LCDs, NCDs, Coverage Articles

Published 03/14/2024

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
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
Ambulance Services
Billing and Coding:
Ambulance Services
A0425, A0426, A0427, A0428, A0429, A0430, A0431, A0432, A0433, A0434, A0435, A0436
 A
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
Billing and Coding: Blepharoplasty, Eyelid
Surgery, and Brow Lift
15820, 15821, 15822, 15823, 67192, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924
 A/B
B-Type Natriuretic
Peptide (BNP)
Testing
Billing and Coding: B-Type Natriuretic Peptide (BNP) Testing
83880
 A
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)
Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA)
75571, 75572, 75573, 75574
 A/B
Cardiac Radionuclide Imaging
Billing and Coding:
Cardiac Blood Pool
Imaging (Multiple
Gated Acquisition
Scanning — MUGA, Ventriculography)
when Performed in
Conjunction with
Cardiotoxic Chemotherapy
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 Resynchron-ization Therapy (CRT) L39080 Billing and Coding:
Cardiac Resynchron-
ization Therapy (CRT)		 A58821 33224, 33225 A/B
Cardiac Event Detection
Billing and Coding:
Cardiac Event Detection
93228, 93229, 93241–93248, 93268, 93270, 93271, 93272, 93799
 A
Cataract Surgery
Complex Cataract Surgery: Appropriate Use and Documentation
66830, 66840, 66850, 66852, 66982, 66920, 66940, 66982, 66983, 66984
 A/B
N/A   Billing and Coding:
Cataract Surgery		 A56613 66989, 66991 A/B
Cervical Disc Replacement L38033 Billing and Coding:
Cervical Disc Replacement		 A57021 22856, 22858, 22861, 0098T, 0375T, 97010–97036, 97039, 97110–97546 A/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
Billing and Coding:
Incomplete Colonoscopy/
Failed Colonoscopy

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
G2204
 A/B
N/A   Billing and Coding:
Colonoscopy/Sigmoid-
oscopy/Proctosigmoid-
oscopy		 A56632 G0105, 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

