Corporate

Medical Policies

Coverage for services under Medicare is primarily established through the Social Security Act. Provisions of the Social Security Act are applied to specific services based on various regulations, National Coverage Determinations established by the Centers for Medicare & Medicaid Services (CMS), various CMS guidelines, and Local Coverage Determinations (LCDs) established by CGS.

  • NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for an item or service.
  • LCDs are developed by Medicare Administrative Contractors (MACs), including CGS, and indicate whether a particular item or service is covered in accordance with the Social Security Act, section 1862(a)(1)(A). (See list of LCDs below.)
  • NCDs and LCDs only address certain services and items; in other words, not every item or service has a corresponding NCD or LCD. In these cases, the Social Security Act, and in some cases, additional guidance published by CMS, establish the basis for coverage.
  • For more information about NCDs, LCDs, and other coverage provisions, refer to the CMS Medicare Program Integrity Manual (Pub. 100-08), chapter 13External PDF.
  • CAC, Compliance and Open Public Meeting

IMPORTANT NOTE: CGS does NOT house LCDs on our website. By following the links below you will be sent directly to the CMS LCD database.

The following CGS Part B Local Coverage Determinations (LCDs) are located on the Centers for Medicare & Medicaid Services (CMS) Medicare Coverage Database (MCD) webpage. CMS also provides the LCD Contractor IndexExternal Website, where providers can browse LCDs by contractor.

ID Title Effective Date Revision Effective Date Last Updated Status HCPC/CPT code
L32553External Website Allergy Immunotherapy 10/1/2015 10/1/2015 10/30/2018 Active

95115, 95117, 95144, 95145, 95146, 95147, 95148, 95149, 95165, 95170, 95180, 95199

L33943External Website B-type Natriuretic Peptide (BNP) Testing 10/1/2015 10/1/2015 11/28/2017 Active

83880

L33944External Website Blepharoplasty 10/1/2015 10/1/2018 11/2/2018 Active

Group 1 Codes: 67909, 67911, 67914, 67915, 67916, 67917, 67921, 67922, 67923, 67924,

Group 2 Codes: 15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908

L33945External Website Cerumen (Earwax) Removal 10/1/2015 1/1/2016 1/30/2018 Active

69209, 69210, G0268

L33946External Website Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy 10/1/2015 10/1/2015 10/30/2018 Active

66820, 66821

L33947External Website Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) 10/1/2015 10/1/2016 10/30/2018 Active

75571, 75572, 75573, 75574

L33949External Website Botulinum Toxins 10/1/2015 10/1/2018 9/18/2018 Active

Group 1 Codes: 43201, 43236, 46505, 52287, 64611, 64612, 64615, 64616, 64617, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 67345,

Group 2 Codes: C9399, J0585, J0586, J0587, J0588, J3590

L33950External Website Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography 10/1/2015 1/1/2018 12/14/2017 Active

19030, 76641, 76642, 77053, 77054, 77058, 77059, 77063, 77065, 77066, 77067, C8903, C8904, C8905, C8906, C8907, C8908, G0279

L33952External Website Cardiac Event Detection 10/1/2015 10/1/2018 10/30/2018 Active

93228, 93229, 93268, 93270, 93271, 93272, 93799

L33954External Website Cataract Extraction 10/1/2015 10/1/2016 12/21/2017 Active

66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984

L33959External Website Cardiac Catheterization and Coronary Angiography 10/1/2015 10/1/2018 10/30/2018 Active

Group 1: 92978, 92979, 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93462, 93463, 93464, 93503, 93505, 93530, 93531, 93532, 93533, 93561, 93562, 93563, 93564, 93565, 93566, 93567, 93568, 93571, 93572, G0269

Group 2 Codes: 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 Codes: G0278

L33960External Website Cardiovascular Nuclear Medicine 10/1/2015 10/1/2015 1/30/2018 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

L33996External Website Vitamin D Assay Testing 10/1/2015 5/1/2017 9/27/2018 Active

82306

L33999External Website Corneal Pachymetry 10/1/2015 10/1/2016 1/30/2018 Active

76514

L34005External Website Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy 10/1/2015 10/1/2018 10/24/2018 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

