LCDs, NCDs, Coverage Articles

Published 12/13/2024

Local Coverage Determinations (LCDs)

Articles

National Coverage Determinations (NCDs)

  • NCDs
  • The link to the Reconsideration Process must be used for any suggested changes to the Centers for Medicare & Medicaid Services (CMS). Only CMS can update NCDs.

The table below provides a current list of all active LCD and MCD articles.

LCD Title LCD ID # Article Title Article ID # CPT®/HCPCS Codes Contract
4Kscore® Assay L36763 Billing and Coding: 4Kscore® Assay A56932 81539 A/B
Advance Care Planning L38970 Billing and Coding: Advance Care Planning A58664 G0438, G0439, 99201–99215, 99217–99226, 99231–99236, 99238, 99239, 99241–99245, 99251–99255, 99281–99285, 99291, 99292, 99304–99310, 99315, 99316, 99318, 99324–99328, 99334–99337, 99341–99345, 99347–99350, 99381–99397, 99468, 99469, 99471, 99472, 99475–99480, 99483, 99495, 99496, 99497, 99498 A/B

Allergy Skin Testing

L33417

Billing and Coding: Allergy Skin
Testing

A56559

95004, 95017, 95018, 95024

 B
Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin L39270 Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin A59042 38240 A/B
Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA) L39851 Billing and Coding: Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA) A59721 0623T, 0624T, 0625T, 0626T A/B
Lab: Bladder/Urothelial Tumor Markers L33420 Billing and Coding: Lab: Bladder/Urothelial Tumor Markers A53095 86294, 86316, 86386, 88120, 88121 A/B

Blepharoplasty, Eyelid Surgery
and Brow Lift

L34411

Billing and Coding: 
Blepharoplasty, Eyelid Surgery and Brow Lift

A56503

15820, 15821, 15822, 15823, 67192, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924

 A/B
Homocysteine Level, Serum L34419 Billing and Coding: Homocysteine Level, Serum A56675 83090 A/B

Brain Natriuretic Peptide (BNP) Level

L33422

Billing and Coding: Brain Natriuretic Peptide (BNP) Level

A56565

83880

 B
Bone Mass Measurement L39268 Billing and Coding: Bone Mass Measurement A59040 76977, 77078, 77080, 77081, 77085, 78350, 78351, G0130, 0554T, 0555T, 0556T, 0557T and 0558T A/B

Cardiac Computed Tomography & Angiography (CCTA)

L33423

Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA)

A56691

75571, 75572, 75573, 75574

 A/B

Cardiac Radionuclide Imaging

L33457

Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning —
MUGA, Ventriculography) when Performed in Conjunction with Cardiotoxic Chemotherapy

A54768

78451, 78452, 78453, 78454, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, A4641, A9500, A9501, A9502, A9505, A9526, A9555

 A/B

N/A

 

 Billing and Coding: Cardiac Radionuclide Imaging A56476

78431

 A/B
Cardiac Resynchronization Therapy (CRT) L39080 Billing and Coding: Cardiac Resynchronization Therapy (CRT) A58821 33224, 33225 A/B

Cataract Surgery

L34413

Billing and Coding: Complex Cataract Surgery: Appropriate Use and Documentation

A53047

66830, 66840, 66850, 66852, 66920, 66940, 66982, 66982, 66983, 66984

 A/B
N/A   Billing and Coding: Cataract Surgery A56613 66989, 66991  
Cervical Disc Replacement L38033 Billing and Coding: Cervical Disc Replacement A57021 22856, 22858, 22861, 0098T, 0375T, 97010–97036, 97039, 97110–97546 A/B
Cervical Fusion L39773 Billing and Coding: Cervical Fusion A59634 22548, 22551, 22552, 22554, 22590, 22595, 22600, 22800, 22802, 22808, 22810, 22812 A/B

Chemodenervation

L33458

Billing and Coding: Chemodenervation

A56646

46505, 52287, 64611, 64612, 64615, 64616, 64617, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 64999, 67345, 95873, 95874, J0585, J0586, J0587, J0588