71250, 71260, 71270

 A/B
Continuous Peripheral Nerve
Blocks (CPNB)
Billing and Coding:
Continuous Peripheral
Nerve Blocks (CPNB)
64416, 64446, 64448, 64449
 A/B
Corneal Pachymetry
Billing and Coding: Corneal Pachymetry
76514
 A/B
Cosmetic and Reconstructive
Surgery
 Billing and Coding: Oral Maxillofacial Prosthesis
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    
CT of the Abdomen
and Pelvis
Billing and Coding:
CT of the Abdomen
and Pelvis
72192, 72193, 72194, 74150, 74160, 74170, 74176, 74177, 74178
 A/B
CT of the Head
Billing and Coding:
CT of the Head
G2187, G2188, G2189, G2190, G2191, G2192, G2193, G2194, G2195, 70450, 70460, 70470
 A/B
Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®)  L38792 Billing and Coding: Dexamethasone Intra-canalicular 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
Billing and Coding: Echocardiography
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 Inter-
ventions 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
Billing and Coding:
Frequency of Hemodialysis
90999
 A/B
GlycoMark® Testing for Glycemic Control L36761 Billing and Coding: GlycoMark Testing for Glycemic Control A56872 84378, 84999 A/B
Health and Behavior Assessment/
Intervention
Billing and Coding:
Health and Behavior
Assessment/Intervention
G2214, 96150, 96151, 96152, 96153, 96154, 96155
 A/B
Homocysteine Level, Serum
Billing and Coding: Homocysteine Level,
Serum
83090
 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
Infliximab
Billing and Coding:
Infliximab
J1745, Q5103, Q5104, Q5109, Q5121
 A/B
Implantable Con-
tinuous Glucose
Monitors (I-CGM)		 L38743 Billing and Coding:
Implantable Continuous
Glucose Monitors (I-CGM)		 A58277 0446T, 0447T, 0448T A/B
Infrared Coagulation
(IRC) of
Hemorrhoids
Billing and Coding:
Infrared Coagulation
(IRC) of Hemorrhoids
46930
 A
Intraoperative Radiation Therapy L37779
Billing and Coding: Intraoperative Radiation Therapy
 19294, 77424, 77425, 77469, 76145, C9726 A/B
Intravenous Immunoglobulin (IVIG)
Billing and Coding:
Intravenous Immuno-
globulin (IVIG)
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, 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: Coenzyme Q10 (CoQ10) L37022 Billing and Coding: Urine Drug Testing A55709 82542 A/B
Lab: Cystatin C Measurement L37581 Billing and Coding: Lab: Cystatin C Measurement A56948 82610 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 8312, 88313, 88341, 88342, 88344, 88360, 88361 A/B
    Billing and Coding: Lab: Immunohistochemistry (IHC) Indications for Breast Pathology  A53704   /B
Laparoscopic Sleeve Gastrectomy
for Severe Obesity
Billing and Coding:
Laparoscopic Sleeve Gastrectomy for
Severe Obesity
43775
 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
Billing and Coding:
Magnetic Resonance Angiography
70544, 70545, 70546, 70547, 70548, 70549, C8900, C8901, C8902, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, C8920, C8934, C8935, C8936
 A
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
 0398T A/B
Magnetic Resonance Imaging
of the Orbit, Face,
and/or Neck
Billing and Coding:
Magnetic Resonance
Imaging of the Orbit,
Face, and/or Neck
70540, 70542, 70543
 A
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, 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
Near-Infrared Spectroscopy in Wound and Flap Management L39385 Billing and Coding: Near-Infrared Spectroscopy in Wound and Flap Managemen A59158 0640T, 0641T, 0642T A/B
Nerve Blocks and Electrostimulation
for Peripheral
Neuropathy
Billing and Coding:
Nerve Blocks and Electrostimulation
for Peripheral Neuropathy
64450, 97032, 97139, G0282, G0283
 A/B
Nerve Conduction
Studies and
Electromyography
Billing and Coding: Nerve Conduction Studies and Electromyography
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
table 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
Ophthalmic 
Angiography
(Fluorescein and Indocyanine Green)
Billing and Coding:
Ophthalmic Angio-
graphy (Fluorescein and Indocyanine Green)
92235, 92240, 92242
 A/B
Ophthalmology:
Extended
Ophthalmoscopy and Fundus
Photography
Billing and Coding: Ophthalmology:
Extended Ophthalmo-
scopy and Fundus
Photography
92201, 92202, 92227, 92228, 92250
 A/B
Outpatient Observation Bed/
Room Services
Billing and Coding:
Outpatient Observation Bed/Room Services
99221, 99222, 99223, 99231, 99232, 99233, 99234, 99235, 99236, 99238, 99239, G0378, G0379
 A
Outpatient Occupational
Therapy
Billing and Coding:
CPT® Code 97755 — 
Assistive Technology Assessment
29065, 29075, 29085, 29086, 29105, 29125, 29126, 29130, 29131, 29200, 29240, 29260, 29280, 29345, 29365, 29405, 29505, 29515, 29520, 29530, 29540, 29550, 29799, 90901, 90911, 92526, 92548, 92610, 95851, 95852, 96112, 96113, 96125, 97010, 97012, 97016, 97018, 97022, 97024, 97026, 97032, 97033, 97034, 97035, 97036, 97110, 97112, 97113, 97124, 97140, 97150, 97165, 97166, 97167, 97168, 97530, 97533, 97535, 97537, 97542, 97545, 97546, 97597, 97598, 97602, 97605, 97606, 97610, 97750, 97755, 97760, 97761, 97763, 97799, G0281, G0283, G0329, G0515
 A
N/A
 
Low frequency, non-
contact, non-thermal
ultrasound (CPT® Code 97610)
 
  
N/A
 
Billing and Coding: Outpatient Occupational Therapy
90912, 90913, 97129, 97130, 97550, 97551, 97552
  