L34008External Website Computerized Corneal Topography 10/1/2015 5/1/2018 5/9/2018 Active

92025

L34032External Website Debridement Services 10/1/2015 10/1/2018 9/17/2018 Active

11000, 11001, 11042, 11043, 11044, 11045, 11046, 11047

L34037External Website Flow Cytometry 10/1/2015 10/1/2018 9/21/2018 Active

86355, 86356, 86357, 86359, 86360, 86361, 86367, 88182, 88184, 88185, 88187, 88188, 88189

L34045External Website Non-Invasive Vascular Studies 10/1/2015 10/1/2018 10/30/2018 Active

Group 1 Codes: 93880 93882 93886 93888 93890 93892 93893

Group 2 Codes: 93922 93923 93924 93925 93926 93930 93931

Group 3 Codes: 93970 93971

Group 4 Codes: 93975 93976 93978 93979

Group 5 Codes: 93990 G0365

L34046External Website Speech-Language Pathology 10/1/2015 1/1/2018 07/30/2018 Active

31579, 92507, 92508, 92521, 92522, 92523, 92524, 92597, 92607, 92608, 92609, 92626, 92627, 96105, 96110, 96111, 96125, 97533, G0515

L34048External Website Vertebroplasty and Vertebral Augmentation (Percutaneous) 10/1/2015 9/1/2018 10/15/2018 Active

22510, 22511, 22512, 22513, 22514, 22515, 76380

L34049External Website Outpatient Physical and Occupational Therapy Services 10/1/2015 1/1/2018 5/31/2018 Active

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 90911 95831 95832 95833 95834 95851 95852 96125 97010 97012 97016 97018 97022 97024 97026 97028 97032 97033 97034 97035 97036 97039 97110 97112 97113 97116 97124 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 G0515

L34055External Website Virtual Colonoscopy (CT Colonography) 10/1/2015 10/1/2017 9/27/2018 Active

74261, 74262

L34056External Website Urodynamics 10/1/2015 10/1/2018 11/7/2018 Active

51725, 51726, 51727, 51728, 51729, 51736, 51741, 51792, 51797

L34061External Website Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) 10/1/2015 4/1/2018 9/19/2018 Active

92133, 92134

L34062External Website Dialysis Access Maintenance 10/1/2015 1/1/2018 1/30/2018 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

L34063External Website RAST Type Tests 10/1/2015 10/1/2015 07/30/2018 Active

86001, 86003, 86005

L34064External Website Panretinal (Scatter) Laser Photocoagulation 10/1/2015 10/1/2016 2/26/2018 Active

67228

L34081External Website Endoscopy by Capsule 10/1/2015 10/1/2017 2/26/2018 Active

91110, 91111, 91299

L34082External Website Varicose Veins of the Lower Extremity, Treatment of 10/1/2015 1/1/2018 9/27/2018 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

L34084External Website Transcatheter Infusion Therapy 10/1/2015 10/1/2018 9/21/2018 Active

61650, 61651

L34085External Website Post-Void Residual Urine and/or Bladder Capacity by Ultrasound 10/1/2015 10/1/2016 2/26/2018 Active

51798

L34087External Website Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-Web Based 10/1/2015 10/1/2015 8/13/2018 Active

93282, 93283, 93284, 93287, 93289, 93292, 93295, 93296

L34089External Website Human Papillomavirus (HPV) Testing 10/1/2015 10/1/2015 3/28/2018 Active

87623, 87624

L34090External Website Laser Ablation of the Prostate 10/1/2015 10/1/2015 3/28/2018 Active

52647, 52648, 52649

L34093External Website Chemotherapy and Biologicals 10/1/2015 10/11/2018 11/20/2018 Active

N/A

L34171External Website Nasal Punctum-Nasolacrimal Duct Dilation and Probing with or without Irrigation 10/1/2015 10/1/2015 5/31/2018 Active

68801 68810 68811 68815 68816 68840 

L34175External Website Ophthalmic Angiography (Fluorescein and Indocyanine Green) 10/1/2015 10/1/2016 5/31/2018 Active

92235 92240

L34181External Website Ophthalmic Biometry for Intraocular Lens Power Calculation 10/1/2015 10/1/2016 5/31/2018 Active