 B

Chiropractic Services

L37387

Billing and Coding: Chiropractic Services

A56616

98940, 98941, 98942

 B
Cognitive Assessment and Care Plan Service L39266 Billing and Coding: Cognitive Assessment and Care Plan Service A59036 90785, 90791, 90792, 96127, 96146, 96160, 96161, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99242, 99243, 99244, 99245, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99366, 99367, 99368, 99483, 99497, 99498, 99605, 99606, 99607 A/B
Colon Capsule Endoscopy (CCE) L38755 Billing and Coding: Colon Capsule Endoscopy (CCE) A58321 91113 A/B
Colonoscopy/Sigmoidoscopy/
Proctosigmoidoscopy

L34454 

Billing and Coding: Incomplete Colonoscopy/Failed Colonoscopy

A55227

G0105, G0121, 44388, 44389, 44390, 44391, 44392, 44394, 44401, 44402, 45300, 45303, 45305, 45307, 45308, 45309, 45315, 45317, 45320, 45321, 45327, 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45340, 45341, 45342, 45346, 45347, 45349, 45378, 45379, 45380, 45380, 45381, 45381, 45382, 45382, 45384, 45384, 45385, 45385, 45386, 45388, 45389, 45390, 45391, 45392, 45393, 45398

 A/B

N/A

 

Billing and Coding: Screening Colonoscopy Converted
to a Diagnostic
and/or Therapeutic Colonoscopy

A55069

G2204

 A/B
N/A   Billing and Coding: Colonoscopy / Sigmoidoscopy / Proctosigmoidoscopy A56632 G9998, G9999 A/B

Computed Tomography
Cerebral Perfusion Analysis
(CTP)

 L38769 Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP) A58354 0042T A/B

Computerized Axial Tomography (CT), Thorax

L33459

Billing and Coding: Computerized Axial Tomography (CT), Thorax

A56580

71250, 71260, 71270

 A/B

Continuous Peripheral Nerve
Blocks (CPNB)

L37641

Billing and Coding: Continuous Peripheral Nerve
Blocks (CPNB)

A56607

64416, 64446, 64448, 64449

 A/B

Corneal Pachymetry

L34512

Billing and Coding: Corneal Pachymetry

A56611

76514

 A/B

Cosmetic and Reconstructive
Surgery

L33428

 Billing and Coding: Oral Maxillofacial Prosthesis

A53497

E0485, E0486, 15780, 15781, 15782, 15783, 15830, 15847, 19316, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 19318, 30400, 30410, 30420, 30430, 30435, 30450, 30460, 30462, 15730, 15733, 21076, 21077, 21079, 21080, 21081, 21082, 21083, 21084, 21086, 21087, 21088, 21089, 21120, 21121, 21122, 21123, 21125, 21127, 21137, 21138, 21139, 21141, 21142, 21143, 21145, 21146, 21147, 21150, 21151, 21154, 21155, 21159, 21160, 21172, 21175, 21179, 21180, 21181, 21182, 21183, 21184, 21188, 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21208, 21209, 21210, 21215, 21230, 21240, 21242, 21243, 21244, 21245, 21246, 21247, 21248, 21249, 21255, 21256, 21260, 21261, 21263, 21267, 21268, 21270, 21275, 21280, 21282, 21295, 21296, 21299

 A/B
N/A   Billing and Coding: Cosmetic and Reconstructive
Surgery		 A56658 30465  

CT of the Abdomen and Pelvis

L34415

Billing and Coding: CT of the Abdomen and Pelvis

A56421

72192, 72193, 72194, 74150, 74160, 74170, 74176, 74177, 74178

 A/B

CT of the Head

L34417

Billing and Coding: CT of the Head

A56612

G2187, G2188, G2189, G2190, G2191, G2192, G2193, G2194 G2195, 70450, 70460, 70470

 A/B
Dexamethasone Intracanalicular Ophthalmic
Insert (Dextenza®)		 L38792 Billing and Coding: Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®) A58392 65800, 65810, 65815, 65820, 65850, 65855, 65860, 65865, 65870, 65875, 65880, 66170, 66172, 66180, 66183, 66184, 66185, 66820, 66821, 66825, 66982, 66984, 67005, 67010, 67015, 67025, 67027, 67028, 67030, 67031, 67036, 67039, 67040, 67041, 67042, 67043, 68841 A/B