Outpatient Physical Therapy
CPT® Code 97755 —
 Assistive Technology Assessment
29065, 29075, 29085, 29105, 29125, 29126, 29130, 29131, 29200, 29240, 29260, 29280, 29345, 29365, 29405, 29445, 29505, 29515, 29520, 29530, 29540, 29550, 29580, 29799, 90901, 92548, 95851, 95852, 95992, 97010, 97012, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97110, 97112, 97113, 97116, 97124, 97140, 97150, 97161, 97162, 97163, 97164, 97530, 97533, 97535, 97537, 97542, 97545, 97546, 97597, 97598, 97602, 97605, 97606, 97610, 97750, 97755, 97760, 97761, 97763, 97799, G0281, G0283, G0329
 A
N/A
 
Low frequency, non-
contact, non-thermal
ultrasound (CPT® Code 97610)
 
  
N/A
 
Billing and Coding:
Outpatient Physical Therapy
90912, 90913, 97550, 97551, 97552
  
Outpatient Speech Language
Pathology
Billing and Coding:
Outpatient Speech
Language Pathology
31579, 92507, 92508, 92511, 92512, 92517, 92518, 92519, 92520, 92521, 92522, 92523, 92524, 92526, 92597, 92605, 92606, 92607, 92608, 92609, 92610, 92611, 92612, 92613, 92614, 92615, 92616, 92617, 92618, 92626, 92627, 92630, 92633, 92650, 92651, 92652, 92653, 95857, 96105, 96112, 96113, 96116, 96121, 96125, 97129, 97130, 97150, 97533, 97535, 97550, 97551, 97552
 A
Partial Hospitalization Programs
Billing and Coding:
Partial Hospitalization
Programs
90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90846, 90847, 90875, 90876, 90899, 96116, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, G0129, G0176, G0177, G0410, G0411
 A
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
Accreditation and
Credentialing Require-
ments for Polysomnography
95782, 95783, 95800, 95801, 95803, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400
 A/B
    Billing and Coding: Polysomnography A56995    
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
Billing and Coding
for Removal of Benign
and Malignant Skin
Lesions
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
Respiratory Therapy
(Respiratory Care)
Billing and Coding:
Respiratory Therapy (Respiratory Care)
31500, 31502, 31720, 92950, 94002, 94003, 94004, 94010, 94011, 94012, 94013, 94060, 94070, 94150, 94200, 94375, 94450, 94621, 94640, 94642, 94660, 94662, 94664, 94667, 94668, 94669, 94726, 94727, 94728, 94729, 94772, G0237, G0238, G0239
 A
Retroperitoneal Ultrasound
Billing and Coding: Retroperitoneal
Ultrasound
76770, 76775, 76776
 A/B
Rituximab
Billing and Coding:
Rituximab
J3590, J9311, J9312, Q5123, Q5115
 A/B
Routine Foot Care
Billing and Coding:
Routine Foot Care
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)
Billing and Coding:
Scanning Computerized Ophthalmic Diagnostic
Imaging (SCODI)
92132, 92133, 92134
 A/B
Somatosensory Testing
Billing and Coding: Somatosensory Testing
95925, 95926, 95927
 A/B
Spinal Cord Stimulators for
Chronic Pain
Billing and Coding:
Spinal Cord Stimulators
for Chronic Pain
63650, 63655, 63661, 63662, 63663, 63664, 63685, 63688, 95970, 95971, 95972, L8680
 A/B
Stretta Procedure
Billing and Coding: Stretta Procedure
43257
 A
Surgical Treatment of Nails  L39258 Billing and Coding: Surgical Treatment of Nails A59028 11730, 11732, 11750, 11765 A/B
Supervised Exercise Therapy for the
Treatment of Per-
ipheral Arterial Dis-
ease with Sympto-
matic Lower Ex-
tremity Intermittent Claudication		 L37774
Billing and Coding:
Supervised Exercise
Therapy for the Treat-
ment of Peripheral
Arterial Disease with Symptomatic Lower
Extremity Intermittent Claudication
 93668 A/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 Arthro-
plasty
Billing and Coding:
Total Joint Arthroplasty
27130, 27132, 27134, 27137, 27138, 27445, 27447, 27486, 27487
 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 Males with Low Testosterone L39086 Billing and Coding: Treatment of Males with Low Testosterone A58828

