LCDs / Medical Policies
A Local Coverage Determination (LCD), as defined in §1869(f)(2)(B) of the Social Security Act (SSA), is a Medicare Administrative Contractor's (MAC's) determination as to whether a particular item or service is covered on a contractor–wide basis in accordance with section 1862(a)(1)(A) of the Act. For additional information on the LCD process, please reference the CMS Medicare Program Integrity Manual (Pub. 100-08), chapter 13.
- New LCD Request Process
- LCD Reconsideration Process
- LCD Stakeholder Meeting Schedule and Recordings
- Draft LCD Comment Submission Form
How to Find CGS' LCDs
CMS and MACs use the Medicare Coverage Database (MCD) to maintain all National Coverage Determinations (NCDs) and LCDs. The CMS MCD Archive
contains outdated (no longer in effect) LCDs and articles.
For your convenience, the table below includes direct links to CGS' active and future LCD policies and their related billing and coding articles (listed alphabetically by title).
- Download a copy of this table in Excel spreadsheet format
(Revised: 11.06.23)
NOTE: An NCD/LCD policy does not exist for every item or service that Medicare covers. If your search (e.g., keyword or CPT/HCPCS code) on this page or the CMS MCD does not yield a result, use the Social Security Act, CMS Medicare Benefit Policy Manual (Pub. 100-02), Code of Federal Regulations and/or other CMS/CGS resources to determine coverage guidance.
ID | Title | Effective Date | Revision Effective Date | Last Updated | Status | HCPCS/CPT Code | Related Article(s) |
---|---|---|---|---|---|---|---|
L32553![]() |
Allergy Immunotherapy | 10/1/15 | 10/27/22 | 10/21/22 | Active | 95115, 95117, 95144, 95145, 95146, 95147, 95148, 95149, 95165, 95170, 95180, 95199 | A56424 – Billing and Coding: Allergy Immunotherapy![]() |
L36975![]() |
Bladder/Urothelial Tumor Markers | 3/6/17 | 1/26/23 | 1/20/23 | Active | 86294, 86316, 86386, 88120, 88121 | A56471 – Billing and Coding: Bladder / Urothelial Tumor Markers![]() |
L33944![]() |
Blepharoplasty | 10/1/15 | 10/27/22 | 10/21/22 | Active | Group 1: 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924 Group 2: 15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908 |
A56439 – Billing and Coding: Blepharoplasty![]() |
L36460![]() |
Bone Mass Measurement | 2/1/16 | 1/5/23 | 12/28/22 | Active | 76977, 77078, 77080, 77081, 77085, 78350, 78351, G0130, 0508T, 0554T, 0555T, 0556T, 0557T, 0558T | A57132 – Billing and Coding: Bone Mass Measurement![]() |
L33949![]() |
Botulinum Toxins | 10/1/15 | 12/1/22 | 12/29/22 | Active | Group 1: 31573, 43201, 43236, 46505, 52287, 64611, 64612, 64615, 64616, 64617, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 67345 Group 2: C9399, J0585, J0586, J0587, J0588, J3590 |
A56472 – Billing and Coding: Botulinum Toxins![]() |
L33950![]() |
Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography | 10/1/15 | 12/1/22 | 11/23/22 | Active | 19030, 76641, 76642, 77046, 77047, 77048, 77049, 77053, 77054, 77063, 77065, 77066, 77067, C8903, C8905, C8906, C8908, G0279 | A56448 – Billing and Coding: Breast Imaging Mammography / Breast Echography (Sonography) / Breast MRI / Ductography![]() |
L33943![]() |
B-type Natriuretic Peptide (BNP) Testing | 10/1/15 | 12/1/22 | 11/23/22 | Active | 83880 | A56425 – Billing and Coding: B-type Natriuretic Peptide (BNP) Testing![]() |
L33946![]() |
Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy | 10/1/15 | 10/27/22 | 10/21/22 | Active | 66820, 66821 | A56493 – Billing and Coding: Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy![]() |
L33959![]() |
Cardiac Catheterization and Coronary Angiography | 10/1/15 | 10/27/22 | 10/21/22 | Active | Group 1: 92978, 92979, 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93462, 93463, 93464, 93503, 93505, 93563, 93564, 93565, 93566, 93567, 93568, 93571, 93572, 93593, 93594, 93595, 93596, 93597, 93598, G0269 Group 2: 36140, 36200, 36215, 36216, 36217, 36218, 36221, 36222, 36223, 36224, 36225, 36226, 36227, 36228, 36245, 36246, 36247, 36248, 75625, 75630, 75635, 75705, 75710, 75716 Group 3: G0278 |
A56500 – Billing and Coding: Cardiac Catheterization and Coronary Angiography![]() |
L33947![]() |
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) | 10/1/15 | 10/5/23 | 9/29/23 | Active | 75571, 75572, 75573, 75574 | A56451 – Billing and Coding: Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)![]() |
L33952![]() |
Cardiac Event Detection | 10/1/15 | 12/1/22 | 11/23/22 | Active | 93228, 93229, 93268, 93270, 93271, 93272, 93799 | A56452 – Billing and Coding: Cardiac Event Detection![]() |
L33960![]() |
Cardiovascular Nuclear Medicine | 10/1/15 | 1/26/23 | 1/20/23 | Active | 78451, 78452, 78453, 78454, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78494, 78496, 93015, 93016, 93017, 93018, A9500, A9501, A9502, A9505, A9512, A9538, A9560, J0153, J1245, J1250, J2785, J3490 | A56494 – Billing and Coding: Cardiovascular Nuclear Medicine![]() |
L33954![]() |
Cataract Extraction | 10/1/15 | 1/5/23 | 12/28/22 | Active | 66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984 | A56453 – Billing and Coding: Cataract Extraction![]() |
L33945![]() |
