Solutions, Inc. 05/13/2021
L37632 Spinal Cord Stimulators for Chronic Pain-Palmetto GBA 05/13/2021
L33642 Pressure Reducing Support Surfaces - Group 2-Noridian Healthcare Solutions, LLC 05/01/2021
L33646 Botulinum Toxins-National Government Services, Inc. 05/01/2021
L33692 Pressure Reducing Support Surfaces - Group 3-Noridian Healthcare Solutions, LLC 05/01/2021
L33821 Negative Pressure Wound Therapy Pumps-Noridian Healthcare Solutions, LLC 05/01/2021
L33830 Pressure Reducing Support Surfaces - Group 1-Noridian Healthcare Solutions, LLC 05/01/2021
L33831 Surgical Dressings-Noridian Healthcare Solutions, LLC 05/01/2021
L34454 Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy-Palmetto GBA 04/29/2021
L33930 Facet Joint Interventions for Pain Management-First Coast Service Options, Inc. 04/25/2021
L34892 Facet Joint Interventions for Pain Management-Novitas Solutions, Inc. 04/25/2021
L35083 Cardiology Non-emergent Outpatient Stress Testing-Novitas Solutions, Inc. 04/25/2021
L38396 Cardiology Non-emergent Outpatient Stress Testing-First Coast Service Options, Inc. 04/25/2021
L36125 MolDX: Breast Cancer Assay: Prosigna®-Palmetto GBA 04/22/2021
L36129 MolDX: Biomarkers in Cardiovascular Risk Assessment-Palmetto GBA 04/22/2021
L36358 MolDX: Biomarkers in Cardiovascular Risk Assessment-Noridian Healthcare Solutions, LLC 04/22/2021
L36362 MolDX: Biomarkers in Cardiovascular Risk Assessment-Noridian Healthcare Solutions, LLC 04/22/2021
L36380 MolDX: Breast Cancer Assay: Prosigna®-Noridian Healthcare Solutions, LLC 04/22/2021
L36386 MolDX: Breast Cancer Assay: Prosigna®-Noridian Healthcare Solutions, LLC 04/22/2021
L33417 Allergy Skin Testing-Palmetto GBA 04/15/2021
L35074 Heavy Metal Testing-National Government Services, Inc. 04/15/2021
L34215 Lab: Flow Cytometry-Noridian Healthcare Solutions, LLC 04/08/2021
L36094 Lab: Flow Cytometry-Noridian Healthcare Solutions, LLC 04/08/2021
L33274 Botulinum Toxins-First Coast Service Options, Inc. 03/21/2021
L33671 Diagnostic Colonoscopy-First Coast Service Options, Inc. 03/21/2021
L34028 Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow-First Coast Service Options, Inc. 03/21/2021
L35004 Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow-Novitas Solutions, Inc. 03/21/2021
L33420 Lab: Bladder/Urothelial Tumor Markers-Palmetto GBA 03/04/2021
L36678 Lab: Bladder/Urothelial Tumor Markers-Noridian Healthcare Solutions, LLC 03/04/2021
L36680 Lab: Bladder/Urothelial Tumor Markers-Noridian Healthcare Solutions, LLC 03/04/2021
L36864 GlycoMark® Testing for Glycemic Control-Noridian Healthcare Solutions, LLC 03/04/2021
L36866 GlycoMark® Testing for Glycemic Control-Noridian Healthcare Solutions, LLC 03/04/2021
L34554 In Vitro Chemosensitivity & Chemoresistance Assays-Palmetto GBA 02/25/2021
L37022 Lab: Coenzyme Q10 (CoQ10)-Palmetto GBA 02/25/2021
L37066 Lab: Coenzyme Q10 (CoQ10)-Noridian Healthcare Solutions, LLC 02/25/2021
L37068 Lab: Coenzyme Q10 (CoQ10)-Noridian Healthcare Solutions, LLC 02/25/2021
L37260 MolDX: Prometheus IBD sgi Diagnostic® Policy-Palmetto GBA 02/25/2021
L37299 MolDX: Prometheus IBD sgi Diagnostic® Policy-Noridian Healthcare Solutions, LLC 02/25/2021
L37313 MolDX: Prometheus IBD sgi Diagnostic® Policy-Noridian Healthcare Solutions, LLC 02/25/2021
L37628 In Vitro Chemosensitivity & Chemoresistance Assays-Noridian Healthcare Solutions, LLC 02/25/2021
L33270 Bisphosphonates (Intravenous [IV]) and Monoclonal Antibodies in the Treatment of Osteoporosis and Their Other Indications-First Coast Service Options, Inc. 01/21/2021
L34106 Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)-Noridian Healthcare Solutions, LLC 01/10/2021
L34228 Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)-Noridian Healthcare Solutions, LLC 01/10/2021
L33609 Autonomic Function Tests-First Coast Service Options, Inc. 01/07/2021
L33747 Pegfilgrastim-First Coast Service Options, Inc. 01/01/2021