11980, 84410, 96372, J1071, J3121, J3145, J3490

 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
Trigger Point Injections (TPI) L39671 Billing and Coding: Trigger Point Injections (TPI) A59498 20552, 20553 A/B
Upper Gastrointestinal Endoscopy
and Visualization
Billing and Coding:
Upper Gastrointestinal Endoscopy and
Visualization
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, J0585, 0652T, 0653T, 0654T
 A/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 Neparvovec-
rzyl (Luxturna®)		 A56419 J3398, 67036, 67299 A/B
White Cell Colony Stimulating Factors
Billing and Coding: Neulasta®(pegfilgrastim)
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
Billing and Coding:
Wireless Capsule
Endoscopy
91110, 91111
 A/B
YAG Capsulotomy
Billing and Coding:
YAG Capsulotomy
66821
 A/B
N/A
N/A
Billing and Coding:
Additional Claim Documentation
Requirements for Not Otherwise Classified
(NOC) Drugs and Bio-
logical Products with
Specific FDA Label
Indications
A4641, A9699, J3490, J3590, J9999
 A/B
N/A
N/A
 Billing and Coding: Chemotherapy A56141

 

 A/B
N/A N/A

Billing and Coding:
Complex Drug
Administration Coding

 A58527

96365, 96366, 96367, 96368, 96372, 96374, 96375, 96376, 96377, 96379, J0129, J0222, J0248, Jo491, J0485, J0517, J0565, J0638, J0717, J0896, J0897, J1300, J1301, J1442, J1442, J1602, J2182, J2323, J2353, J2354, J2357, J2506, J2786, J2793, J3245, J3358, J3380, J3590, Q5101, Q5101, Q5108, Q5110, Q5110, Q5111, Q5120, Q5122, Q5127, Q5130

 A/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:
Frequency and Duration
for Cardiac Rehabilitation
and Intensive Cardiac Rehabilitation
93797, 93798, G0422, G0423
 A/B
N/A
N/A
 Billing and Coding:
Gender Reassignment Services for Gender
Dysphoria
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:
Hospital Outpatient
Drugs and Biologicals
Under the Outpatient Prospective Payment
System (OPPS) 

 A55913 C9399, J3490, J3590 A
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: Intravesical Instillation
of Bacillus Calmette-
Guérin (BCG)		 A56754   A/B
N/A N/A Billing and Coding: Percutaneous Ventricular Assist Device 33990, 33991, 33992, 33993 33995, 33997 A
N/A N/A
Billing and Coding:
Medicare Preventive
Coverage for Certain
Vaccines
 90630, 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 Billing and Coding:
Single Chamber and
Dual Chamber Permanent Cardiac Pacemaker		 33206, 33207, 33208, 33274, 33275 A/B
N/A N/A Billing and Coding:
Spiracur SNaP® Wound
Care System		 A53781 33206, 33207, 33208 A/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, 0449T, 0671T, 0699T A/B
N/A
N/A
Billing and Coding Instructions for Lem-
trada® (alemtuzumab)
When Used in the
Treatment of Relapsing Multiple Sclerosis
J0202
 A/B
N/A
N/A
Billing and Coding:
PET Scan Claims to
Identify Bone Meta-
stasis of Cancer
78811, 78812, 78813, 78814, 78815, 78816
 A
N/A N/A Billing and Coding for Hospital Outpatient
Drugs and Biologicals
Under the Outpatient Prospective Payment
System (OPPS) 		 A55913 C9399, J3490, J3590  A
N/A N/A Billing and Coding:
Use of Laterality
Modifiers		 A56869 15820, 15821, 15822, 15823, 20610, 20611, 66940, 66982, 66983, 66984, 67027, 67028, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67917, 67921, 67922, 67923, 0191T, 0449T A/B
N/A
N/A
Once in a Lifetime
Abdominal Aortic
Aneurysm (AAA)
Screening Article
76706
 A/B

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