Cerumen (Earwax) Removal | 10/1/15 | 1/26/23 | 1/20/23 | Active | 69209, 69210, G0268 | A56454 – Billing and Coding: Cerumen (Earwax) Removal![]() |
L37254![]() |
Chiropractic Services | 11/6/17 | 1/26/23 | 1/20/23 | Active | 98940, 98941, 98942 | A56455 – Billing and Coding: Chiropractic Services![]() |
L37126![]() |
Coenzyme Q10 (CoQ10) | 7/10/17 | 1/26/23 | 1/20/23 | Active | 82542 | A55715 – Billing and Coding: Coenzyme Q10 (CoQ10)![]() |
L38777![]() |
Colon Capsule Endoscopy (CCE) | 3/29/21 | 1/30/22 | 12/10/21 | Active | NA | A58362 – Billing and Coding: Colon Capsule Endoscopy![]() |
L34005![]() |
Colonoscopy/Sigmoidoscopy/ Proctosigmoidoscopy | 10/1/15 | 1/26/23 | 1/20/23 | Active | 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, 45378, 45379, 45380, 45381, 45382, 45384, 45385, 45386, 45388, 45389, 45391, 45392, 45399 | A56456 – Billing and Coding: Colonoscopy / Sigmoidoscopy / Proctosigmoidoscopy![]() |
L38694![]() |
Computed Tomography Cerebral Perfusion Analysis (CTP) | 11/2/20 | 11/2/20 | 9/11/20 | Active | 0042T | A58218 – Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)![]() |
L34008![]() |
Computerized Corneal Topography | 10/1/15 | 1/26/23 | 1/20/23 | Active | 92025 | A56816 – Billing and Coding: Computerized Corneal Topography![]() |
L33999![]() |
Corneal Pachymetry | 10/1/15 | 1/26/23 | 1/20/23 | Active | 76514 | A56457 – Billing and Coding: Billing and Coding for Corneal Pachymetry![]() |
L34032![]() |
Debridement Services | 10/1/15 | 10/5/23 | 9/29/23 | Active | 11000, 11001, 11042, 11043, 11044, 11045, 11046, 11047 | A56459 – Billing and Coding: Debridement Services![]() |
L34062![]() |
Dialysis Access Maintenance | 10/1/15 | 2/9/23 | 1/31/23 | Active | 36005, 36010, 36140, 36215, 36216, 36217, 36218, 36245, 36246, 36247, 36593, 36831, 36832, 36833, 36901, 36902, 36903, 36904, 36905, 36906, 36907, 37186, 37211, 37212, 37213, 37214, 37236, 37237, 37246, 37247, 37248, 37249, 75710, 75820, 75822, 75825, 75827, 93990 | A56460 – Billing and Coding: Dialysis Access Maintenance![]() |
L38992![]() |
Electroretinography (ERG) | 1/30/22 | 1/12/23 | 1/4/23 | Active | 92273, 92274, 0509T | A58706 – Billing and Coding: Electroretinography (ERG)![]() |
L34081![]() |
Endoscopy by Capsule | 10/1/15 | 3/2/23 | 2/23/23 | Active | Group 1: 91110 Group 2: 91111, 91299 |
A56461 – Billing and Coding: Endoscopy by Capsule![]() |
L39015![]() |
Epidural Steroid Injections for Pain Management | 12/5/21 | 9/21/23 | 9/13/23 | Active | Group 1: 62321, 62323, 64479, 64480, 64483, 64484 Group 2: 62320, 62322 |
A58731 – Billing and Coding: Epidural Steroid Injections for Pain Management![]() |
L34356![]() |
Erythropoiesis Stimulating Agents (ESA) | 10/1/15 | 3/2/23 | 2/23/23 | Active | J0881, J0882, J0885, J0890. Q4081, Q5105, Q5106 | A56462 – Billing and Coding: Erythropoiesis Stimulating Agents (ESA)![]() |
L38773![]() |
Facet Joint Interventions for Pain Management | 5/2/21 | 3/17/22 | 3/11/22 | Active | Group 1 64490, 64491, 64493, 64494, 64633, 64634, 64635, 64636 Group 2 64492, 64495, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T |
A58364 – Billing and Coding: Facet Joint Interventions for Pain Management![]() |
L34037![]() |
Flow Cytometry | 10/1/15 | 3/2/23 | 2/23/23 | Active | Group 1: 88182, 88184, 88185, 88187, 88188, 88189 Group 2: 86355, 86356, 86357, 86359, 86360, 86361, 86367 |
A56464 – Billing and Coding: Flow Cytometry![]() |
L38378![]() |
Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH) | 4/1/20 | 10/22/23 | 8/29/23 | Active | C2596, 0421T | A57926 – Billing and Coding: Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH)![]() |
L37364![]() |
Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification Tests (NAATs) | 1/7/19 | 2/2/23 | 1/27/23 | Active | Group 1: 87505, 87506 Group 2: 87507, 0097U |
A56596 – Billing and Coding: Foodborne Gastrointestinal Panels Identified by Multiplex Nucleic Acid Amplification (NAATs)![]() |
L37575![]() |
Frequency of Hemodialysis | 4/1/19 | 1/26/23 | 1/27/23 | Active | 90999 | A56159 – Billing and Coding: Frequency of Hemodialysis![]() |
L36906![]() |
GlycoMark® Testing for Glycemic Control | 3/6/17 | 3/2/22 | 2/20/23 | Active | 84378, 84999 | A56465 – Billing and Coding: GlycoMark® Testing for Glycemic Control![]() |
L38307![]() |
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea | 4/1/20 | 3/2/23 | 2/24/23 | Active | 64582 | A57149 – Billing and Coding: Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea![]() |
L38268![]() |
Immune Thrombocytopenia (ITP) Therapy | 4/1/20 | 3/2/23 | 3/14/22 | Active | 38100, 38120, 90283, J1459, J1460, J1556, J1557, J1560, J1561, J1566, J1568, J1569, J1572, J1599, J2788, J2790, J2791, J2792, J2796, J8499, J9312 | A57160 – Billing and Coding: Immune Thrombocytopenia (ITP) Therapy![]() |
L38662![]() |
Implantable Continuous Glucose Monitors (I-CGM) | 11/2/20 | 10/5/23 | 9/29/23 | Active | 0446T, 0447T, 0448T | A58127 – Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM)![]() |
L35891![]() |
Intravenous Immune Globulin | 10/1/15 | 3/23/23 | 3/13/23 | Active | J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572 | A56779 – Billing and Coding: Intravenous Immune Globulin![]() |
L34090![]() |
