Local Coverage Determinations (LCDs)


 

Sort by policy number or name by clicking the column name below.

Policy No.

Policy Name

Date Implemented

Date Last Revised

Revision Reason

LCD-4874

Rural Health Clinic

12/27/02

11/16/07

Correction

LCD-26156

Category III CPT Codes

09/29/07

04/03/08

Code Update

LCD-23499

Cardiac Rehabilitation

09/30/06

03/11/08

Typo Correction

LCD-23488

Viscosupplementation Therapy (Hyaluronate)

09/30/06

01/29/08

HCPCS Update

LCD-23482

Audiology

09/30/06

04/03/08

Code Update

LCD-23480

Cardiac CT

09/30/06

04/03/08

Code Update

LCD-23478

Virtual Colonoscopy

09/30/06

10/30/07

Link Update

LCD-22951

Inpatient Rehabilitation

08/01/07

04/23/08

Typographical Change

LCD-20724

(Retired 04/07/2006) Natrecor

Retired

LCD-20721

Carboplatin

09/30/05

06/21/07

Link Update

LCD-20626

[RETIRED 11/07/05] Dysphagia Services

LCD-1959

Percutaneous Vertebroplasty

09/29/02

06/21/07

Link Update

LCD-1951

Kyphoplasty

09/29/02

06/21/07

Link Update

LCD-1948

Infliximab

09/29/02

06/21/07

Link Update

LCD-1944

Human Skin Equivalent

09/29/02

04/03/08

Code Update

LCD-1942

Erythropoietin Analog

09/29/02

04/03/08

Code Update

LCD-1938

Epoetin Alfa (Epogen, EPO, Erythropoietin)

09/29/02

09/28/07

Code Update

LCD-1865

Removal of Benign Skin Lesions

12/27/96

12/12/07

HCPCS Update

LCD-1831

Wireless Capsule Endoscopy

09/29/02

10/30/07

Link Update

LCD-17673

Low Vision Rehabilitation

09/29/04

12/12/07

Code Update

LCD-17645

Resynchronization Therapy for CHF

09/29/04

06/25/07

Link Update

LCD-17639

Physical Medicine and Rehabilitation Modalities

09/29/04

05/10/07

Revised Text

LCD-17637

Occupational Therapy

09/30/05

10/30/07

Link Update

LCD-17635

Alefacept Therapy

09/29/04

10/30/07

Link Update

LCD-17632

Oxaliplatin for Injection (Eloxitin)

09/29/04

03/18/08

Link Update

LCD-1686

Troponin

09/28/00

10/30/07

Link Update

LCD-1682

Transthoracic Echocardiography (TTE)