L33967 Vitamin B12 Injections-First Coast Service Options, Inc. 01/01/2021
L33975 Psychiatric Inpatient Hospitalization-First Coast Service Options, Inc. 01/01/2021
L34002 G-CSF Filgrastim-First Coast Service Options, Inc. 01/01/2021
L35050 Outpatient Sleep Studies-Novitas Solutions, Inc. 01/01/2021
L36711 Intensity Modulated Radiation Therapy (IMRT)-Novitas Solutions, Inc. 01/01/2021
L34924 Treatment of Chronic Venous Insufficiency of the Lower Extremities-Novitas Solutions, Inc. 12/27/2020
L37893 Endovenous Stenting-Novitas Solutions, Inc. 12/27/2020
L38231 Endovenous Stenting-First Coast Service Options, Inc. 12/27/2020
L36351 Lab: Special Histochemical Stains and Immunohistochemical Stains-Noridian Healthcare Solutions, LLC 12/24/2020
L36353 Lab: Special Histochemical Stains and Immunohistochemical Stains-Noridian Healthcare Solutions, LLC 12/24/2020
L33693 Non-Invasive Evaluation of Extremity Veins-First Coast Service Options, Inc. 12/17/2020
L35451 Non-Invasive Peripheral Venous Studies-Novitas Solutions, Inc. 12/17/2020
L35396 Biomarkers for Oncology-Novitas Solutions, Inc. 12/13/2020
L33418 Assays for Vitamins and Metabolic Function-Palmetto GBA 12/10/2020
L36499 BRCA1 and BRCA2 Genetic Testing-First Coast Service Options, Inc. 12/10/2020
L36715 BRCA1 and BRCA2 Genetic Testing-Novitas Solutions, Inc. 12/10/2020
L34561 Home Health - Psychiatric Care-Palmetto GBA 12/03/2020
L33569 Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)-National Government Services, Inc. 12/01/2020
L37635 Trigger Point Injections-Palmetto GBA 11/26/2020
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
L38367 Fluid Jet System Treatment for LUTS/BPH-National Government Services, Inc. 11/01/2020
L33771 Vitamin D; 25 hydroxy, includes fraction(s), if performed-First Coast Service Options, Inc. 10/29/2020
L33793 Refractive Lenses-Noridian Healthcare Solutions, LLC 10/01/2020
L34648 Bisphosphonate Drug Therapy-Wisconsin Physicians Service Insurance Corporation 08/27/2020
L34833 Cardiac Rhythm Device Evaluation-Novitas Solutions, Inc. 08/13/2020
L35070 Speech - Language Pathology (SLP) Services: Communication Disorders-Novitas Solutions, Inc. 08/13/2020
L37761 Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor-Palmetto GBA 08/13/2020
L37633 Partial Hospitalization Programs-Palmetto GBA 08/06/2020
L37485 Prostate Rectal Spacers-National Government Services, Inc. 08/01/2020
L35125 Wound Care-Novitas Solutions, Inc. 07/23/2020
L37166 Wound Care-First Coast Service Options, Inc. 07/23/2020
L33252 Psychiatric Diagnostic Evaluation and Psychotherapy Services-First Coast Service Options, Inc. 07/01/2020
L33405 Polysomnography and Sleep Testing-First Coast Service Options, Inc. 07/01/2020
L33707 Pulmonary Diagnostic Services-First Coast Service Options, Inc. 07/01/2020
L34372 Magnetic Resonance Angiography (MRA)-First Coast Service Options, Inc. 07/01/2020
L34520 Psychological and Neuropsychological Tests-First Coast Service Options, Inc. 07/01/2020
L34865 Magnetic Resonance Angiography (MRA)-Novitas Solutions, Inc. 07/01/2020
L34914 Assays for Vitamins and Metabolic Function-Novitas Solutions, Inc. 07/01/2020
L35101 Psychiatric Codes-Novitas Solutions, Inc. 07/01/2020
L35360 Pulmonary Function Testing-Novitas Solutions, Inc. 07/01/2020
L38371 Multimarker Serum Tests Related to Ovarian Cancer Testing-National Government Services, Inc. 07/01/2020
L35428 Thrombolytic Agents-Novitas Solutions, Inc. 05/24/2020
L34977 Anorectal Manometry, Anal Electromyography, and Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters-Novitas Solutions, Inc. 04/30/2020
L33410 Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)-First Coast Service Options, Inc. 04/19/2020
L35076 Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT)-National Government Services, Inc. 04/01/2020
L38262 Salvage High-intensity Focused Ultrasound (HIFU) Treatment in Prostate Cancer (PCa)-National Government Services, Inc. 04/01/2020
