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Active Local Coverage Determination (LCDs) & Articles

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The CPT/HCPCs codes listed below are contained in the applicable LCDs and/or articles listed; however, inclusion in this list does not necessarily mean coverage or non-coverage. Please refer to the LCD and/or Article for specific information. (bill types, CPT/HCPCS codes, diagnosis codes, and revenue codes)

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ACTIVE | DRAFT | RETIRED | Update History

Title

LCD #

Article #

CPT / HCPCS Codes

3D Interpretation and Reporting of Imaging Studies

L35408

N/A

76376, 76377

Acute Care: Inpatient, Observation and Treatment Room Services

N/A

A52985

99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99224, 99225, 99226, 99234, 99235, 99236, G0378, G0379

Allergen Immunotherapy

L36240

N/A

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

Allergy Testing

L36241

N/A

82785, 86001, 86003, 86005, 95004, 95017, 95018, 95024, 95027, 95028, 95044, 95052, 95056, 95060, 95065, 95076, 95079

Ambulance Services (Ground Ambulance)

L35162

A54574

A0425, A0426, A0427, A0428, A0429, A0433, A0434, A0888, A0999

Anorectal Manometry, Anal Electromyography, and Biofeedback Training for Perineal Muscles and Anorectal or Urethral Sphincters

L34977

N/A

51784, 51785, 90901, 90911, 91117, 91122

Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds

L35041

A54117

15002, 15003, 15004, 15005, 15040, 15050, 15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278, C5271, C5272, C5273, C5274, C5275, C5276, C5277, C5278, 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, Q4166, Q4169, Q4172, Q4173, Q4175

Approved Drugs and Biologicals; Includes Cancer Chemotherapeutic Agents

N/A

A53049

***This article is applicable to all drugs and biological CPT and HCPCS codes. ***

The following codes are specifically listed in the text of this article:

36593, 96360, 96361, 96365, 96366, 96367, 96368, 96372, 96373, 96374, 96375, 96376, 96379, 96401, 96402, 96405, 96406, 96409, 96411, 96413, 96415, 96416, 96417, 96420, 96422, 96423, 96425, 96440, 96446, 96450, 96521, 96522, 96523, 96542, 96549, 99211, J3490, J7999, J8999

Assays for Vitamins and Metabolic Function

L34914

N/A

82180, 82306, 82379, 82607, 82652, 82746, 83090, 83698, 84207, 84252, 84255, 84425, 84446, 84590, 84591, 84597, 84999, 85385, 86352

Auricular Peripheral Nerve Stimulation (Electro-Acupuncture Device)

N/A

A55240

64555, 64999

Autonomic Function Tests

L35395

A54954

95921, 95922, 95923, 95924, 95943, 95999

Bariatric Surgical Management of Morbid Obesity

L35022

N/A

43644, 43645, 43659, 43770, 43771, 43772, 43773, 43774, 43775, 43842, 43843, 43845, 43846, 43847, 43848, 43886, 43887, 43888, 43999

Barium Swallow Studies, Modified

L35433

N/A

70370, 70371, 74230

Billing and Coding for Rezum® Procedure

N/A

A55352

53899

Billing and Coding Information Regarding Uses, Including Off-Label Uses, of Anti-Vascular Endothelial Growth Factor (anti-VEGF), for The Treatment of Ophthalmological Diseases

N/A

A53121

67028, C9257, J0178, J2778, J9035

Biomarkers for Oncology

L35396

A52986

0002U, 0003U, 0005U, 0008M, 0009U, 0013U, 0014U, 0016U, 0017U, 81170, 81206, 81207, 81208, 81210, 81218, 81219, 81235, 81245, 81246, 81261, 81262, 81263, 81270, 81272, 81273, 81275, 81276, 81287, 81292, 81293, 81294, 81301, 81310, 81311, 81313, 81314, 81315, 81316, 81321, 81322, 81323, 81327, 81340, 81342, 81350, 81400, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81408, 81435, 81436, 81437, 81438, 81450, 81479, 81503, 81525, 81538, 81540, 81545, 88120, 88121

Biomarkers Overview

L35062

N/A

0001U, 81161, 81200, 81201, 81202, 81203, 81205, 81209, 81220, 81221, 81222, 81223, 81224, 81225, 81226, 81227, 81228, 81229, 81240, 81241, 81242, 81243, 81244, 81250, 81251, 81252, 81253, 81254, 81255, 81256, 81257, 81260, 81265, 81266, 81267, 81268, 81288, 81290, 81291, 81295, 81296, 81297, 81298, 81299, 81300, 81302, 81303, 81304, 81317, 81318, 81319, 81324, 81325, 81326, 81330, 81331, 81332, 81355, 81370, 81371, 81372, 81373, 81374, 81375, 81376, 81377, 81378, 81379, 81380, 81381, 81382, 81383, 81410, 81411, 81412, 81413, 81414, 81415, 81416, 81417, 81420, 81425, 81426, 81427, 81430, 81431, 81439, 81434, 81440, 81442, 81460, 81465, 81470, 81471, 81490, 81595

Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)

L34834

N/A

82947, 82948, 82962

BRCA1 and BRCA2 Genetic Testing

L36715

N/A

81162, 81211, 81212, 81213, 81214, 81215, 81216, 81217, 81432, 81433, 81445, 81455

Cardiac Event Detection Monitoring

L34953

N/A

93268, 93270, 93271, 93272

Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Physician Requirements

N/A

A55758

93797, 93798, G0422, G0423

Cardiac Rhythm Device Evaluation

L34833

N/A

93260, 93261, 93279, 93280, 93281, 93282, 93283, 93284, 93286, 93287, 93288, 93289, 93292, 93293, 93294, 93295, 93296, 93724

Cardiovascular Nuclear Medicine

L35083

N/A

78451, 78452, 78453, 78454, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78494, 78496, 93015, 93016, 93017, 93018, A4641, A9500, A9501, A9502, A9505, A9512, A9538, A9560, J0153, J0395, J1245, J1250, J2785

Cataract Extraction (including Complex Cataract Surgery)

L35091

N/A

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

Chiropractic Services

L35424

A52987

98940, 98941, 98942

Co-Management of Surgical Procedures

L34862

A52989

N/A

Compounded Drugs Used in an Implantable Infusion Pump

See Implantable Infusion Pump

A54100

36260, 36261, 36262, 62350, 62351, 62355, 62361, 62362, 62365, 62367, 62368, 62369, 62370, 95990, 95991, 96522, A4220, E0782, E0783, E0785, E0786, J0475, J2278, J7999

Controlled Substance Monitoring and Drugs of Abuse Testing

L35006

N/A

80159, 80171, 80173, 80183, 80184, 80305, 80306, 80307, 83789, 83992, 84999, G0431, G0480, G0481, G0482, G0483, G0659

Corus® CAD Test

L36713

N/A

81493

Cosmetic and Reconstructive Surgery

L35090

N/A

11920, 11921, 11922, 15775, 15776, 15780, 15781, 15782, 15783, 15830, 15847, 17999, 19300, 19316, 19318, 19324, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19366, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 30400, 30410, 30420, 30430, 30435, 30450, 30460, 30462

C-Reactive Protein High Sensitivity Testing (hsCRP)

L34856

N/A

86140, 86141

Debridement of Mycotic Nails

L35013

N/A

11720, 11721

Diagnostic Abdominal Aortography and Renal Angiography

L35092

N/A

36200, 36245, 36246, 36247, 36248, 36251, 36252, 36253, 36254, 75625, 75630, 75726, G0278

Epidural Injections for Pain Management

L36920

 

62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 64479, 64480, 64483, 64484

Evaluation and Management Services Provided in a Nursing Facility

L35068

N/A

99251, 99252, 99253, 99254, 99255, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318

Facet Joint Injections

L34974

N/A

0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 64490, 64491, 64492, 64493, 64494, 64495, 64999

Flow Cytometry

L35032

N/A

88182, 88184, 88185, 88187, 88188, 88189

Frequency of Dialysis

L35014

A55723
Frequency of Hemodialysis
(Effective Date to be Determined)

90999

Frequency of Laboratory Tests

L35099

N/A

80061, 82465, 82948, 82962, 82985, 83036, 83718, 83721, 84436, 84439, 84443, 84478, 84479

Hemophilia Factor Products

L35111

N/A

C9140, J7175, J7179, J7180, J7181, J7182, J7183, J7185, J7186, J7187, J7188, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7198, J7200, J7201, J7202, J7205, J7207, J7209

Hyaluronan Acid Therapies for Osteoarthritis of the Knee

L35427

A55036

20610, J7320, J7321, J7322, J7323, J7324, J7325, J7326, J7327, J7328

Hydration Therapy

L34960

N/A

96360, 96361, J7030, J7040, J7042, J7050, J7060, J7070, J7120, J7121

Hyperbaric Oxygen (HBO) Therapy

L35021

N/A

99183, G0277

Implantable Infusion Pump

L35112

See Compounded Drugs Used in an Implantable Infusion Pump

36260, 36261, 36262, 62350, 62351, 62355, 62361, 62362, 62365, 62367, 62368, 62369, 62370, 95990, 95991, 96522, A4220, E0782, E0783, E0785, E0786, J0475, J7999

In Vitro Chemosensitivity & Chemoresistance Assays

L36634

N/A

81535, 81536, 84999, 89240

Independent Diagnostic Testing Facility (IDTF)

L35448

A53252

Due to numerous CPT/HCPCS codes, please review the policy.