76519 92136

L34183External Website Psychiatric Inpatient Hospitalization 10/1/2015 10/1/2018 9/14/2018 Active

N/A

L34195External Website Mohs Micrographic Surgery 10/1/2015 10/1/2018 9/14/2018 Active

17311, 17312, 17313, 17314, 17315

L34196External Website Psychiatric Partial Hospitalization Programs 10/1/2015 10/1/2016 2/26/2018 Active

90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90846, 90847, 90849, 90853, 90899, 96101, 96102, 96103, 96116, 96118, 96119, 96120, G0129, G0176, G0177, G0410, G0411

L34200External Website Removal of Benign Skin Lesions 10/1/2015 10/01/2018 11/2/2018 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

L34246External Website Routine Foot Care and Debridement of Nails 10/1/2015 10/1/2018 9/18/2018 Active

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

L34337External Website Transesophageal Echocardiography (TEE) 10/1/2015 10/4/2018 9/20/2018 Active

76376, 76377, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, C8925, C8926, C8927

L34338External Website Transthoracic Echocardiography (TTE) 10/1/2015 10/1/2018 11/13/2018 Active

Group 1 Codes: 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 Codes: C9399, J0153, J0280, J0461, J1245, J1250, J2785, J3490

L34353External Website Outpatient Psychiatry and Psychology Services 10/1/2015 10/1/2018 9/21/2018 Active

90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90865, 90870, 90880, 90885, 90887, 90899, 96101, 96102, 96103, 96105, 96110, 96111, 96116, 96118, 96119, 96120

L34356External Website Erythropoiesis Stimulating Agents (ESA) 10/1/2015 10/1/2018 9/26/2018 Active

J0881, J0882, J0885, J0890, Q4081, Q5105, Q5106

L34370External Website Category III CPT® Codes 10/1/2015 3/18/2018 2/26/2018 Active

N/A

L34393External Website Ocular Photography - External 10/1/2015 10/1/2018 9/24/2018 Active

92285

L34394External Website Visual Fields Testing 10/1/2015 10/1/2018 9/27/2018 Active

92081, 92082, 92083

L34399External Website Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) 10/1/2015 10/1/2017 5/31/2018 Active

92225 92226 92227 92228 92250

L34539External Website Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians 10/1/2015 10/1/2015 2/26/2018 Active

90785, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90846, 90847, 90849, 90853, 90863, 90880, 90899

L34540External Website Stretta Procedure 10/1/2015 10/1/2015 8/13/2018 Active

43257

L34541External Website Transtelephonic Spirometry 10/1/2015 10/1/2015 9/27/2018 Active

94014, 94015, 94016

L34807External Website Lumbar Epidural Steroid Injections (ESI) 10/1/2015 10/1/2017 12/21/2017 Active

62323, 62327, 64483, 64484,

L34832External Website Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy 10/1/2015 10/1/2016 12/21/2017 Active

64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636

L35249External Website Nerve Blocks for Peripheral Neuropathy 10/1/2015 10/1/2015 4/30/2018 Active

64450 76881 76882 76942 76999 97032 97139 G0282 G0283

L35332External Website MolDX: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing 10/1/2015 10/1/2017 8/13/2018 Active

81225, 81226, 81227, 81355, 81479

L35349External Website MolDX: Genetic Testing for Lynch Syndrome 10/1/2015 9/3/2018 10/30/2018 Active

Group 1: 81210, 81288, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81301, 81317, 81318, 81319, 81403, 81435, 81479

Group 2: 81445, 81455

L35442External Website MolDX: NRAS Genetic Testing 10/1/2015 1/19/2017 2/7/2017 Active

81311, 81479

L35443External Website MolDX: GeneSight ® Assay for Refractory Depression 10/1/2015 3/8/2018 10/30/2018 Active

81479

L35891External Website Intravenous Immune Globulin 10/1/2015 3/1/2018 3/28/2018 Active

J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572,  

L35897External Website Nerve Conduction Studies and Electromyography 10/1/2015 10/1/2018 8/27/2018 Active

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

L35906External Website Somatosensory Testing 10/1/2015 10/1/2018 9/19/2018 Active

95925, 95926, 95927, 95928

L35984External Website MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR) 10/1/2015 12/31/2015 7/2/2018 Active