08/04/05

05/14/08

Code Update

LCD-1676

Transrectal Echography for Prostatic Disease

12/27/96

10/30/07

Link Update

LCD-1669

Syphilis Test

10/16/97

10/30/07

Link Update

LCD-1664

Steroid Injections

07/26/05

04/03/08

Code Update

LCD-1642

Potassium - Serum

07/27/05

03/20/08

Code Update

LCD-1641

Hepatitis B

07/22/95

03/20/08

Code Update

LCD-1628

Rheumatoid Factor Test

10/16/97

10/30/07

Link Update

LCD-1626

Respiratory Therapy

09/30/05

03/20/08

Code Update

LCD-1605

Pulmonary Rehabilitation

06/01/02

01/09/07

Policy Number Update

LCD-1597

Removal Impacted Cerumen

07/27/05

10/30/07

Link Update

LCD-1594

Pulmonary Perfusion Imaging

08/06/05

09/27/07

Code Update

LCD-1593

Psychiatry and Psychology Services

08/05/05

12/12/07

HCPCS Update

LCD-1567

Urinalysis

05/15/98

03/20/08

Code Update

LCD-1565

HCG, Human Chorionic Gonadotropin Qualitative

07/01/97

10/05/07

Link Update

LCD-1428

Prostatic Acid Phosphatase, PAP

10/16/77

10/05/07

Link Update

LCD-1426

PRN Orders for Skilled Nursing Facilities

04/01/98

10/05/07

Link Update

LCD-1413

Percutaneous Transluminal Angioplasy in Renal Dise

12/27/96

05/24/07

Code Update

LCD-1412

Pelvic Echography for Prostate Follow-up

08/04/05

10/05/07

Link Update

LCD-1406

Patient Education

07/25/05

03/20/08

Code Update

LCD-1379

Partial Hospitalization

07/26/05

11/29/07

Code Update

LCD-13725

Psychiatric Inpatient Hospitalization

12/06/03

09/28/07

Code Update

LCD-1372

Psychiatric Services - Outpatient Hospital Based

09/28/00

12/12/07

HCPCS Update

LCD-1363

Occult Blood - Feces

10/16/97

12/12/07

HCPCS Update

LCD-13570

Wound Care

12/06/03

11/16/07

HCPCS Update

LCD-1352

Noninvasive Vascular Studies

12/27/96

03/20/08

Code Update

LCD-1348

Barium Swallow (Vedio/Cine)

10/16/97

10/04/07

Code Update

LCD-1343

Bone Density Measurement

01/01/98

03/07/08

Code Update

LCD-1340

Magnesium

07/26/05

09/17/07

Code Update

LCD-1338

Lumbosacral Spine X-ray

07/26/05

03/20/08

Code Update

LCD-13302

Dialysis Frequency

09/30/03

04/03/08

CodeUpdate

LCD-13295

Renal and Iliac Angio and Aortography

09/30/03

12/19/07

HCPCS Update

LCD-13281

ESWT for Musculoskeletal Problems

09/30/03

10/05/07

Link Update

LCD-1326

Lumbar Spine MRI

07/26/05

03/20/08

Code Update

LCD-13243

Adenosine (Adenocard)

09/30/03

10/02/07

Link Update

LCD-13239

Neupogen and Neulasta

09/30/03

05/23/08

Link Update

LCD-13232

Ferrlecit and Venofer

09/30/03

10/02/07

Link Update

LCD-13228

Intensity Modulated Radiation Therapy (IMRT)

09/30/03

03/18/08

Link Update

LCD-13225

Mohs Micrographic Surgery

12/08/05

10/04/07

Code Update

LCD-1321

Botulinum Toxin Type A

12/27/96

10/02/07

Code Additions

LCD-13202

Non-Covered Services

09/30/03

11/29/07

HCPCS Update

LCD-1316

Blood Glucose Testing

07/22/05

03/20/08

Code Update

LCD-13121

Off-Label Coverage of FDA Approved Drugs and Bio

09/30/03

05/14/08

CodeUpdate

LCD-13093

(Retired 04/01/2006) Bariatric Surgery

LCD-1306

Blepharoplasty

09/28/00

10/02/07

Link Update

LCD-1303

Bladder Tumor Antigen

07/1997

10/02/07

Link Update

LCD-1293

Bacterial Culture

10/19/97

09/17/07

Code Update

LCD-1290

Anesthesia for Transvenous Pacemaker Insertion

07/26/05

10/02/07

Link Update

LCD-1281

Acute Care: Inpatient, Observation and Treatment

06/01/02

12/12/07

HCPCS Update

LCD-1266

Leuprolide/Goserelin

10/16/97

10/02/07

Link Update

LCD-1264

Laser Assisted Uvulopalatoplasty (LAUP)

08/04/05

10/02/07

Link Update

LCD-1257

Ionized Calcium

07/26/05

03/20/08

Code Update

LCD-1253

IVIG Intravenous Immunoglobin

06/01/02

03/20/08

Code Update

LCD-1249

Interventional Cardiology

12/27/96

10/02/07

Link Update

LCD-1248

Injection, Tendon Sheath, Ligament, Trigge

08/04/05

10/02/07

Link Update

LCD-1247

Injectable Iron Preparation

07/19/05

03/19/08

Link Update

LCD-1244

Indocyanine Green Angiography

12/27/96

09/17/07

Link Update

LCD-1243

Impotency Treatment

08/04/05

09/17/07

Link Update

LCD-1242

Ifosfamide (Ifex)