Echocardiography

L37379

Billing and Coding: Echocardiography

A56625

91139, 93303, 93304, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, 93350, 93351, 93352, 93355, A9700, J0153, J0280, J0461, J1245, J1250, M1150

 A/B
Echocardiography for Myocardial Perfusion L38786 Billing and Coding: Echocardiography
for Myocardial Perfusion		 A58503 0439T, 93306, 93307, 93308, 93350, 93351, 93352, A9700, Q9950, Q9955, Q9956 A/B
Epidural Steroid Injections
for Pain Management		 L38994 Billing and Coding: Epidural Steroid Injections for
Pain Management		 A58695 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 64479, 64480, 64483, 64484, 78630 A/B
Erythropoiesis Stimulating Agents L39237 Billing and Coding: Erythropoiesis Stimulating Agents A58982 J0881, J0882, J0885, J0887, J0888, J0890, Q4081, Q5105, Q5106 A/B
Extracorporeal Shock Wave
Therapy (ESWT)		 L38775 Billing and Coding: Extracorporeal Shock Wave
Therapy (ESWT)		 A58367 0101T, 0102T A/B
Facet Joint Interventions
for Pain Management		 L38765 Billing and Coding: Facet Joint Interventions for Pain Management A58350

64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T

 A/B
Frequency of Hemodialysis L34575

Billing and Coding: Frequency of Hemodialysis

 A55354 90999 A/B
GlycoMark® Testing for Glycemic Control L36761 Billing and Coding: GlycoMark Testing for Glycemic Control A56872 84378, 84999 A/B

HbA1c

L33431

Billing and Coding: HbA1c

A56686

83036, M1211

 B

Health and Behavior
Assessment/Intervention

L37638

Billing and Coding: Health and Behavior Assessment
/ Intervention

A56562

G2214, 96150, 96151, 96152, 96153, 96154, 96155

 A/B
Hyaluronic Acid Injections for Knee Osteoarthritis L39260 Billing and Coding: Hyaluronic Acid Injections for Knee Osteoarthritis A59030 J7318, J7320, J7321, J7322, J7324, J7325, J7326, J7327, J7328, J7329, J7331, J7332, 20610, 20611 A/B
Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea L38276 Billing and Coding: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea A58075 61886, 61888, 64582, 64583, 64584 A/B
Implantable Continuous
Glucose Monitors (I-CGM)		 L38743 Billing and Coding: Implantable Continuous
Glucose Monitors
(I-CGM)		 A58277 0446T, 0447T, 0448T A/B

Implantable Infusion Pump

L33461

 Billing and Coding: Implantable Infusion Pump A56695

J2274, J2278, J7999

 B

Infliximab

L35677

Billing and Coding: Infliximab

A56432

J1745, Q5103, Q5104, Q5109, Q5121

 A/B
Intraoperative Radiation
Therapy		 L37779

Billing and Coding: Intraoperative Radiation Therapy

A56684

 19294, 76145, 77424, 77425, 77469, C9726 A/B

Intravenous Immunoglobulin
(IVIG)

L34580

Billing and Coding: Intravenous Immunoglobulin
(IVIG)

A56718

J1459, J1554, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1576, J1599, J2791, J2792

 A/B
In Vitro Chemosensitivity & Chemoresistance Assays L34554 Billing and Coding: In Vitro Chemosensitivity & Chemoresistance Assays A56871 84999, 89240, 0564T, 0083U, 0248U, 0324U, 0325U, 0435U A/B
Urine Drug Testing L35724 Billing and Coding: Urine Drug Testing A54799 80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659, 0227U, 0328U A/B
Lab: Cystatin C Measurement L37581 Billing and Coding: Lab: Cystatin C Measurement A56948 82610 A/B
Lab: Coenzyme Q10 (CoQ10) L37022 Billing and Coding: Lab: Coenzyme Q10 (CoQ10) A55709 82542 A/B
Lab: Flow Cytometry L34513 Billing and Coding: Lab: Flow Cytometry A55717 86355, 86356, 86357, 86359, 86360, 86361, 86367, 88182, 88184, 88185, 88187, 88188, 88189 A/B
Lab: Special Histochemical Stains and Immunohistochemical Stains L35922 Billing and Coding: Lab: Special Histochemical Stains and Immunohistochemical Stains A56838 88312, 88313, 88341, 88342, 88344, 88360, 88361 A/B