81240, 81241, 81291

L35986External Website Special Histochemical Stains and Immunohistochemical Stains 10/1/2015 8/31/2017 7/16/2018 Active

88312, 88313, 88341, 88342, 88344, 88360, 88361

L36002External Website MolDX: Prolaris™ Prostate Cancer Genomic Assay 10/5/2015 1/1/2018 07/30/2018 Active

81541

L36006External Website MolDX-CDD: ConfirmMDx Epigenetic Molecular Assay 10/5/2015 1/1/2018 8/13/2018 Active

81551

L36011External Website MolDX: Molecular RBC Phenotyping 10/5/2015 1/1/2018 7/2/2018 Active

0001U

L36021External Website Molecular Diagnostic Tests (MDT) 10/1/2015 6/21/2018 10/30/2018 Active

81105-81112 81120 81121 81161-81599 84999 85999 86152 86153 86849 87999 88120 88121 88199 88299 0001M 0002M 0003M 0004M 0006M 0007M 0009M 0011M 0012M 0013M 0001U-0014U 0016U-0044U

L36029External Website Controlled Substance Monitoring and Drugs of Abuse Testing 10/5/2015 10/1/2018 9/21/2018 Active

80305, 80306, 80307, G0480, G0481, G0482, G0483, G0659

L36048External Website MolDX: HLA-B*15:02 Genetic Testing 10/5/2015 10/5/2015 5/31/2018 Active

81381

L36113External Website MolDX: MGMT Promoter Methylation Analysis 10/5/2015 10/5/2017 5/31/2018 Active

81287

L36117External Website MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease 10/5/2015 10/5/2017 8/23/2018 Active

81206, 81207, 81208, 81219, 81270, 81402, 81403, 81445, 81450, 81455, 81479

L36139External Website MolDX: Biomarkers in Cardiovascular Risk Assessment 10/5/2015 10/1/2018 9/21/2018 Active

82172, 82610, 83090, 83695, 83698, 83700, 83701, 83704, 83719, 83719, 83721, 86141

L36174External Website MolDX: NSCLC, Comprehensive Genomic Profile Testing 10/1/2015 10/5/2017 7/2/2018 Active

81445, 81455, 81479

L36206External Website MolDX: Genomic Health™ Oncotype DX® Prostate Cancer Assay 10/5/2015 1/1/2018 5/31/2018 Active

81479

L36425External Website MolDX: Breast Cancer Assay: Prosigna 2/1/2016 1/1/2018 8/13/2018 Active

81520

L36456External Website MolDX: BRCA1 and BRCA2 Genetic Testing 2/15/2016 07/12/2018 07/24/2018 Active

81162, 81211, 81212, 81213, 81214, 81215, 81216, 81217, 81432, 81445, 81455, 81479

L36458External Website MolDX: Breast Cancer Index™ Genetic Assay 2/1/2016 2/1/2016 7/2/2018 Active

81479

L36460External Website Bone Mass Measurement 2/1/2016 3/1/2018 5/7/2018 Active

76977, 77078, 77080, 77081, 77085, 78350, 78351, G0130

L36469External Website Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder 2/8/2016 2/8/2016 12/21/2017 Active

90867, 90868, 90869

L36485External Website MolDX: HLA-DQB1*06:02 Testing for Narcolepsy 2/15/2016 3/6/2017 12/21/2017 Active

81383

L36494External Website Minimally-Invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint 2/1/2016 2/1/2016 12/21/2017 Active

27279

L36656External Website MolDX: Decipher® Prostate Cancer Classifier Assay 10/10/2016 3/8/2018 10/30/2018 Active

81479

L36658External Website Proton Beam Therapy 10/24/2016 10/1/2018 9/19/2018 Active

77520, 77522, 77523, 77525

L36675External Website MolDX- CDD: ProMark Risk Score 10/10/2016 10/17/2017 10/30/2018 Active

81479

L36690External Website Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities 10/10/2016 1/1/2018 11/13/2018 Active

Group 1 Codes: 15002, 15003, 15004, 15005, 15040, 15050, 15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278, C5271, C5272, C5273, C5274, C5275, C5276, C5277, C5278