07/26/05

03/19/08

Link Update

LCD-1241

Electrocardiographic Monitoring for 24 hours

07/12/00

03/19/08

Link Update

LCD-1162

Ground Ambulance

06/01/02

12/27/07

Policy Correction

LCD-1140

Flow Cytometry

12/06/05

09/10/07

Code Update

LCD-1139

Electrophysiology Studies, EPS

07/26/05

12/12/07

HCPCS Update

LCD-1137

Electrocardiogram

04/01/98

03/19/08

Link Update

LCD-1130

Diagnostic Mammogram

10/16/97

09/10/07

Link Update

LCD-1116

Colonoscopy

12/27/96

09/10/07

Link Update

LCD-1081

Chest X-ray

07/19/05

03/19/08

Link Update

LCD-1068

Cardiac Catheterization

03/15/99

03/11/08

Narrative Change

LCD-104-03

(Converted to LCD) Psychiatric Inpatient Hosp

12/06/03

12/14/05

Converted to L13725

LCD-102-03

(Converted to LCD) Wound Care

12/06/03

12/14/05

Converted to L13570

LCD-100-03

(Converted to LCD) Bariatric Surgery

09/30/03

12/13/05

Converted to L13093

LCD-099-03

(Converted to LCD) Renal and Iliac Angio and

09/30/03

12/13/05

Converted to L13295

LCD-098-03

(Converted to LCD) Dialysis Frequency

09/30/03

12/13/05

Converted to L13302

LCD-097-03

(Converted to LCD) ESWT for Musculoskeletal Proble

09/30/03

12/16/05

Converted to L13281

LCD-096-03

(Converted to LCD) Adenosine (Adenocard)