Laparoscopic Sleeve Gastrectomy
for Severe Obesity

L34576

Billing and Coding: Laparoscopic Sleeve Gastrectomy for Severe Obesity

A56852

43775

 A/B
Lower Esophageal Magnetic Sphincter Augmentation L39780 Billing and Coding: Lower Esophageal Magnetic Sphincter Augmentation A59654 43284, 43285 A/B
Lumbar Artificial Disc Replacement L37826 Billing and Coding: Lumbar Artificial Disc Replacement A56390 22857, 22860, 22862, 0165T A/B
Lumbar Spinal
Fusion		 L37848 Billing and Coding: Lumbar Spinal Fusion A56396 22533, 22558, 22612, 22630, 22633 A/B
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs L39387 Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs A59160 11981, 11982, 11983, 96402, J1950, J1952, J1954, J9202, J9217, J9219, J9225, J3315 A/B
Magnesium L39400 Billing and Coding: Magnesium A59186 83735 A/B
Magnetic Resonance Angiography L34424 Billing and Coding: Magnetic Resonance Angiography A56775 70544, 70545, 70546, 70547, 70548, 70549, C8900, C8901, C8902, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, C8920, C8934, C8935, C8936 A/B
Magnetic Resonance Image Guided
High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor		 L37761

Billing and Coding: Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor

A56690

 0398T A/B
Magnetic Resonance Imaging of the Head and Neck L34425 Billing and Coding: Magnetic Resonance Imaging of the Head and Neck A56729 70540, 70542, 70543 A/B
MDS FISH L37602 Billing and Coding: MDS FISH A56913 88271, 88273, 88274, 88275, 88291 A/B
Micro-Invasive Glaucoma Surgery (MIGS) L37531 Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS) A56866 65820, 66174, 66175, 66183, 66710, 66711, 66982, 66987, 66988 66989, 66991, 66999, 0253T, 0449T, 0450T, 0474T, 0621T, 0622T, 0671T A/B
Minimally Invasive Surgical (MIS) Fusion of the Sacroiliac Joint (SIJ) L39025 Billing and Coding: Minimally Invasive Surgical (MIS) Fusion of the Sacroiliac Joint (SIJ A58739 27279 A/B

Mohs Micrographic Surgery (MMS)

L33436

Billing and Coding: Mohs Micrographic Surgery (MMS)

A56732

17311, 17312, 17313, 17314, 17315

 B
Near-Infrared Spectroscopy in Wound and Flap Management L39385 Billing and Coding: Near-Infrared Spectroscopy in Wound and Flap Management A59158 0640T, 0641T, 0642T  

Nerve Blocks and Electrostimulation for Peripheral Neuropathy

L37642

Billing and Coding: Nerve Blocks and Electrostimulation
for Peripheral Neuropathy

A56731

64450, 97032, 97139, G0282, G0283

 A/B

Nerve Conduction Studies and Electromyography

L35048 

Billing and Coding: Nerve Conduction Studies and Electromyography

A56619

51785, 92265, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95885, 95886, 95887, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95933, 95937, 95999, G0255

 A/B

Non-Invasive Fractional Flow
Reserve (FFR) for Stable
Ischemic Heart Disease

 L38278 Billing and Coding: Non- Invasive Fractional Flow
Reserve (FFR) for Stable Ischemic Heart Disease		 A58406 0501T, 0502T, 0503T, 0504T A/B

Octreotide Acetate for Injectable Suspension (Sandostatin LAR depot)

L33438

Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin LAR® depot)

A56531

J2353

 B

Ophthalmic Angiography (Fluorescein and Indocyanine Green)