Group 2 Codes: Q4100, Q4101, Q4102, Q4103, Q4104, Q4105, Q4106, Q4107, Q4108, Q4110, Q4111, Q4115, Q4117, Q4118, Q4121, Q4122, Q4123, Q4124, Q4126, Q4127, Q4128, Q4131, Q4132, Q4133, Q4134, Q4135, Q4136, Q4137, Q4140, Q4141, Q4146, Q4147, Q4148, Q4151, Q4152, Q4153, Q4154, Q4156, Q4157, Q4158, Q4159, Q4160, Q4161, Q4163, Q4164, Q4165, Q4169, Q4172, Q4173, Q4174, Q4175, Q4177, Q4178

L36902External Website Polysomnography and Other Sleep Studies 3/6/2017 3/6/2017 1/30/2018 Active

Group 1 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400

Group 2 95803

L36906External Website GlycoMark Testing for Glycemic Control 3/6/2017 3/6/2017 4/4/2018 Active

84378, 84999

L36908External Website MolDX: Percepta© Bronchial Genomic Classifier 3/13/2017 7/20/2017 7/28/2017 Active

81479

L36910External Website MolDX: APC and MUTYH Gene Testing 3/13/2017 3/8/2018 4/4/2018 Active

81201, 81202, 81203, 81403, 81406, 81435, 81479

L36951External Website MolDX: Oncotype DX® Breast Cancer for DCIS (Genomic Health™) 3/6/2017 7/20/2017 10/30/2018 Active

81479

L36973External Website MolDX: Circulating Tumor Cell Marker Assays 3/6/2017 7/20/2017 3/28/2018 Active

86152, 86153

L36975External Website Bladder/Urothelial Tumor Markers 3/6/2017 3/23/2017 1/30/2018 Active

86294, 86316, 86386, 88120 , 88121

L36979External Website MolDX: 4Kscore Assay 3/13/2017 3/13/2017 10/30/2018 Active

81539

L37126External Website Coenzyme Q10 (CoQ10) 7/10/2017 7/10/2017 5/31/2018 Active

N/A

L37130External Website MolDX: DecisionDx-UM (Uveal Melanoma) 7/10/2017 7/20/2017 5/31/2018 Active

81599

L37134External Website MolDX: Xpresys Lung 7/10/2017 7/13/2017 5/31/2018 Active

81599

L37142External Website MolDX: Prolaris™ Prostate Cancer Genomic Assay for Men with Favorable Intermediate Risk Disease 7/10/2017 1/1/2018 5/31/2018 Active

81541

L37254External Website Chiropractic Services 11/6/2017 1/16/2018 N/A Active

98940, 98941, 98942

L37348External Website MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels 12/3/2018 12/3/2018 10/11/2018 Active 87631, 87632, 87633
L37352External Website MolDX: Prometheus IBD sgi Diagnostic Policy 11/6/2017 3/8/2018 8/13/2018 Active

81479, 82397, 83520, 86140

L37354External Website MolDX: Oncotype DX® Genomic Prostate Score for Men with Favorable Intermediate Risk Prostate Cancer 3/6/2018 8/16/2018 8/23/2018 Active

81479

L37356External Website MolDX: EndoPredict Breast Cancer Gene Expression Test 3/6/2018 8/23/2018 8/23/2018 Active

81599

L37362External Website MolDX: AlloSure® Donor-Derived Cell-Free DNA Test 3/6/2018 N/A 1/12/2018 Active

81479

L37366External Website MolDX: Guardant360® Plasma-Based Comprehensive Genomic Profiling in Non-Small Cell Lung Cancer (NSCLC) 11/19/2018 N/A 9/25/2018 Active

81479

L37578External Website Micro-Invasive Glaucoma Surgery (MIGS) 3/19/2018 11/8/2018 11/21/2018 Active

0191T, 0449T, 0450T, 0474T, 0376T

L37598External Website MolDX: Cystatin C Measurement 12/17/2018 N/A 10/24/2018 Future 82610
L37787External Website MolDX: Corus® CAD Assay 11/12/2018 N/A 9/21/2018 Active

81493

L37790External Website Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor 10/1/2018 N/A 8/9/2018 Active

0398T

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