09/30/03

12/16/05

Converted to L13243

LCD-095-03

(Converted to LCD) Neupogen and Neulasta

09/30/03

12/13/05

Converted to L13239

LCD-094-03

(Converted to LCD) Ferrlecit and Venofer

09/30/03

12/13/05

Converted to L13232

LCD-093-03

(Converted to LCD) Intensity Modulated Radiation

09/30/03

11/01/05

Converted to L13228

LCD-092-03

(Converted to LCD) Mohs Micrographic Surgery

09/30/03

12/08/05

Converted to L13225

LCD-091-03

(Converted to LCD) Off-Label Coverage of FDA Appr

09/30/03

12/16/05

Converted to L13121

LCD-090-02

(Converted to LCD) Erythropoietin Analogs

09/29/02

12/14/05

Converted to L1942

LCD-089-02

(Converted to LCD) Epoetin Alfa

09/29/02

12/15/05

Converted to L1938

LCD-088-02

(Converted to LCD) Infliximab

09/29/02

12/13/05

Converted to L1948

LCD-087-02

(Converted to LCD) Human Skin Equivalent

09/29/02

12/16/05

Converted to L1944

LCD-086-02

(Converted to LCD) Kyphoplasty

09/29/02

12/15/05

Converted to L1951

LCD-085-02

(Converted to LCD) Percutaneous Vertebroplasty

09/29/02

12/13/05

Converted to L1959

LCD-084-02

(Converted to LCD) Wireless Capsule Endoscopy

09/29/02

12/13/05

Converted to L1831

LCD-083-02

(Converted to LCD) Rural Health Clinic

12/27/02

12/28/05

Converted to L4874

LCD-079-01

(Converted to LCD) Pulmonary Rehabilitation

06/01/02

12/05/03

Converted to L1605

LCD-078-00

(Converted to LCD) Electrocardiographic Monitoring

07/12/00

12/13/05

Converted to L1241

LCD-077-00

(Converted to LCD) Troponin

09/28/00

12/13/05

Converted to L1686

LCD-076-00

[RETIRED 09/24/02] Self-administered Inj Drugs

LCD-075-00

(Converted to LCD) Psychiatric Services-Outpatient

09/28/00

12/15/05

Converted to L1372

LCD-074-00

(Converted to LCD) Blepharoplasty

09/28/00

10/31/02

Converted to L1306

LCD-073-99

(Converted to LCD) HCG, Human Chorionic Gonado

07/01/97

12/07/05

Converted to L1565

LCD-072-99

[RETIRED 01/13/03] CA19-9 Tumor Antigen

LCD-071-99

[RETIRED 01/13/03] CA15-CA27.29 Tumor Antigen

LCD-070-99

[RETIRED 01/13/03] CA125 Tumor Antigen

LCD-069-99

[RETIRED 01/13/03] Alpha-fetoprotein Tumor Antigen

LCD-068-99

(Converted to LCD) Bladder Tumor Antigen

07/1997

12/07/05

Converted to L1303

LCD-067-99

[RETIRED 01/13/03] CEA Carcinoembryonic Antigen

LCD-066-99

[RETIRED 01/13/03] Blood Count (CBC)

LCD-065-99

[RETIRED 01/13/03 HIV] Testing (Diagnostic)

LCD-064-99

[RETIRED 01/13/03] Lipid Profile

LCD-063-99

(Converted to LCD) Cardiac Catheterization

03/15/99

12/07/05

Converted to L1068

LCD-062-98

(Converted to LCD) Urinalysis

05/15/98

12/07/05

Converted to L1567

LCD-061-98

(Retired 09/30/2005) Respiratory Therapy

LCD-059-98

(Retired 12/31/2005) Speech Therapy

05/15/98

02/17/05

Code Update

LCD-058-98

[RETIRED 06/01/02] Observation Room Services

LCD-057-98

(Converted to LCD) PRN Orders for Skilled Nursing

04/01/98

12/07/05

LCD-056-98

(Converted to LCD) Electrocardiogram

04/01/98

12/07/05

Converted to L1137

LCD-055-97

(Retired 12/31/2005) Physical Therapy

01/01/98

01/31/05

Text Revision

LCD-054-97

(Converted to LCD) Bone Density Measurement

01/01/98

12/07/05

Converted to L1343

LCD-053-97

[RETIRED 01/13/03] Bacterial Culture, Urine

LCD-052-97

[RETIRED] Sedimentation Rate, Erythrocyte

LCD-051-97

(Converted to LCD) Rheumatoid Factor Test

10/16/05

12/07/05

Converted to L1628

LCD-050-97

(Converted to LCD) Syphilis Test

10/16/05

12/07/05

Converted to L1669

LCD-049-97

(Converted to LCD) Prostatic Acid Phosphatase, PAP

10/16/97

12/07/05

Converted to L1428

LCD-048-97

(Converted to LCD) Bacterial Culture

10/19/05

09/18/05

Converted to L1297

LCD-047-97

(Converted to LCD) Barium Swallow (Video/Cine)