Laser Ablation of the Prostate | 10/1/15 | 3/23/23 | 3/15/23 | Active | 52647, 52648, 52649 | A56467 – Billing and Coding: Laser Ablation of the Prostate![]() |
L37790![]() |
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor | 10/1/18 | 9/7/23 | 8/31/23 | Active | 0398T | A58323 – Billing and Coding: Magnetic Resonance Guided Focused Ultrasound Surgery System (MRgFUS) for the treatment of neurologic conditions![]() |
L37578![]() |
Micro-Invasive Glaucoma Surgery (MIGS) | 3/19/18 | 3/23/23 | 3/15/23 | Active | Group 1: 66989, 66991 Group 2: 0449T Group 3: 0253T, 0450T, 0474T, |
A56491 – Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS)![]() |
L36494![]() |
Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint | 2/1/16 | 1/5/23 | 12/29/22 | Active | 27279 | A56535 – Billing and Coding: Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint![]() |
L34195![]() |
Mohs Micrographic Surgery | 10/1/15 | 4/27/23 | 4/19/23 | Active | 17311, 17312, 17313, 17314, 17315 | A56836 – Billing and Coding: Mohs Micrographic Surgery![]() |
L36139![]() |
MolDX: Biomarkers in Cardiovascular Risk Assessment | 10/5/15 | 3/2/23 | 2/24/23 | Active | 81439, 82172, 82610, 83090, 83695, 83698, 83700, 83701, 83704, 83719, 83721, 86141 | A54685 – Billing and Coding: MolDX: Arrhythmogenic Right Ventricular Dysplasia / Cardiomyopathy (ARVD / C) Testing ![]() A57386 – Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment ![]() |
L38249![]() |
MolDX: Blood Product Molecular Antigen Typing | 11/1/20 | 4/27/23 | 4/21/23 | Active | Group 1: 81403, 0001U, 0084U Group 2: 81105, 81106, 81107, 81108, 81109, 81110, 81111, 81112, 0180U, 0181U, 0182U, 0183U, 0184U, 0185U, 0186U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0194U, 0195U, 0196U, 0197U, 0198U, 0199U, 0200U, 0201U, 0221U, 0222U |
A57155 – Billing and Coding: MolDX: Blood Product Molecular Antigen Typing![]() |
L36425![]() |
MolDX: Breast Cancer Assay: Prosigna® | 2/1/16 | 3/2/23 | 2/20/23 | Active | 81520 | A56989 – Billing and Coding: MolDX: Breast Cancer Assay: Prosigna®![]() |
L37832![]() |
MolDX: Breast Cancer Index® (BCI) Gene Expression Test | 4/1/19 | 9/22/22 | 9/14/22 | Active | 81518 | A56884 – Billing and Coding: MolDX: Breast Cancer Index™ (BCI) Gene Expression Test![]() |
L36675![]() |
ProMark® Risk Score | 10/10/16 | 11/24/22 | 11/16/22 | Active | 81479 | A57034 – Billing and Coding: ProMark® Risk Score![]() |
L36006![]() |
MolDX: ConfirmMDx Epigenetic Molecular Assay | 10/5/15 | 4/21/22 | 4/15/22 | Active | 81551 | A57031 – Billing and Coding: MolDX: ConfirmMDx Epigenetic Molecular Assay![]() |
L37598![]() |
Cystatin C Measurement | 12/17/18 | 6/9/22 | 6/1/22 | Active | 82610 | A56988 – Billing and Coding: Cystatin C Measurement![]() |
L37130![]() |
MolDX: DecisionDx-UM (Uveal Melanoma) | 7/10/17 | 5/18/23 | 5/8/23 | Active | 81552 | A56981 – Billing and Coding: MolDX: DecisionDx-UM (Uveal Melanoma)![]() |
L37356![]() |
MolDX: EndoPredict Breast Cancer Gene Expression Test | 3/6/18 | 4/17/23 | 4/21/23 | Active | 81522 | A56997 – Billing and Coding: MolDX: EndoPredict Breast Cancer Gene Expression Test![]() |
L37905![]() |
MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test | 5/20/19 | 5/19/22 | 5/12/22 | Active | 81554 | A56985 – Billing and Coding: MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test![]() |
L36117![]() |
MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease | 10/5/15 | 7/6/23 | 7/14/23 | Active | 81206, 81207, 81208, 0040U 81206, 81207, 81208, 81219, 81270, 81279, 81338, 81339 81450 81479, 0027U, 0040U |
A54686 – Billing and Coding: MolDX: BCR-ABL![]() A56999 – Billing and Coding: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease ![]() |
L35984![]() |
MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) | 10/1/15 | 7/20/23 | 7/14/23 | Active | 81240, 81241, 81291 | A56980 – Billing and Coding: MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)![]() |
L36485![]() |
MolDX: HLA-DQB1*06:02 Testing for Narcolepsy | 2/15/16 | 8/24/23 | 8/11/23 | Active | 81383 | A56881 – Billing and Coding: MolDX: HLA-DQB1*06:02 Testing for Narcolepsy![]() |
L37903![]() |
MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer | 5/13/19 | 6/15/23 | 6/6/23 | Active | 81479, 0388U | A56982 – Billing and Coding: MolDX: Inivata™, InVisionFirst®, Liquid Biopsy for Patients with Lung Cancer![]() |
L39017![]() |
MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer | 8/21/22 | 3/30/23 | 3/24/23 | Active | Group 1: 81202, 81215, 81217, 81293, 81296, 81299, 81308, 81318, 81322, 81353, 81403, 81404, 81405, 81406, 81432, 81433, 81435, 81436, 81437, 81438, 81479, 0101U, 0102U, 0103U, 0129U Group 2: 81163, 81164, 81165, 81166, 81167, 81201, 81203, 81212, 81216, 81292, 81294, 81295, 81297, 81298, 81300, 81307, 81317, 81319, 81321, 81323, 81351 |
A58734 – Billing and Coding: MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer![]() |
L37608![]() |
MolDX: MDS FISH | 5/6/19 | 6/30/22 | 6/1/23 | Active | 88271, 88273, 88274, 88275, 88291 | A56926 – Billing and Coding: MolDX: MDS FISH![]() |
L38016![]() |
MolDX: Melanoma Risk Stratification Molecular Testing | 6/24/19 | 5/18/23 | 5/12/23 | Active | 81479, 81529, 81599 | A57165 – Billing and Coding: MolDX: Melanoma Risk Stratification Molecular Testing![]() |