L38387 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-National Government Services, Inc. 04/01/2020
L38310 Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea-Noridian Healthcare Solutions, LLC 03/15/2020
L37630 In Vitro Chemosensitivity & Chemoresistance Assays-Noridian Healthcare Solutions, LLC 02/25/2020
L35111 Hemophilia Factor Products-Novitas Solutions, Inc. 02/13/2020
L34074 Immune Globulin Intravenous (IVIg)-Noridian Healthcare Solutions, LLC 02/01/2020
L34314 Immune Globulin Intravenous (IVIg)-Noridian Healthcare Solutions, LLC 02/01/2020
L37798 4Kscore Test Algorithm-First Coast Service Options, Inc. 01/06/2020
L33312 Wheelchair Seating-Noridian Healthcare Solutions, LLC 01/01/2020
L33317 External Breast Prostheses-Noridian Healthcare Solutions, LLC 01/01/2020
L33318 Knee Orthoses-Noridian Healthcare Solutions, LLC 01/01/2020
L33369 Therapeutic Shoes for Persons with Diabetes-Noridian Healthcare Solutions, LLC 01/01/2020
L33399 EEG – Ambulatory Monitoring-National Government Services, Inc. 01/01/2020
L33631 Outpatient Physical and Occupational Therapy Services-National Government Services, Inc. 01/01/2020
L33641 Orthopedic Footwear-Noridian Healthcare Solutions, LLC 01/01/2020
L33686 Ankle-Foot/Knee-Ankle-Foot Orthosis-Noridian Healthcare Solutions, LLC 01/01/2020
L33690 Automatic External Defibrillators-Noridian Healthcare Solutions, LLC 01/01/2020
L33733 Canes and Crutches-Noridian Healthcare Solutions, LLC 01/01/2020
L33735 Cold Therapy-Noridian Healthcare Solutions, LLC 01/01/2020
L33736 Commodes-Noridian Healthcare Solutions, LLC 01/01/2020
L33737 Eye Prostheses-Noridian Healthcare Solutions, LLC 01/01/2020
L33738 Facial Prostheses-Noridian Healthcare Solutions, LLC 01/01/2020
L33739 Speech Generating Devices (SGD)-Noridian Healthcare Solutions, LLC 01/01/2020
L33784 Heating Pads and Heat Lamps-Noridian Healthcare Solutions, LLC 01/01/2020
L33786 Intrapulmonary Percussive Ventilation System-Noridian Healthcare Solutions, LLC 01/01/2020
L33787 Lower Limb Prostheses-Noridian Healthcare Solutions, LLC 01/01/2020
L33788 Manual Wheelchair Bases-Noridian Healthcare Solutions, LLC 01/01/2020
L33790 Spinal Orthoses: TLSO and LSO-Noridian Healthcare Solutions, LLC 01/01/2020
L33791 Walkers-Noridian Healthcare Solutions, LLC 01/01/2020
L33795 Mechanical In-exsufflation Devices-Noridian Healthcare Solutions, LLC 01/01/2020
L33799 Patient Lifts-Noridian Healthcare Solutions, LLC 01/01/2020
L33820 Hospital Beds And Accessories-Noridian Healthcare Solutions, LLC 01/01/2020
L33823 Cervical Traction Devices-Noridian Healthcare Solutions, LLC 01/01/2020
L33824 Immunosuppressive Drugs-Noridian Healthcare Solutions, LLC 01/01/2020
L33825 Infrared Heating Pad Systems-Noridian Healthcare Solutions, LLC 01/01/2020
L33826 Oral Anticancer Drugs-Noridian Healthcare Solutions, LLC 01/01/2020
L33827 Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics)-Noridian Healthcare Solutions, LLC 01/01/2020
L33832 Tracheostomy Care Supplies-Noridian Healthcare Solutions, LLC 01/01/2020
L33834 Health and Behavior Assessment/Intervention-First Coast Service Options, Inc. 01/01/2020
L34821 Transcutaneous Electrical Joint Stimulation Devices (TEJSD)-Noridian Healthcare Solutions, LLC 01/01/2020
L34823 Tumor Treatment Field Therapy (TTFT)-Noridian Healthcare Solutions, LLC 01/01/2020
L34824 Vacuum Erection Devices (VED)-Noridian Healthcare Solutions, LLC 01/01/2020
L35162 Ambulance Services (Ground Ambulance)-Novitas Solutions, Inc. 01/01/2020
L37792 4Kscore Test Algorithm-Novitas Solutions, Inc. 12/30/2019
L33580 Speech-Language Pathology-National Government Services, Inc. 12/19/2019
L33937 Proton Beam Radiotherapy-First Coast Service Options, Inc. 12/16/2019
L37643 Routine Foot Care-Palmetto GBA 12/05/2019
L34010 Treatment of Varicose Veins of the Lower Extremities-Noridian Healthcare Solutions, LLC 12/01/2019