10/16/97

12/06/05

Converted to L1348

LCD-046-97

(Converted to LCD) Leuprolide/Goserelin

10/16/97

12/06/05

Converted to L1266

LCD-045-97

(Converted to LCD) Occult Blood - Feces

10/16/97

12/06/05

Converted to L1363

LCD-044-97

(Converted to LCD) Diagnostic Mammogram

10/16/97

12/06/05

Converted to L1130

LCD-043-96

[RETIRED] Immunoassay for Tumor Antigen

LCD-042-96

(Converted to LCD) Percutaneous Transluminal

12/27/96

12/06/05

Converted to L1413

LCD-041-96

[RETIRED] Serum Cholesterol

LCD-040-96

(Converted to LCD) Botulinum Toxin Type A

12/27/96

12/06/05

Converted to L1321

LCD-039-96

(Converted to LCD) Interventional Cardiology

12/27/96

12/06/05

Converted to L1249

LCD-038-96

(Converted to LCD) Colonoscopy

12/27/96

12/06/05

Converted to L1116

LCD-035-96

(Converted to LCD) Indocyanine Green Angiography

12/27/96

12/06/05

Converted to L1244

LCD-034-96

[RETIRED] CBC with Platelet Counts

LCD-033-96

(Converted to LCD) Noninvasive Vascular Studies

12/27/96

07/24/03

Converted to L1352

LCD-032-96

(Converted to LCD) Flow Cytometry

12/27/96

12/06/05

Converted to L1140

LCD-031-96

(Converted to LCD) Psychiatry and Psychology Servi

08/06/05

08/06/05

Converted to L1593

LCD-030-96

[RETIRED] Nerve Conduction/Latency Study: Motor

LCD-029-96

(Converted to LCD) Pulmonary Perfusion Imaging

08/06/05

08/06/05

Converted to L1594

LCD-028-96

(Converted to LCD) Pelvic Echography for Prostate

08/04/05

08/04/05

Converted to L1412

LCD-027-96

(Converted to LCD) Transthoracic Echocardiography

08/04/05

08/04/05

Converted to LCD

LCD-026-96

(Converted to LCD) Injection, Tendon Sheath, Liga

08/04/05

08/04/05

Converted to L1248

LCD-025-96

(Converted to LCD) Injectable Iron Preparation

07/18/05

07/18/05

Converted to L1247

LCD-024-96

(Converted to LCD) Impotency Treatment

08/04/05

08/04/05

Converted to L1243

LCD-023-96

(Converted to LCD) Laser Assisted Uvulopalatoplasy

08/04/05

08/04/05

Converted to L1264

LCD-022-96

(Converted to LCD) Removal Impacted Cerumen

07/27/05

07/27/05

Converted to L1597

LCD-021-96

(Converted to LCD) Potassium - Serum

07/27/05

07/27/05

Converted to L1642

LCD-020-96

[RETIRED 01/13/03] Prothrombin Time

LCD-019-96

(Converted to LCD) Steroid Injections

7/26/05

7/26/05

Converted to L1664

LCD-018-96

(Converted to LCD) Anesthesia for Transvenous Pac

07/26/05

07/26/05

Converted to L1290

LCD-017-96

(Converted to LCD) Lumbar Spine MRI

07/26/05

07/26/05

Converted to L1326

LCD-016-96

(Converted to LCD) Lumbosacral Spine X-ray

07/26/05

07/06/05

Converted to L1338

LCD-015-96

[RETIRED] Right Heart Catheterization

LCD-014-96

(Converted to LCD) Electrophysiology Studies EPS

07/26/05

07/26/05

Converted to L1139

LCD-013-96

[RETIRED] Low Osmolar Contrast Material

LCD-012-96

[RETIRED] Additional Automated Hemogram Indices

LCD-011-96

[RETIRED] CBC with Differential

LCD-010-96

(Converted to LCD) Ionized Calcium

07/26/05

07/26/05

Converted to L1257

LCD-009-96

[RETIRED 01/13/03] Glycated Protein

LCD-008-96

(Converted to LCD) Ifosfamide (Ifex)

07/26/05

07/26/05

Converted to L1242

LCD-007-96

[RETIRED 01/13/03] Iron Studies

LCD-006-96

(Converted to LCD) Magnesium

07/26/05

07/06/05

Converted to L1340

LCD-005-96

[RETIRED 01/13/03] Thyroid Panel

LCD-005-95

(Converted to LCD) Partial Hospitalization

07/26/05

07/06/05

Converted to L1379

LCD-004-96

[RETIRED 01/13/03] Digoxin

LCD-004-95

(Converted to LCD) Patient Education

07/25/05

07/25/05

Converted to L1406

LCD-003-96

(Converted to LCD) Blood Glucose Testing

07/22/05

07/22/05

Converted to L1316

LCD-003-95

(Converted to LCD) Hepatitis B