L34426

Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)

A56774

92235, 92240, 92242

 A/B

Ophthalmology: Extended Ophthalmoscopy and Fundus Photography

L33467

Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography

A53060

 

92201, 92202, 92227, 92228, 92250

 A/B
Opioid Treatment Programs L39849 Billing and Coding: Opioid Treatment Programs A59718 G0137, G1028, G2067, G2068, G2069, G2070, G2071, G2072, G2073, G2074, G2075, G2076, G2077, G2078, G2079, G2080, G2215, G2216 A/B
Outpatient Psychotherapy L39853 Billing and Coding: Outpatient Psychotherapy A59723 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90846, 90847, 90849, 90853, 90863, 90887, 90889, 90899, G0017, G0018, G0323, G0409, G0410, G0411 A/B

Percutaneous Vertebral
Augmentation (PVA) for Osteoporotic Vertebral
Compression Fracture (VCF)

 L38737 Billing and Coding: Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) A58275 22510, 22511, 22512, 22513, 22514, 22515 A/B
Peroral Endoscopic Myotomy (POEM) L38747 Billing and Coding: Peroral Endoscopic Myotomy (POEM) A58287 43497 A/B
Platelet Rich Plasma L38745 Billing and Coding: Platelet Rich Plasma A58282 G0465, M0076, P9020, S9055, 0232T A/B

Polysomnography

L36593

Accreditation and Credentialing Requirements for Polysomnography

A55958

95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400

 A/B
N/A   Billing and Coding: Polysomnography A56995    
N/A   Billing and Coding:
E/M Coding for Oral Surgeons		 A56006 99202–99215  

Pulmonary Stress Testing

L33444

Billing and Coding: Pulmonary Stress Testing

A56784

94617, 94618, 94619, 94621

 B
Radiation Therapies L39553 Billing and Coding: Radiation Therapies A59350 61796, 61797, 61798, 61799, 61800, 77293, 77301, 77338, 77371, 77372, 77373, 77385, 77386, 77432, 77435, G0339, G0340, G6015, G6016 A/B

Removal of Benign and Malignant
Skin Lesions

L33445

Billing and Coding for Removal of Benign and Malignant Skin Lesions

A56346

11300, 11301, 11302, 11303, 11305, 11306, 11307, 11308, 11310, 11311, 11312, 11313, 11400, 11401, 11402, 11403, 11404, 11406, 11420, 11421, 11422, 11423, 11424, 11426, 11440, 11441, 11442, 11443, 11444, 11446, 11600, 11601, 11602, 11603, 11604, 11606, 11620, 11621, 11622, 11623, 11624, 11626, 11640, 11641, 11642, 17000, 17003, 17004, 17110, 17111, 17260, 17261, 17262, 17263, 17264, 17266, 17270, 17271, 17272, 17273, 17274, 17276, 17280, 17281, 17282, 17283, 17284, 17286

 A/B

Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder

L34869

Billing and Coding: Repetitive Transcranial Magnetic Stimulation (rTMS)
in Adults with Treatment Resistant Major Depressive Disorder

A57813

90867, 90868, 90869

 B

Respiratory Therapy and Oximetry
Services

L33446

Billing and Coding: Respiratory Therapy and Oximetry Services

A56730

31720, 94640, 94664, 94760, 94761, 94762

 B

Retroperitoneal Ultrasound

L34577

Billing and Coding: Retroperitoneal Ultrasound

A55336

76770, 76775, 76776

 A/B

Rituximab

L35026

Billing and Coding: Rituximab

A56380

J3590, J9311, J9312, Q5123,Q5115

 A/B

Routine Foot Care

L37643

Billing and Coding: Routine Foot Care

A56680

11055, 11056, 11057, 11719, 11720, 11721, G0127

 A/B
Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence L39543 Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence A59332 64561, 64581, 64585, 64590, 64595, 64596, 64597, 64598, 95970, 95971, 95972, A4290, C1767, C1778, C1820, C1883, C1897, L8678 A/B
Sacroiliac Joint Injections and Procedures L39402 Billing and Coding: Sacroiliac Joint Injections and Procedures A59192 27096, 64451, 64625, 77002, 77012, G0260 A/B
Scalp Cooling for the Prevention of Chemotherapy-Induced Alopecia L39573 Billing and Coding: Scalp Cooling for the Prevention of Chemotherapy-Induced Alopecia  A59371 0662T, 0663T A/B