L36113![]() |
MolDX: MGMT Promoter Methylation Analysis | 10/5/15 | 7/20/23 | 7/12/23 | Active | 81287 | A56983 – Billing and Coding: MolDX: MGMT Promoter Methylation Analysis![]() |
L38822![]() |
MolDX: Minimal Residual Disease Testing for Cancer | 12/26/21 | 10/6/22 | 9/27/22 | Active | Group 1: 81445, 81479, 0340U Group 2: 81479 Group 1: 81450, 81479 Group 2: 81479 Group 3: 81206, 81207, 81208, 81310, 81315, 81316, 81334, 81401, 81479, 0040U Group 4: 81261, 81263, 81264, 81340, 81342, 81450, 81479 |
A58434 – Billing and Coding: MolDX: Minimal Residual Disease Testing for Solid Tumor Cancers![]() A58998 – Billing and Coding: MolDX: Minimal Residual Disease Testing for Hematologic Cancers ![]() |
L39389![]() |
MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma | 8/6/23 | N/A | 6/15/23 | Active | 81479, 0090U, 0314U | A59163 – Billing and Coding: MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma ![]() |
L39427![]() |
MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis | 10/15/23 | N/A | N/A | Active | 81599 | A59529 – Billing and Coding: MolDX: Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis![]() |
L38997![]() |
MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer | 7/17/22 | 7/27/23 | 7/21/23 | Active | 81313, 81479, 81551 | A58713 – Billing and Coding: MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer![]() |
L39038![]() |
MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing | 7/16/22 | 5/4/23 | 4/25/23 | Active | Group 1: 87631, 87636, 87637, 87801, 0240U, 0241U Group 2: 87505 Group 3: 87483 Group 4: 87154 Group 5: 81513, 81514, 87800, 87801, 87999, 0352U, 0353U Group 6: 87632, 87633, 87801, 87999, 0115U, 0202U, 0223U, 0225U Group 7: 87506, 87507 Group 8: 90 codes |
A58747 – Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing![]() |
L39276![]() |
MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia | 6/4/23 | NA | 4/14/23 | Active | 81479, 0114U | A59051 – Billing and Coding: MolDX: Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, and Neoplasia![]() |
L38582![]() |
MolDX: Molecular Testing for Solid Organ Allograft Rejection | 6/6/21 | 7/27/23 | 7/21/23 | Active | 81479, 81595, 81599, 0118U | A58061 – Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection![]() |
L38067![]() |
MolDX: Next-Generation Sequencing for Solid Tumors | 2/10/20 | 6/8/23 | 6/27/23 | Active | 81445, 81479, 0244U, 0250U, 0329U, 0334U | A57870 – Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors![]() |
L38070![]() |
MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies | 2/10/20 | 8/17/23 | 8/8/23 | Active | 81450, 81451, 81479 | A57873 – Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies![]() |
L35442![]() |
MolDX: NRAS Genetic Testing | 10/1/15 | 7/27/23 | 7/21/23 | Active | 81311, 81479 | A56998 – Billing and Coding: MolDX: NRAS Genetic Testing![]() |
L36951![]() |
MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™) | 3/6/17 | 9/28/23 | 9/20/23 | Active | 0045U | A56887 – Billing and Coding: MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™)![]() |
L36908![]() |
MolDX: Percepta® Bronchial Genomic Classifier | 3/13/17 | 9/28/23 | 9/20/23 | Active | 81479 | A56972 – Billing and Coding: MolDX: Percepta® Bronchial Genomic Classifier![]() |
L38394![]() |
MolDX: Pharmacogenomics Testing | 8/3/20 | 8/24/23 | 8/14/23 | Active | 81225, 81226, 81227, 81231, 81232, 81247, 81283, 81306, 81328, 81335, 81350, 81355, 81374, 81377, 81381, 81383, 81401, 81406, 81418, 81479, 0029U, 0030U, 0034U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U, 0286U, 0345U, 0411U, 0419U | A58324 – Billing and Coding: MolDX: Pharmacogenomics Testing![]() |
L38584![]() |
MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells | 7/25/21 | 4/27/23 | 4/21/23 | Active | 81479 | A58063 – Billing and Coding: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells ![]() |
L38111![]() |
MolDX: Pigmented Lesion Assay | 3/30/20 | 10/6/22 | 9/30/22 | Active | 0089U | A57915 – Billing and Coding: MolDX: Pigmented Lesion Assay![]() |
L38065![]() |
MolDX: Plasma-Based Genomic Profiling in Solid Tumors | 7/27/20 | 12/30/21 | 12/22/21 | Active | Group 1: 81445, 81479, 0326U, 0409U Group 2: 0179U |
A57917 – Billing and Coding: MolDX: Plasma-Based Genomic Profiling in Solid Tumors![]() |
L38284![]() |
MolDX: Predictive Classifiers for Early Stage Non-small Cell Lung Cancer | 7/27/20 | 10/20/22 | 10/10/22 | Active | 81479, 0288U | A58038 – Billing and Coding: MolDX: Predictive Classifiers for Early Stage Non-Small Cell Lung Cancer![]() |
L38586![]() |
MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer | 7/18/21 | 8/20/23 | 6/27/23 | Active | 81401, 81403, 81404, 81445, 81479, 0016M | A58065 – Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer![]() |
L37352![]() |
MolDX: Prometheus IBD sgi Diagnostic® Policy | 11/6/17 | 11/17/22 | 11/9/22 | Active | 81479 | A56940 – Billing and Coding: MolDX: Prometheus IBD sgi Diagnostic Policy![]() |
L38303![]() |
MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease | 11/9/20 | 12/29/22 | 12/22/22 | Active | 81541, 81542, 0047U | A58371 – Billing and Coding: MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease![]() |