L34040 Polysomnography and Other Sleep Studies-Noridian Healthcare Solutions, LLC 12/01/2019
L34051 Vitamin D Assay Testing-Noridian Healthcare Solutions, LLC 12/01/2019
L34163 Total Hip Arthroplasty-Noridian Healthcare Solutions, LLC 12/01/2019
L34209 Treatment of Varicose Veins of the Lower Extremities-Noridian Healthcare Solutions, LLC 12/01/2019
L34211 Trigger Point Injections-Noridian Healthcare Solutions, LLC 12/01/2019
L34328 Peripheral Nerve Stimulation-Noridian Healthcare Solutions, LLC 12/01/2019
L35136 Spinal Cord Stimulators for Chronic Pain-Noridian Healthcare Solutions, LLC 12/01/2019
L35702 Mohs Micrographic Surgery-Noridian Healthcare Solutions, LLC 12/01/2019
L35704 Mohs Micrographic Surgery-Noridian Healthcare Solutions, LLC 12/01/2019
L36204 Spinal Cord Stimulators for Chronic Pain-Noridian Healthcare Solutions, LLC 12/01/2019
L36524 Nerve Conduction Studies and Electromyography-Noridian Healthcare Solutions, LLC 12/01/2019
L36526 Nerve Conduction Studies and Electromyography-Noridian Healthcare Solutions, LLC 12/01/2019
L36573 Total Hip Arthroplasty-Noridian Healthcare Solutions, LLC 12/01/2019
L36575 Total Knee Arthroplasty-Noridian Healthcare Solutions, LLC 12/01/2019
L36577 Total Knee Arthroplasty-Noridian Healthcare Solutions, LLC 12/01/2019
L36692 Vitamin D Assay Testing-Noridian Healthcare Solutions, LLC 12/01/2019
L36859 Trigger Point Injections-Noridian Healthcare Solutions, LLC 12/01/2019
L36861 Polysomnography and Other Sleep Studies-Noridian Healthcare Solutions, LLC 12/01/2019
L36886 MolDX: Percepta© Bronchial Genomic Classifier-Noridian Healthcare Solutions, LLC 12/01/2019
L36891 MolDX: Percepta© Bronchial Genomic Classifier-Noridian Healthcare Solutions, LLC 12/01/2019
L37244 Micro-Invasive Glaucoma Surgery (MIGS)-National Government Services, Inc. 12/01/2019
L37360 Peripheral Nerve Stimulation-Noridian Healthcare Solutions, LLC 12/01/2019
L33632 Psychiatry and Psychology Services-National Government Services, Inc. 11/28/2019
L33751 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-First Coast Service Options, Inc. 11/28/2019
L33922 Nail Debridement-First Coast Service Options, Inc. 11/28/2019
L35026 Rituximab-Palmetto GBA 11/28/2019
L36035 Spinal Cord Stimulation for Chronic Pain-First Coast Service Options, Inc. 11/28/2019
L37398 Electroretinography (ERG)-First Coast Service Options, Inc. 11/28/2019
L37561 Cystatin C Measurement-First Coast Service Options, Inc. 11/28/2019
L37697 Emergency and Non-Emergency Ground Ambulance Services-First Coast Service Options, Inc. 11/28/2019
L33575 Varicose Veins of the Lower Extremity, Treatment of-National Government Services, Inc. 11/21/2019
L33616 Osteopathic Manipulative Treatment-National Government Services, Inc. 11/21/2019
L35035 Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography-Novitas Solutions, Inc. 11/21/2019
L35068 Evaluation and Management Services Provided in a Nursing Facility-Novitas Solutions, Inc. 11/21/2019
L35089 Wireless Capsule Endoscopy-Novitas Solutions, Inc. 11/21/2019
L35098 Nerve Conduction Studies and Electromyography-National Government Services, Inc. 11/21/2019
L36850 Peripheral Nerve Blocks-National Government Services, Inc. 11/21/2019
L37371 Electroretinography (ERG)-Novitas Solutions, Inc. 11/21/2019
L33393 Hospice - Determining Terminal Status-National Government Services, Inc. 11/14/2019
L33449 Swallowing Studies for Dysphagia-Palmetto GBA 11/14/2019
L33624 Psychiatric Inpatient Hospitalization-National Government Services, Inc. 11/14/2019
L34559 Hospice - Renal Care-Palmetto GBA 11/14/2019
L34822 Luteinizing Hormone-Releasing Hormone (LHRH) Analogs-Novitas Solutions, Inc. 11/14/2019
L34864 Loss-of-Heterozygosity Based Topographic Genotyping with PathfinderTG ®-Novitas Solutions, Inc. 11/14/2019
L34961 Mohs Micrographic Surgery (MMS)-Novitas Solutions, Inc. 11/14/2019