Scanning Computerized Ophthalmic
Diagnostic Imaging
(SCODI)

L34431

Billing and Coding: Scanning Computerized Ophthalmic
Diagnostic
Imaging (SCODI)

A56825

92132, 92133, 92134

 A/B

Somatosensory Testing

L34433

Billing and Coding: Somatosensory Testing

A56769

95925, 95926, 95927

 A/B

Special Electroencephalography

L33447

Billing and Coding: Special Electroencephalography

A56771

95700, 95705, 95708, 95717, 95719, 95721, 95812, 95813, 95816, 95819, 95822

 B

Spinal Cord Stimulators for Chronic Pain

L37632

Billing and Coding: Spinal Cord Stimulators for Chronic Pain

A56876

63650, 63655, 63661, 63662, 63663, 63664, 63685, 63688, 95970, 95971, 95972, L8680

 A/B
Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication L37774

Billing and Coding: Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication

A56384

 93668 A/B
Surgical Treatment of Nails L39258 Billing and Coding: Surgical Treatment of Nails A59028 11730, 11732, 11750, 11765 A/B

Swallowing Studies for Dysphagia

L33449

Billing and Coding: Swallowing Studies for Dysphagia

A56621

70370, 70371, 74230

 B
Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain L39420 Billing and Coding: Thermal Destruction of the Intraosseous Basivertebral Nerve (BVN) for Vertebrogenic Lower Back Pain A59205 64628, 64629 A/B
Topical Oxygen Therapy L37873 Billing and Coding: Topical Oxygen Therapy A56431 A4575 A/B

Total Joint Arthroplasty

L33456

Billing and Coding: Total Joint Arthroplasty

A56777

27130, 27132, 27134, 27137, 27138, 27445, 27447, 27486, 27487

 A/B
Total Shoulder Arthroplasty L39956 Billing and Coding: Total Shoulder Arthroplasty A59878 23472 A/B
Transanal Endoscopic Surgery (TES) L38551 Billing and Coding: Transanal Endoscopic Surgery (TES) A58000 0184T A/B
Transurethral Waterjet
Ablation of the Prostate		 L38549 Billing and Coding: Transurethral Waterjet Ablation of the Prostate A58008 C2596, K1010, K1011, K1012, 0421T A/B
Treatment of Varicose Veins of the Lower Extremities L39121 Billing and Coding: Treatment of Varicose Veins of the Lower Extremities A58876 36465, 36466, 36468, 36470, 36471, 36473, 36474, 36475, 36476, 36478, 36479, 36482, 36483, 37500, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37785 A/B
Treatment of Males with Low Testosterone L39086 Billing and Coding: Treatment of Males with Low Testosterone A58828 11980, 84410, 96372, J1071, J3121, J3145, J3490 A/B
Trigger Point Injections (TPI) L39671 Billing and Coding: Trigger Point Injections (TPI)

A59498

20552, 20553

 A/B

Upper Gastrointestinal Endoscopy and Visualization

L34434

Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization

A56389

43191, 43192, 43193, 43194, 43195, 43196, 43197, 43198, 43200, 43201, 43202, 43204, 43205, 43206, 43210, 43211, 43212, 43213, 43214, 43215, 43216, 43217, 43220, 43226, 43227, 43229, 43231, 43232, 43233, 43235, 43236, 43237, 43238, 43239, 43240, 43241, 43242, 43243, 43244, 43245, 43246, 43247, 43248, 43249, 43250, 43251, 43252, 43253, 43254, 43255, 43259, 43260, 43261, 43262, 43263, 43264, 43265, 43266, 43270, 43274, 43275, 43276, 43277, 43278, 43499, 74235, 0652T, 0653T, 0654T