L38288![]() |
MolDX: Repeat Germline Testing | 6/7/20 | 11/24/22 | 11/15/22 | Active | Group 1: 81105, 81106, 81107, 81108, 81109, 81110, 81111, 81112, 81161, 81162, 81163, 81164, 81165, 81166, 81167, 81171, 81172, 81173, 81174, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81200, 81201, 81202, 81203, 81204, 81205, 81209, 81212, 81215, 81216, 81217, 81225, 81226, 81227, 81228, 81229, 81230, 81231, 81232, 81233, 81234, 81238, 81239, 81240, 81241, 81242, 81243, 81244, 81247, 81248, 81249, 81250, 81251, 81252, 81253, 81254, 81255, 81256, 81257, 81258, 81259, 81260, 81269, 81271, 81274, 81283, 81284, 81285, 81286, 81288, 81289, 81290, 81291, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81302, 81303, 81304, 81306, 81312, 81317, 81318, 81319, 81321, 81322, 81323, 81324, 81325, 81326, 81328, 81329, 81330, 81331, 81332, 81333, 81335, 81336, 81337, 81340, 81341, 81342, 81343, 81344, 81345, 81346, 81350, 81355, 81361, 81362, 81363, 81364, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81420, 81422, 81425, 81426, 81427, 81430, 81431, 81432, 81433, 81434, 81435, 81436, 81437, 81438, 81439, 81440, 81442, 81443, 81448, 81460, 81465, 81470, 81471 Group 2: 81479 |
A57141 – Billing and Coding: MolDX: Repeat Germline Testing![]() |
L36021![]() |
Molecular Diagnostic Tests (MDT) | 10/1/15 | 5/4/23 | 5/1/23 | Active | 0004M, 0006M, 0007M, 0011M, 0012M, 0013M, 0016M, 0017M, 0001U, 0005U, 0012U, 0013U, 0014U, 0016U, 0017U, 0018U, 0019U, 0022U, 0023U, 0026U, 0027U, 0029U, 0030U, 0031U, 0032U, 0033U, 0034U, 0036U, 0037U, 0040U, 0045U, 0046U, 0047U, 0048U, 0049U, 0050U, 0055U, 0056U, 0060U, 0069U, 0070U, 0071U, 0072U, 0073U, 0074U, 0075U, 0076U, 0078U, 0079U, 0084U, 0087U, 0088U, 0089U, 0090U, 0091U, 0094U, 0101U, 0102U, 0103U, 0111U, 0113U, 0114U, 0118U, 0120U, 0129U, 0130U, 0131U, 0132U, 0133U, 0134U, 0135U, 0136U, 0137U, 0138U, 0153U, 0154U, 0155U, 0156U, 0157U, 0158U, 0159U, 0160U, 0161U, 0162U, 0168U, 0169U, 0170U, 0171U, 0172U, 0173U, 0175U, 0177U, 0179U, 0180U, 0181U, 0182U, 0183U, 0184U, 0185U, 0186U, 0187U, 0188U, 0189U, 0190U, 0191U, 0192U, 0193U, 0194U, 0195U, 0196U, 0197U, 0198U, 0199U, 0200U, 0201U, 0203U, 0204U, 0205U, 0208U, 0209U, 0211U, 0212U, 0213U, 0214U, 0215U, 0216U, 0217U, 0218U, 0221U, 0222U, 0228U, 0229U, 0230U, 0231U, 0232U, 0233U, 0234U, 0235U, 0236U, 0237U, 0238U, 0239U, 0242U, 0244U, 0245U, 0246U, 0250U, 81105, 81106, 81107, 81108, 81109, 81110, 81111, 81112, 81120, 81121, 81161, 81162, 81163, 81164, 81165, 81166, 81167, 81168, 81170, 81171, 81172, 81173, 81174, 81175, 81176, 81177, 81178, 81179, 81180, 81181, 81182, 81183, 81184, 81185, 81186, 81187, 81188, 81189, 81190, 81191, 81192, 81193, 81194, 81200, 81201, 81202, 81203, 81204, 81205, 81206, 81207, 81208, 81209, 81210, 81212, 81215, 81216, 81217, 81218, 81219, 81220, 81221, 81222, 81223, 81224, 81225, 81226, 81227, 81228, 81229, 81230, 81231, 81232, 81233, 81234, 81235, 81236, 81237, 81238, 81239, 81240, 81241, 81242, 81243, 81244, 81245, 81246, 81247, 81248, 81249, 81250, 81251, 81252, 81253, 81254, 81255, 81256, 81257, 81258, 81259, 81260, 81261, 81262, 81263, 81264, 81265, 81266, 81267, 81268, 81269, 81270, 81271, 81272, 81273, 81274, 81275, 81276, 81277, 81278, 81279, 81283, 81284, 81285, 81286, 81287, 81288, 81289, 81290, 81291, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81301, 81302, 81303, 81304, 81305, 81306, 81307, 81308, 81309, 81310, 81311, 81312, 81313, 81314, 81315, 81316, 81317, 81318, 81319, 81320, 81321, 81322, 81323, 81324, 81325, 81326, 81327, 81328, 81329, 81330, 81331, 81223, 81327, 81333, 81334, 81335, 81336, 81337, 81338, 81339, 81340, 81341, 81342, 81343, 81344, 81345, 81346, 81347, 81348, 81350, 81351, 81352, 81353, 81355, 81357, 81360, 81361, 81362, 81363, 81364, 81374, 81377, 81381, 81383, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81419, 81420, 81422, 81425, 81426, 81427, 81430, 81431, 81432, 81433, 81434, 81435, 81436, 81437, 81438, 81439, 81440, 81442, 81443, 81445, 81448, 81450, 81455, 81460, 81465, 81470, 81471, 81479, 81490, 81493, 81504, 81506, 81507, 81518, 81519, 81520, 81521, 81522, 81523, 81525, 81528, 81529, 81540, 81541, 81542, 81546, 81551, 81552, 81554, 81595, 81599, 84999, 88341, 88342, 88360, 88361, | A54241 – Billing and Coding: MolDX: 4q25-AF Risk Genotype Guidelines![]() A54242 – Billing and Coding: MolDX: 9p21 Genotype Test ![]() A55716 – Billing and Coding: MolDX: Abbott RealTime IDH1 and IDH2 testing for Acute Myeloid Leukemia (AML) ![]() A54185 – Billing and Coding: MolDX: Afirma™ Assay by Veracyte Update ![]() A54244 – Billing and Coding: MolDX: ApoE Genotype ![]() A54685 – Billing and Coding: MolDX: Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) Testing ![]() A54253 – Billing and Coding: MolDX: Aspartoacyclase 2 Deficiency(ASPA) Testing ![]() A54254 – Billing and Coding: MolDX: ATP7B Gene Tests ![]() A54255 – Billing and Coding: MolDX: BCKDHB Gene Test ![]() A54188 – Billing and Coding: MolDX: bioTheranostics Cancer TYPE ID® ![]() A54256 – Billing and Coding: MolDX: BLM Gene Analysis ![]() A54257 – Billing and Coding: MolDX: BluePrint® Test ![]() A54243 – Billing and Coding: MolDX: CHD7 Gene Analysis Guidelines ![]() A54189 – Billing and Coding: MolDX: cobas® EGFR Mutation Test Guidelines ![]() A54262 – Billing and Coding: MolDX: ENG and ACVRL1 Gene Tests ![]() A54263 – Billing and Coding: MolDX: FANCC Genetic Testing ![]() A54191 – Billing and Coding: MolDX: FDA-Approved BRAF Tests ![]() A54192 – Billing and Coding: MolDX: FDA-Approved EGFR Tests ![]() A54688 – Billing and Coding: MolDX: FDA-Approved KRAS Tests ![]() A54264 – Billing and Coding: MolDX: Fragile X ![]() A54265 – Billing and Coding: MolDX: GBA Genetic Testing ![]() A54689 – Billing and Coding: Germline testing for use of PARP inhibitors ![]() A54266 – Billing and Coding: MolDX: HAX1 Gene Sequencing ![]() A54267 – Billing and Coding: MolDX: HBB Gene Tests ![]() A54268 – Billing and Coding: MolDX: HEXA Gene Analysis ![]() A54269 – Billing and Coding: MolDX: HTTLPR Gene Testing ![]() A54270 – Billing and Coding: MolDX: IKBKAP Genetic Testing ![]() A54271 – Billing and Coding: MolDX: Immunohistochemistry (IHC) Indications for Breast Pathology ![]() A54272 – Billing and Coding: MolDX: KIF6 Genotype ![]() A54273 – Billing and Coding: MolDX: know error® ![]() A54274 – Billing and Coding: MolDX: L1CAM Gene Sequencing Guidelines ![]() A54275 – Billing and Coding: MolDX: LPA-Aspirin Genotype ![]() A54276 – Billing and Coding: MolDX: LPA-Intron 25 Genotype ![]() A54194 – Billing and Coding: MolDX: MammaPrint ![]() A54277 – Billing and Coding: MolDX: MCOLN1 Genetic Testing Guidelines ![]() A54278 – Billing and Coding: MolDX: MECP2 Genetic Testing ![]() A56106 – Billing and Coding: MolDX: Microsatellite Instability-High (MSI-H) and Mismatch Repair Deficient (dMMR) Biomarker for Patients with Unresectable or Metastatic Solid Tumors ![]() A54288 – Billing and Coding: MolDX: Mitochondrial Nuclear Gene Tests Guidelines ![]() A54209 – Billing and Coding: MolDX: MMACHC Test ![]() A56973 – Billing and Coding: MolDX: Molecular Diagnostic Tests (MDT) ![]() A54290 – Billing and Coding: MolDX: myPap™ ![]() A54291 – Billing and Coding: MolDX: NSD1 Gene Tests ![]() A54195 – Billing and Coding: MolDX: Oncotype DX® Breast Cancer Assay ![]() A54196 – Billing and Coding: MolDX: Oncotype DX® Colon Cancer Assay Update ![]() A54293 – Billing and Coding: MolDX: PAX6 Gene Sequencing Guidelines ![]() A54295 – Billing and Coding: MolDX: PIK3CA Gene Tests ![]() A54197 – Billing and Coding: MolDX: Progensa® PCA3 Assay Coverage Update ![]() A54297 – Billing and Coding: MolDX: PTCH1 Gene Testing ![]() A54198 – Billing and Coding: MolDX: ResponseDX Tissue of Origin® ![]() A54299 – Billing and Coding: MolDX: RPS19 Gene Tests ![]() A54300 – Billing and Coding: MolDx: SEPT9 Gene Test ![]() A54830 – Billing and Coding: Short Tandem Repeat (STR) Markers and Chimerism (CPT® codes 81265-81268) ![]() A54285 – Billing and Coding: MolDX: SMPD1 Genetic Testing ![]() A54284 – Billing and Coding: MolDX: STAT3 Gene Testing ![]() A54283 – Billing and Coding: MolDX: SULT4A1 Genetic Testing ![]() A54901 – Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next Generation Sequencing Testing in Cancer ![]() A54282 – Billing and Coding: MolDX: TERC Gene Tests ![]() A54199 – Billing and Coding: MolDX: Therascreen® EGFR RGQ PCR Kit Guidelines ![]() A54200 – Billing and Coding: MolDX: therascreen® KRAS PCR Kit Guidelines ![]() A54281 – Billing and Coding: MolDX: TP53 Gene Test ![]() A54279 – Billing and Coding: MolDx: VEGFR2 Tests ![]() |
L34171![]() |
Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation | 10/1/15 | 5/25/23 | 5/19/23 | Active | 68801, 68810, 68811, 68815, 68816, 68840 | A57284 – Billing and Coding: Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation![]() |
L35249![]() |
Nerve Blocks for Peripheral Neuropathy | 10/1/15 | 4/27/23 | 4/19/23 | Active | Group 1: 64450 Group 2: 76881, 76882, 76942, 76999, 97032, 97139, G0282, G0283 |
A57663 – Billing and Coding: Nerve Blocks for Peripheral Neuropathy![]() |
L35897![]() |
Nerve Conduction Studies and Electromyography | 10/1/15 | 4/27/23 | 4/19/23 | Active | 51784, 51785, 92265, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95873, 95874, 95885, 95886, 95887, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95933, 95937, 95999, G0255 | A57307 – Billing and Coding: Nerve Conduction Studies and Electromyography![]() |
L38771![]() |
Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease | 04/25/21 | 9/7/23 | 8/31/23 | Active | 0501T, 0502T, 0503T, 0504T | A58359 – Billing and Coding: Non-Invasive Fractional Flow Reserve (FFR) for Stable Ischemic Heart Disease![]() |
L34045![]() |
Non-Invasive Vascular Studies | 10/1/15 | 10/27/22 | 10/21/22 | Active | Group 1: 93880, 93882, Group 2: 93886, 93888, 93890, 93892, 93893 Group 3: 93922, 93923, 93924, 93925, 93926, 93930, 93931 Group 4: 93970, 93971 Group 5: 93975, 93976, 93978, 93979 Group 6: 93985, 93986, 93990 Group 7: 93930, 93931, 93970, 93971 Group 8: 93970, 93971 |
A56697 – Billing and Coding: Non-Invasive Vascular Studies![]() |
L34393![]() |
Ocular Photography – External | 10/1/15 | 4/27/23 | 4/19/23 | Active | 92285 | A57068 – Billing and Coding: Ocular Photography – External![]() |
L38920![]() |