L34996 Neuromuscular Junction Testing-Novitas Solutions, Inc. 11/14/2019
L35003 Intraoperative Neurophysiological Testing-Novitas Solutions, Inc. 11/14/2019
L35011 Surgery: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control-Novitas Solutions, Inc. 11/14/2019
L35028 Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency-National Government Services, Inc. 11/14/2019
L35032 Flow Cytometry-Novitas Solutions, Inc. 11/14/2019
L35112 Implantable Infusion Pump-Novitas Solutions, Inc. 11/14/2019
L35391 Multiple Imaging in Oncology-Novitas Solutions, Inc. 11/14/2019
L35395 Autonomic Function Tests-Novitas Solutions, Inc. 11/14/2019
L35433 Barium Swallow Studies, Modified-Novitas Solutions, Inc. 11/14/2019
L36007 Lower Extremity Major Joint Replacement (Hip and Knee)-Novitas Solutions, Inc. 11/14/2019
L33573 B-type Natriuretic Peptide (BNP) Testing-National Government Services, Inc. 11/07/2019
L33591 RAST Type Tests-National Government Services, Inc. 11/07/2019
L33614 Debridement Services-National Government Services, Inc. 11/07/2019
L33623 Percutaneous Coronary Intervention-National Government Services, Inc. 11/07/2019
L34577 Retroperitoneal Ultrasound-Palmetto GBA 11/07/2019
L34834 Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)-Novitas Solutions, Inc. 11/07/2019
L34856 C-Reactive Protein High Sensitivity Testing (hsCRP)-Novitas Solutions, Inc. 11/07/2019
L35001 Reduction Mammaplasty-National Government Services, Inc. 11/07/2019
L35075 Proton Beam Therapy-National Government Services, Inc. 11/07/2019
L35092 Diagnostic Abdominal Aortography and Renal Angiography-Novitas Solutions, Inc. 11/07/2019
L35099 Frequency of Laboratory Tests-Novitas Solutions, Inc. 11/07/2019
L36538 Treatment of Males with Low Testosterone-Noridian Healthcare Solutions, LLC 11/01/2019
L36569 Treatment of Males with Low Testosterone-Noridian Healthcare Solutions, LLC 11/01/2019
L36846 Measurement of Salivary Hormones-Noridian Healthcare Solutions, LLC 11/01/2019
L36857 Measurement of Salivary Hormones-Noridian Healthcare Solutions, LLC 11/01/2019
L37547 Chest X-Ray Policy-Noridian Healthcare Solutions, LLC 11/01/2019
L37549 Chest X-Ray Policy-Noridian Healthcare Solutions, LLC 11/01/2019
L34552 Outpatient Observation Bed/Room Services-Palmetto GBA 10/31/2019
L34565 Home Health-Surface Electrical Stimulation in the Treatment of Dysphagia-Palmetto GBA 10/31/2019
L34570 Psychiatric Inpatient Hospitalization-Palmetto GBA 10/31/2019
L35038 Scanning Computerized Ophthalmic Diagnostic Imaging-Novitas Solutions, Inc. 10/31/2019
L35081 Nerve Conduction Studies and Electromyography-Novitas Solutions, Inc. 10/31/2019
L35408 3D Interpretation and Reporting of Imaging Studies-Novitas Solutions, Inc. 10/31/2019
L36854 MolDX: Percepta® Bronchial Genomic Classifier-Palmetto GBA 10/31/2019
L33977 Transcranial Doppler Studies-First Coast Service Options, Inc. 10/29/2019
L33396 Posterior Tibial Nerve Stimulation for Voiding Dysfunction-National Government Services, Inc. 10/24/2019
L33443 Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control-Palmetto GBA 10/24/2019
L33445 Removal of Benign and Malignant Skin Lesions-Palmetto GBA 10/24/2019
L33452 Virtual Colonoscopy (CT Colonography)-Palmetto GBA 10/24/2019
L33576 Urodynamics-National Government Services, Inc. 10/24/2019
L33585 Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography-National Government Services, Inc. 10/24/2019
L34424 Magnetic Resonance Angiography-Palmetto GBA 10/24/2019
L34544 Hospice - Liver Disease-Palmetto GBA 10/24/2019
L34547 Hospice - Neurological Conditions-Palmetto GBA 10/24/2019
L34562 Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances-Palmetto GBA 10/24/2019
L37636 Nonobstetric Pelvic Ultrasound-Palmetto GBA 10/24/2019
L37774 Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication-Palmetto GBA 10/24/2019
L34953 Cardiac Event Detection Monitoring-Novitas Solutions, Inc. 10/17/2019