 A/B

Vestibular Function Testing

L34537

Billing and Coding: Vestibular Function Testing

A56497

92517, 92519, 92537, 92538, 92540, 92541, 92542, 92544, 92545, 92546, 92547, 92548, 92549, 92552, 92553, 92556, 92557, 92581

 B

Virtual Colonoscopy (CT Colonography)

L33452

Billing and Coding: Virtual Colonoscopy (CT Colonography)

A56772

74261, 74262

 B
Vitamin D Assay Testing L39391 Billing and Coding: Vitamin D Assay Testing A59170 82306, 82652 A/B
Voretigene Neparvovecrzyl (Luxturna®) L37863 Billing and Coding: Voretigene Neparvovecrzyl (Luxturna®) A56419 J3398, 67036, 67299 A/B

White Cell Colony Stimulating Factors

L37176

Neulasta® (pegfilgrastim) Onpro® Kit (On-Body Injector)

A54682

96372, 96377, J1442, J1447, J2506, J2820, Q5101, Q5108, Q5110, Q5111

 A/B
N/A   Billing and Coding: White Cell Colony Stimulating Factors A56748 J1449, Q5120, Q5122, Q5125, Q5127, Q5130 A/B

Wireless Capsule Endoscopy

L36427

Billing and Coding: Wireless Capsule Endoscopy

A56727

91110, 91111

 A/B

Wireless Gastrointestinal Motility Monitoring Systems

L33455

Billing and Coding: Wireless Gastrointestinal Motility Monitoring Systems

A56724

91112

 B

YAG Capsulotomy

L37644

Billing and Coding: YAG Capsulotomy

A56792

66821

 A/B
N/A

N/A

Billing and Coding: Aflibercept (EYLEA®) Coding and Billing Guidelines

A53387

67028, J0177, J0178

 B

N/A

N/A

Billing and Coding: Guidance for Anti-Inhibitor Coagulant Complex (AICC) National Coverage Determination (NCD) 110.3

 A56065 J7170, J7175, J7179, J7180, J7181, J7183, J7182, J7185, J7186, J7187, J7188, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7196, J7197, J7198, J7200, J7201, J7202, J7203, J7204, J7205, J7207, J7208, J7209, J7210, J7211, J7212 B

N/A

N/A

Billing and Coding: Instructions for Lemtrada® (alemtuzumab) When Used in the Treatment of Relapsing Multiple Sclerosis

A55310

J0202

 A/B

N/A

N/A

Billing and Coding: Additional Claim Documentation Requirements for Not Otherwise Classified (NOC) Drugs and Biological Products with Specific FDA Label Indications

A54880

A4641, A9699, J3490, J3590, J9999

 A/B

N/A

N/A

Billing and Coding: Amniotic Membrane Billing Guidelines for HCPCS Code V2790

A53441

65775, 65778, 65779, 65780, V2790

 B

N/A

N/A

 Billing and Coding: Chemotherapy A56141

 

 A/B

N/A

N/A

Billing and Coding: Endometrial Hyperplasia Treatment

A53043

58999

 B
N/A N/A Billing and Coding: FDA Approved CLL Companion Diagnostic Test A56008 88271, 88275, 88291, 88374, 88377 A/B

N/A

N/A

Billing and Coding: FDA approves Iluvien for Diabetic Macular Edema

A54750

67028, J7313

 B

N/A

N/A

Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation

A53775

93797, 93798, G0422, G0423

 A/B

N/A

N/A

Billing and Coding: Gender Reassignment Services for Gender Dysphoria

A53793

11950, 11951, 11952, 11954, 15775, 15776, 15820, 15821, 15822, 15823, 15824, 15825, 15826, 15828, 15829, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15876, 15877, 15878, 15879, 17380, 19303, 19304, 19316, 19325, 19350, 21120, 21121, 21122, 21123, 21125, 21127, 21208, 21209, 30400, 30410, 30420, 30430, 30435, 30450, 53420, 53425, 53430, 54660, 54125, 54520, 54690, 55175, 55180, 55866, 55970, 55980, 56625, 56800, 56805, 57106, 57110, 57291, 57292, 57295, 57296, 57335, 57426, 58150, 58180, 58260, 58262, 58275, 58290, 58291, 58541, 58542, 58543, 58544, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573, 58720