Off-label Use of Rituximab and Rituximab Biosimilars | 8/8/21 | 6/29/23 | 6/22/23 | Active | J9312, Q5115, Q5119 | A58582 – Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars![]() |
L34175![]() |
Ophthalmic Angiography (Fluorescein and Indocyanine Green) | 10/1/15 | 6/3/22 | 5/26/22 | Active | 92235, 92240 | A57069 – Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)![]() |
L34181![]() |
Ophthalmic Biometry for Intraocular Lens Power Calculation | 10/1/15 | 5/25/23 | 5/19/23 | Active | 76519, 92136 | A57070 – Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation![]() |
L34399![]() |
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) | 10/1/15 | 5/25/23 | 5/19/23 | Active | 92201, 92202, 92227, 92228, 92250 | A57071 – Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)![]() |
L34049![]() |
Outpatient Physical and Occupational Therapy Services | 10/1/15 | 5/25/23 | 5/19/23 | Active | Group 1: 29065, 29075, 29085, 29086, 29105, 29125, 29126, 29130, 29131, 29200, 29240, 29260, 29280, 29345, 29355, 29365, 29405, 29425, 29445, 29505, 29515, 29520, 29530, 29540, 29550, 29580, 29799, 90901, 90912, 90913, 95851, 95852, 96125, 97010, 97012, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97112, 97113, 97116, 97124, 97129, 97130, 97139, 97140, 97150, 97161, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 97530, 97533, 97535, 97537, 97542, 97597, 97598, 97602, 97605, 97606, 97607, 97608, 97750, 97755, 97760, 97761, 97763, 97799, G0281, G0283, G0329 Group 2 98966, 98967, 98968, 98970, 98971, 98972, 98975, 98976, 98977, 98980, 98981, G2010, G2012, G2250, G2251 |
A57067 – Billing and Coding: Outpatient Physical and Occupational Therapy Services![]() |
L34353![]() |
Outpatient Psychiatry and Psychology Services | 10/1/15 | 5/25/23 | 5/19/23 | Active | 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90865, 90870, 90880, 90885, 90887, 90889, 90899, 96105, 96110, 96112, 96113, 96116, 96130, 96131, 96136, 96137, 96138, 96139, 96146 | A57065 – Billing and Coding: Outpatient Psychiatry and Psychology Services![]() |
L34064![]() |
Panretinal (Scatter) Laser Photocoagulation | 10/1/15 | 3/2/23 | 2/24/23 | Active | 67228 | A56594 – Billing and Coding: Panretinal (Scatter) Laser Photocoagulation![]() |
L38201![]() |
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) | 11/18/19 | 10/5/23 | 9/29/23 | Active | 22510, 22511, 22512, 22513, 22514, 22515 | A57282 – Billing and Coding: Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)![]() |
L39023![]() |
Platelet Rich Plasma Injections for Non-Wound Injections | 1/3/22 | 7/21/22 | 2/9/23 | Active | G0460, M0076, P9020, 0232T | A58737 – Billing and Coding: Platelet Rich Plasma Injections for Non-Wound Injections![]() |
L36902![]() |
Polysomnography and Other Sleep Studies | 3/6/17 | 1/26/23 | 1/20/23 | Active | Group 1: 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400 Group 2: 95803 |
A57049 – Billing and Coding: Polysomnography and Other Sleep Studies![]() |
L39521![]() |
Positron Emission Tomography (PET) Scan for Inflammation and Infection | 8/13/23 | N/A | 6/22/23 | Active | Group 1: 78811, 78812, 78813, 78814, 78815, 78816, A9552, A9598, A9601 Group 2: 78429, 78432, 78433, 78459 Group 3: 78811, 78812, 78813, 78814, 78815, 78816 Group 4: 78608, 78609, G0219, G0235, G0252 |
A59318 – Billing and Coding: Positron Emission Tomography (PET) Scan for Inflammation and Infection |
L34085![]() |
Post-Void Residual Urine and/or Bladder Capacity by Ultrasound | 10/1/15 | 3/2/23 | 2/23/23 | Active | 51798 | A57050 – Billing and Coding: Post-Void Residual Urine and / or Bladder Capacity by Ultrasound![]() |
L39284![]() |
Prostate Cancer Detection with IsoPSA® | 11/20/22 | NA | 9/30/22 | Active | 81599 | A59066 – Billing and Coding: Prostate Cancer Detection with IsoPSA®![]() |
L36658![]() |
Proton Beam Therapy | 10/24/16 | 10/5/23 | 9/29/23 | Active | 77520, 77522, 77523, 77525 | A55315 – Billing and Coding: Proton Beam Therapy![]() |
L34183![]() |
Psychiatric Inpatient Hospitalization | 10/1/15 | 3/2/23 | 2/24/23 | Active | NA | A57052 – Billing and Coding: Psychiatric Inpatient Hospitalization![]() |
L34196![]() |
Psychiatric Partial Hospitalization Programs | 10/1/15 | 3/2/23 | 2/24/23 | Active | 90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90846, 90847, 90849, 90853, 90899, 96116, 96130, 96131, 96136, 96137, 96138, 96139, 96146, G0129, G0176, G0177, G0410, G0411 | A57053 – Billing and Coding: Psychiatric Partial Hospitalization Programs![]() |
L34539![]() |
Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians | 10/1/15 | 3/24/23 | 2/24/23 | Active | 90785, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90846, 90847, 90849, 90853, 90863, 90880, 90899 | A57054 – Billing and Coding: Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians![]() |
L34063![]() |
RAST Type Tests | 10/1/15 | 8/3/23 | 7/25/23 | Active | 86001, 86003, 86005 | A57043 – Billing and Coding: RAST Type Tests![]() |
L34200![]() |
Removal of Benign Skin Lesions | 10/1/15 | 8/3/23 | 7/25/23 | Active | 11200, 11201, 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, 17000, 17003, 17004, 17106, 17107, 17108, 17110, 17111, 17340 | A57044 – Billing and Coding: Removal of Benign Skin Lesions![]() |