L34975 Neurophysiology Evoked Potentials (NEPs)-Novitas Solutions, Inc. 10/17/2019
L34997 Real-Time, Outpatient Cardiac Telemetry-Novitas Solutions, Inc. 10/17/2019
L35006 Controlled Substance Monitoring and Drugs of Abuse Testing-Novitas Solutions, Inc. 10/17/2019
L35007 Vestibular and Audiologic Function Studies-Novitas Solutions, Inc. 10/17/2019
L35016 Transesophageal Echocardiography (TEE)-Novitas Solutions, Inc. 10/17/2019
L35049 Monitored Anesthesia Care-Novitas Solutions, Inc. 10/17/2019
L35138 Routine Foot Care-Novitas Solutions, Inc. 10/17/2019
L35350 Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)-Novitas Solutions, Inc. 10/17/2019
L35397 Non-Invasive Cerebrovascular Arterial Studies-Novitas Solutions, Inc. 10/17/2019
L35409 Non-Vascular Extremity Ultrasound-Novitas Solutions, Inc. 10/17/2019
L35434 Oximetry Services-Novitas Solutions, Inc. 10/17/2019
L36831 Visual Electrophysiology Testing -National Government Services, Inc. 10/17/2019
L33459 Computerized Axial Tomography (CT), Thorax-Palmetto GBA 10/10/2019
L33578 Transrectal Ultrasound-National Government Services, Inc. 10/10/2019
L33584 Implantable Miniature Telescope (IMT)-National Government Services, Inc. 10/10/2019
L34573 Cardiac Event Detection-Palmetto GBA 10/10/2019
L36039 Total Joint Arthroplasty-National Government Services, Inc. 10/10/2019
L36406 Minimally-invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint-National Government Services, Inc. 10/10/2019
L37638 Health and Behavior Assessment/Intervention-Palmetto GBA 10/10/2019
L37606 Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases-National Government Services, Inc. 10/03/2019
L33282 Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries-First Coast Service Options, Inc. 10/01/2019
L33380 Long-Term Wearable Electrocardiographic Monitoring (WEM)-First Coast Service Options, Inc. 10/01/2019
L33411 Surgical Management of Morbid Obesity-First Coast Service Options, Inc. 10/01/2019
L33413 Therapy and Rehabilitation Services-First Coast Service Options, Inc. 10/01/2019
L33557 Cardiac Catheterization and Coronary Angiography-National Government Services, Inc. 10/01/2019
L33560 Cardiovascular Nuclear Medicine-National Government Services, Inc. 10/01/2019
L33567 Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)-National Government Services, Inc. 10/01/2019
L33577 Transthoracic Echocardiography (TTE)-National Government Services, Inc. 10/01/2019
L33579 Transesophageal Echocardiography (TEE)-National Government Services, Inc. 10/01/2019
L33583 Diagnostic and Therapeutic Esophagogastroduodenoscopy-First Coast Service Options, Inc. 10/01/2019
L33619 Nonvascular Extremity Ultrasound-National Government Services, Inc. 10/01/2019
L33627 Non-Invasive Vascular Studies-National Government Services, Inc. 10/01/2019
L33633 Magnetic Resonance Angiography (MRA)-National Government Services, Inc. 10/01/2019
L33667 Duplex Scan Of Lower Extremity Arteries-First Coast Service Options, Inc. 10/01/2019
L33669 Electrocardiography-First Coast Service Options, Inc. 10/01/2019
L33696 Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries-First Coast Service Options, Inc. 10/01/2019
L33755 Susceptibility Studies-First Coast Service Options, Inc. 10/01/2019
L33756 Transesophageal Echocardiogram-First Coast Service Options, Inc. 10/01/2019
L33763 Vascular Stenting of Lower Extremity Arteries-First Coast Service Options, Inc. 10/01/2019
L33767 Viscosupplementation Therapy For Knee-First Coast Service Options, Inc. 10/01/2019
L33768 Transthoracic Echocardiography (TTE)-First Coast Service Options, Inc. 10/01/2019
L33912 Injection of Trigger Points-First Coast Service Options, Inc. 10/01/2019
L33923 Noninvasive Ear or Pulse Oximetry For Oxygen Saturation-First Coast Service Options, Inc. 10/01/2019
L33941 Routine Foot Care-First Coast Service Options, Inc. 10/01/2019