 A/B
N/A N/A

Billing and Coding: Hemorrhoid Artery Ligation

A53006

46948

 B
N/A N/A Billing and Coding: IDTFs and Low Dose CT Scan for Lung Cancer Screening for CPT® Code 71271 A58641 71271, G0296 A/B

N/A

N/A

 Billing and Coding: Implantable Automatic Defibrillators A56343 33202, 33203, 33215, 33216, 33217, 33218, 33220, 33223, 33224, 33225, 33230, 33231, 33240, 33241, 33243, 33244, 33249, 33262, 33263, 33264, 33270, 33271, 33272, 33273, C7537, C7538, C7539, C7540, G0448 A/B

N/A

N/A

Billing and Coding: Implantable Miniature Telescope (IMT) for Macular Degeneration

A53501

0308T

 B

N/A

N/A

 Billing and Coding: Intravesical Instillation of Bacillus Calmette-Guérin (BCG) A56754 J9030 A/B

N/A

N/A

Billing and Coding: Low frequency, non-contact, non-thermal ultrasound

A54555

97597, 97598, 97602, 97605, 97606, 97610

 B

N/A

N/A

Billing and Coding: Percutaneous Ventricular Assist Device

A53986

33990, 33991, 33992, 33993, 33995, 33997

 B
N/A N/A Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemaker

A54831

 33206, 33207, 33208, 33274, 33275 A/B
N/A N/A

Billing and Coding: Spiracur SNaP® Wound Care System

 A53781 97607, 97608 A/B

N/A

N/A

Billing and Coding: Thermal Capsulorrhaphy

A53435

29999

 B

N/A

N/A

 Billing and Coding: Use of Laterality Modifiers A56869 15820, 15821, 15822, 15823, 20610, 20611, 66940, 66982, 66983, 66984, 66987, 66988, 66989, 66991, 67027, 67028, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67917, 67921, 67922, 67923, 68841, 0449T, 0671T, 0699T A/B

N/A

N/A

Billing and Coding: Xofigo Billing Instructions

A54559

A9606

 B

N/A

N/A

Billing and Coding: External Components for Cochlear Implants

A53708

L7510, L7520, L8614, L8615, L8616, L8617, L8618, L8619, L8621, L8622, L8623, L8624, L8627, L8628, L8629, L9900

 B

N/A

N/A

 Billing and Coding: High Resolution Anoscopy

A59323

46601, 46607

 B

N/A

N/A

CPT® Modifier 59: Gastroenterology

A53399

45380, 45385

 B

N/A

N/A

Fracture of Ribs with Internal Fixation

A53931

21811, 21812, 21813

 B

N/A

N/A

Glaucoma Screening

A53495

G0117, G0118

 B

N/A

N/A

Billing and Coding: Medicare Preventive Coverage for Certain Vaccines

A54767

90630, 90637, 90638, 90653, 90654, 90655, 90656, 90657, 90660, 90661, 90662, 90670, 90671, 90672, 90673, 90674, 90675, 90676, 90677, 90682, 90685, 90686, 90687, 90688, 90689, 90694, 90702, 90714, 90715, 90732, 90739, 90740, 90743, 90744, 90746, 90747, 90756, 90759, G0008, G0009, G0010, Q2034, Q2035, Q2036, Q2037, Q2038, Q2039

 A/B

N/A

N/A

Once in a Lifetime Abdominal Aortic Aneurysm (AAA) Screening Article

A55071

76706

 A/B

N/A

N/A

Billing and Coding: Periodic Adjustment of Gastric Restrictive Device after the Global Period (Codes added Modifier 25)

A53444

43999

 B

N/A

N/A

Billing and Coding: Pre/Postoperative Care: Date of Service

A53472

66982, 66987, 66988

 B

N/A

N/A

Billing and Coding: Radiology Services: Multiple, Identical Services on Same Day

A53488

73000

 B

N/A

N/A

Spiracur SNaP®
Wound Care System

A53781

97607, 97608

 A/B

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