L34246![]() |
Routine Foot Care and Debridement of Nails | 10/1/15 | 8/3/23 | 7/25/23 | Active | 11055, 11056, 11057, 11719, 11720, 11721, G0127 | A57193 – Billing and Coding: Routine Foot Care and Debridement of Nails![]() |
L39383![]() |
Sacroiliac Joint Injections and Procedures | 3/19/23 | NA | 1/26/23 | Active | 27096, 64451, 64625, 77002, 77012, G0260 | A59154 – Billing and Coding: Sacroiliac Joint Injections and Procedures![]() |
L34061![]() |
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | 10/1/15 | 8/4/23 | 7/28/23 | Active | 92133, 92134 | A56692 – Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)![]() |
L35906![]() |
Somatosensory Testing | 10/1/15 | 3/24/23 | 3/13/23 | Active | 95925, 95926, 95927, 95928 | A57041 – Billing and Coding: Somatosensory Testing![]() |
L35986![]() |
Special Histochemical Stains and Immunohistochemical Stains | 10/1/15 | 6/29/23 | 6/22/23 | Active | NA | NA |
L34046![]() |
Speech-Language Pathology | 10/1/15 | 8/3/23 | 7/28/23 | Active | 31579, 92507, 92508, 92521, 92522, 92523, 92524, 92597, 92607, 92608, 92609, 92626, 92627, 96105, 96110, 96112, 96113, 96125, 97129, 97130, 97533 | A57040 – Billing and Coding: Speech-Language Pathology![]() |
L34540![]() |
Stretta Procedure | 10/1/15 | 8/31/23 | 8/21/23 | Active | 43257 | A57039 – Billing and Coding: Stretta Procedure![]() |
L34087![]() |
Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based | 10/1/15 | 8/31/23 | 8/21/23 | Active | 93282, 93283, 93284, 93287, 93289, 93292, 93295, 93296 | A57038 – Billing and Coding: Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based![]() |
L34084![]() |
Transcatheter Infusion Therapy | 10/1/15 | 9/7/23 | 8/31/23 | Active | 61650, 61651 | A56811 – Billing and Coding: Transcatheter Infusion Therapy![]() |
L36469![]() |
Transcranial Magnetic Stimulation (TMS) | 2/8/16 | 1/5/23 | 12/29/22 | Active | 90867, 90868, 90869 | A57047 – Billing and Coding: Transcranial Magnetic Stimulation (TMS)![]() |
L34337![]() |
Transesophageal Echocardiography (TEE) | 10/1/15 | 8/31/23 | 8/21/23 | Active | 76376, 76377, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, C8925, C8926, C8927 | A56809 – Billing and Coding: Transesophageal Echocardiography (TEE)![]() |
L34541![]() |
Transtelephonic Spirometry | 10/1/15 | 10/5/23 | 9/29/23 | Active | 94014, 94015, 94016 | A56808 – Billing and Coding: Transtelephonic Spirometry![]() |
L34338![]() |
Transthoracic Echocardiography (TTE) | 10/1/15 | 10/5/23 | 9/29/23 | Active | Group 1: 76376, 76377, 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93350, 93351, 93352, A9700, C8921, C8922, C8923, C8924, C8928, C8929, C8930, Q9955, Q9956, Q9957 Group 2: C9399, J0153, J0280, J0461, J1245, J1250, J2785, J3490 |
A57306 – Billing and Coding: Transthoracic Echocardiography (TTE)![]() |
L39616![]() |
Urinary Biomarkers for Chronic Pain Management | 10/8/23 | N/A | N/A | Active | 0117U | A59423 – Billing and Coding: Urinary Biomarkers for Chronic Pain Management![]() |
L36029![]() |
Urine Drug Testing | 10/5/15 | 10/15/23 | 8/24/23 | Active | 80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659 | A56818 – Billing and Coding: Urine Drug Testing![]() |
L34056![]() |
Urodynamics | 10/1/15 | 10/5/23 | 9/29/23 | Active | 51725, 51726, 51727, 51728, 51729, 51736, 51741, 51792, 51797 | A56802 – Billing and Coding: Urodynamics![]() |
L34082![]() |
Varicose Veins of the Lower Extremity, Treatment of | 10/1/15 | 10/5/23 | 9/29/23 | Active | 36465, 36466, 36468, 36470, 36471, 36475, 36476, 36478, 36479, 36482, 36483, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37799, 76942, 93970, 93971 | A57305 – Billing and Coding: Varicose Veins of the Lower Extremity, Treatment of![]() |
L34055![]() |
Virtual Colonoscopy (CT Colonography) | 10/1/15 | 10/5/23 | 9/29/23 | Active | Group 1: 74261, 74262 Group 2: 74263 |
A56800 – Billing and Coding: Virtual Colonoscopy (CT Colonography)![]() |
L34394![]() |
Visual Fields Testing | 10/1/15 | 10/5/23 | 9/29/23 | Active | 92081, 92082, 92083 | A56799 – Billing and Coding: Billing and Coding for Visual Fields Testing![]() |
L33996![]() |
Vitamin D Assay Testing | 10/1/15 | 8/3/23 | 7/28/23 | Active | 82306 | A56798 – Billing and Coding: Vitamin D Assay Testing![]() |
L36690![]() |
Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities | 10/10/16 | 9/1/22 | 8/26/22 | Active | Group 1: 15002, 15003, 15004, 15005, 15040, 15050, 15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278, A2001, C5271, C5272, C5273, C5274, C5275, C5276, C5277, C5278 Group 2: A2001, A2004, A2008, Q4100, Q4101, Q4102, Q4103, Q4104, Q4105, Q4106, Q4107, Q4108, Q4110, Q4111, Q4115, Q4117, Q4118, Q4121, Q4122, Q4123, Q4124, Q4126, Q4127, Q4128, Q4132, Q4133, Q4134, Q4135, Q4136, Q4137, Q4140, Q4141, Q4146, Q4147, Q4148, Q4151, Q4152, Q4153, Q4154, Q4156, Q4157, Q4158, Q4159, Q4160, Q4161, Q4163, Q4164, Q4165, Q4166, Q4169, Q4170, Q4173, Q4175, Q4176, Q4178, Q4180, Q4186, Q4187, Q4188, Q4195, Q4196, Q4197, Q4201, Q4203, Q4232, Q4253, Q4254 |
A56696 – Billing and Coding: Wound Application of Cellular and / or Tissue Based Products (CTPs), Lower Extremities![]() |
Updated: 11.06.23