L33966 Vestibular Function Tests-First Coast Service Options, Inc. 10/01/2019
L33969 Diagnostic Aerosol or Vapor Inhalation-First Coast Service Options, Inc. 10/01/2019
L33974 Troponin-First Coast Service Options, Inc. 10/01/2019
L33979 Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)-Noridian Healthcare Solutions, LLC 10/01/2019
L34011 Ionized Calcium-First Coast Service Options, Inc. 10/01/2019
L34014 Magnesium-First Coast Service Options, Inc. 10/01/2019
L34026 Trastuzumab – Trastuzumab Biologics-First Coast Service Options, Inc. 10/01/2019
L34038 B-type Natriuretic Peptide (BNP) Testing-Noridian Healthcare Solutions, LLC 10/01/2019
L34076 Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma-Noridian Healthcare Solutions, LLC 10/01/2019
L34194 Blepharoplasty, Eyelid Surgery, and Brow Lift-Noridian Healthcare Solutions, LLC 10/01/2019
L34213 Diagnostic and Therapeutic Colonoscopy-Noridian Healthcare Solutions, LLC 10/01/2019
L34218 Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma-Noridian Healthcare Solutions, LLC 10/01/2019
L34233 Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)-Noridian Healthcare Solutions, LLC 10/01/2019
L34247 Pulmonary Function Testing-Noridian Healthcare Solutions, LLC 10/01/2019
L34313 Allergy Testing-Noridian Healthcare Solutions, LLC 10/01/2019
L34315 Electrocardiograms-Noridian Healthcare Solutions, LLC 10/01/2019
L34324 Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography-Noridian Healthcare Solutions, LLC 10/01/2019
L34859 Nerve Conduction Studies and Electromyography-First Coast Service Options, Inc. 10/01/2019
L34912 Genetic Testing for Lynch Syndrome-First Coast Service Options, Inc. 10/01/2019
L35163 Plastic Surgery-Noridian Healthcare Solutions, LLC 10/01/2019
L35170 Botulinum Toxin Types A and B Policy-Noridian Healthcare Solutions, LLC 10/01/2019
L35172 Botulinum Toxin Types A and B-Noridian Healthcare Solutions, LLC 10/01/2019
L35175 MRI and CT Scans of the Head and Neck-Noridian Healthcare Solutions, LLC 10/01/2019
L35427 Hyaluronan Acid Therapies for Osteoarthritis of the Knee-Novitas Solutions, Inc. 10/01/2019
L35526 B-type Natriuretic Peptide (BNP) Testing-Noridian Healthcare Solutions, LLC 10/01/2019
L36037 Urine Drug Testing-National Government Services, Inc. 10/01/2019
L36286 Blepharoplasty, Eyelid Surgery, and Brow Lift-Noridian Healthcare Solutions, LLC 10/01/2019
L36393 Controlled Substance Monitoring and Drugs of Abuse Testing-First Coast Service Options, Inc. 10/01/2019
L36700 Serum Magnesium-Noridian Healthcare Solutions, LLC 10/01/2019
L36702 Serum Magnesium-Noridian Healthcare Solutions, LLC 10/01/2019
L36767 Aortography and peripheral angiography-First Coast Service Options, Inc. 10/01/2019
L36868 Diagnostic and Therapeutic Colonoscopy-Noridian Healthcare Solutions, LLC 10/01/2019
L36889 Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography-Noridian Healthcare Solutions, LLC 10/01/2019
L36962 Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases -First Coast Service Options, Inc. 10/01/2019
L37020 Plastic Surgery-Noridian Healthcare Solutions, LLC 10/01/2019
L37283 Electrocardiograms-Noridian Healthcare Solutions, LLC 10/01/2019
L37373 MRI and CT Scans of the Head and Neck-Noridian Healthcare Solutions, LLC 10/01/2019
L37475 Frequency of Hemodialysis-National Government Services, Inc. 10/01/2019
L37502 Frequency of Hemodialysis-Noridian Healthcare Solutions, LLC 10/01/2019
L37504 Frequency of Hemodialysis-Noridian Healthcare Solutions, LLC 10/01/2019
L34938 Removal of Benign Skin Lesions-Novitas Solutions, Inc. 09/26/2019
L35014 Frequency of Hemodialysis-Novitas Solutions, Inc. 09/26/2019
L35450 Spinal Cord Stimulation (Dorsal Column Stimulation)-Novitas Solutions, Inc. 09/26/2019
L33558 Cataract Extraction-National Government Services, Inc. 09/19/2019
L33574 Visual Fields Testing-National Government Services, Inc. 09/19/2019
L33621 Ophthalmic Biometry for Intraocular Lens Power Calculation-National Government Services, Inc. 09/19/2019
L33628 Panretinal (Scatter) Laser Photocoagulation-National Government Services, Inc. 09/19/2019
L34380 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)-National Government Services, Inc. 09/19/2019
L38014 Corneal Hysteresis-National Government Services, Inc. 09/19/2019
L33562 Computed Tomographic (CT) Colonography for Diagnostic Uses-National Government Services, Inc. 09/12/2019
L33563 Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures-National Government Services, Inc. 09/12/2019
L33630 Corneal Pachymetry-National Government Services, Inc. 09/12/2019
L35013 Debridement of Mycotic Nails-Novitas Solutions, Inc. 09/12/2019
L36236 Autonomic Function Testing-National Government Services, Inc. 09/12/2019
L36356 Bone Mineral Density Studies-First Coast Service Options, Inc. 09/10/2019
L37943 Anorectal Manometry and Electromyography (EMG) of the Urinary and Anal Sphincters-First Coast Service Options, Inc. 08/12/2019
L36773 Intensity Modulated Radiation Therapy (IMRT) -First Coast Service Options, Inc. 07/31/2019
L33774 Wireless Capsule Endoscopy-First Coast Service Options, Inc. 07/11/2019
L33684 Hemophilia Clotting Factors-First Coast Service Options, Inc. 07/01/2019
L37564 Frequency of Hemodialysis-First Coast Service Options, Inc. 07/01/2019
L33256 3D Interpretation and Reporting of Imaging Studies-First Coast Service Options, Inc. 01/08/2019
L33267 B-Type Natriuretic Peptide (BNP)-First Coast Service Options, Inc. 01/08/2019
L33382 Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions-First Coast Service Options, Inc. 01/08/2019
L33406 Posterior Tibial Nerve Stimulation (PTNS)-First Coast Service Options, Inc. 01/08/2019
L33615 Biofeedback-First Coast Service Options, Inc. 01/08/2019
L33618 Major Joint Replacement (Hip and Knee)-First Coast Service Options, Inc. 01/08/2019
L33661 Flow Cytometry-First Coast Service Options, Inc. 01/08/2019
L33674 Duplex Scanning-First Coast Service Options, Inc. 01/08/2019
L33685 Luteinizing Hormone-Releasing Hormone (LHRH) Analogs-First Coast Service Options, Inc. 01/08/2019
L33689 Mohs Micrographic Surgery (MMS)-First Coast Service Options, Inc. 01/08/2019
L33695 Non-invasive Extracranial Arterial Studies-First Coast Service Options, Inc. 01/08/2019
L33766 Visual Field Examination-First Coast Service Options, Inc. 01/08/2019
L33810 Computerized Corneal Topography-First Coast Service Options, Inc. 01/08/2019
L33813 Destruction of Malignant Skin Lesions-First Coast Service Options, Inc. 01/08/2019
L33818 Excision of Malignant Skin Lesions-First Coast Service Options, Inc. 01/08/2019
L33908 High Sensitivity C-Reactive Protein (hsCRP)-First Coast Service Options, Inc. 01/08/2019
L33909 Incision and Drainage of Abscess of Skin, Subcutaneous and Accessory Structures-First Coast Service Options, Inc. 01/08/2019
L33915 Label and Off-label Coverage of Outpatient Drugs and Biologicals-First Coast Service Options, Inc. 01/08/2019
L33929 Osteopathic Manipulative Treatment-First Coast Service Options, Inc. 01/08/2019
L33933 Peripheral Nerve Blocks-First Coast Service Options, Inc. 01/08/2019
L33958 Somatosensory Testing-First Coast Service Options, Inc. 01/08/2019
L33961 Therapy Services billed by Physicians/Nonphysician Practitioners -First Coast Service Options, Inc. 01/08/2019
L34021 Sedimentation Rate, Erythrocyte-First Coast Service Options, Inc. 01/08/2019
L34027 Ultrasound, Soft Tissues of Head and Neck-First Coast Service Options, Inc. 01/08/2019
L34521 Special EEG Tests-First Coast Service Options, Inc. 01/08/2019
L36230 Evaluation and Management Services in a Nursing Facility -First Coast Service Options, Inc. 01/08/2019
L36238 Humanitarian Use Device (HUD) and Humanitarian Device Exemption (HDE) process-First Coast Service Options, Inc. 01/08/2019


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