Infrared Photocoagulation (IRC) of Hemorrhoids

L34861

N/A

46930

Intensity Modulated Radiation Therapy (IMRT)

L36711

N/A

77301, 77338, 77385, 77386, G6015, G6016

Intraoperative Neurophysiological Testing

L35003

N/A

60220, 60240, 60254, 60260, 95940, G0453

Intravenous Immune Globulin (IVIG)

L35093

N/A

J0850, J1459, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1573, J1599, J2788, J2790, J2792

Isolated Ultrafiltration for Management of Fluid Overload in Cardiac Disease

N/A

A53126

37799, 90999

Lacrimal Punctum Plugs

L35095

N/A

68761, A4262, A4263

Loss-of-Heterozygosity Based Topographic Genotyping with PathfinderTG®

L34864

N/A

81479

Lower Extremity Major Joint Replacement (Hip and Knee)

L36007

N/A

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

Luteinizing Hormone-Releasing Hormone (LHRH) Analogs

L34822

N/A

J1950, J3315, J9202, J9217, J9219, J9225, J9226

Magnetic Resonance Angiography (MRA)

L34865

N/A

70544, 70545, 70546, 70547, 70548, 70549, 71555, 72159, 72198, 73225, 73725, 74185, 75557, 75559, 75561, 75563, 75565, C8900, C8901, C8902, C8909, C8910, C8911, C8912, C8913, C8914, C8918, C8919, C8920, C8931, C8932, C8933, C8934, C8935, C8936

Microvascular Therapy

L36434

A54343

97032, 97039, 97139

Moh’s Micrographic Surgery

L34961

A53883

11100, 11101, 17311, 17312, 17313, 17314, 17315, 88300, 88302, 88304, 88305, 88307, 88309, 88331, 88332, 88333, 88334, 88341, 88342

Molecular Diagnostics: Genitourinary Infectious Disease Testing

L35015

N/A

87480, 87481, 87490, 87491, 87510, 87590, 87591, 87660, 87798

Monitored Anesthesia Care

L35049

N/A

00100, 00124, 00148, 00160, 00164, 00300, 00322, 00400, 00410, 00454, 00520, 00522, 00524, 00530, 00532, 00635, 00640, 00702, 00740, 00842, 00920, 00921, 01130, 01380, 01420, 01490, 01680, 01682, 01730, 01780, 01782, 01820, 01829, 01860, 01916, 01920, 01922, 01930, 01935, 01936, 01991, 01992, 01999

Multiple Imaging in Oncology

L35391

N/A

70450, 70460, 70470, 70551, 70552, 70553, 71250, 71260, 71270, 71551, 71552, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72192, 72193, 72194, 72195, 72196, 72197, 74150, 74160, 74170, 74176, 74177, 74178, 74181, 74182, 74183, 78811, 78812, 78813, 78814, 78815, 78816

NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions

N/A

A53134

78459, 78491, 78492, 78608, 78609, 78811, 78814, A4641, A9526, A9552, A9555, A9586, A9599, G0219, G0235, G0252, Q9982, Q9983

NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions

N/A

A53132

78608, 78609, 78811, 78812, 78813, 78814, 78815, 78816, A4641, A9515, A9552, A9580, A9587, A9588, G0219, G0235, G0252

Nerve Conduction Studies and Electromyography

L35081

A54095

51784, 51785, 92265, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95874, 95885, 95886, 95887, 95873, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95933, 95937, 95999, G0255

Neuromuscular Junction Testing

L34996

N/A

95907, 95908, 95909, 95910, 95911, 95912, 95913, 95921, 95922, 95923, 95925, 95926, 95927, 95937

Neurophysiology Evoked Potentials (NEPs)

L34975

N/A

92585, 92586, 95925, 95926, 95927, 95928, 95929, 95930, 95938, 95939

Non-Coronary Vascular Stents

L35084

N/A

37221, 37223, 37226, 37227, 37230, 37231, 37234, 37235, 37236, 37237, 37238, 37239, 92997, 92998

Non-Invasive Cerebrovascular Arterial Studies

L35397

A52992

93880, 93882, 93886, 93888, 93890, 93892, 93893

Non-Invasive Peripheral Venous Studies

L35451

A52993

36475, 36476, 36478, 36479, 93970, 93971, G0365

Non-Vascular Extremity Ultrasound

L35409

A55037

76881, 76882

Oral Maxillofacial Prosthesis

L35047

N/A

21076, 21077, 21079, 21080, 21081, 21082, 21083, 21084, 21085, 21086, 21087, 21088, 21089, 21299

Outpatient Sleep Studies

L35050

N/A

95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, 95999, G0398, G0399, G0400

Outpatient Wireless Pulmonary Artery Pressure Monitoring for Heart Failure

L36419

N/A

93799, C2624, C9741

Oximetry Services

L35434

N/A

94760, 94761, 94762

Pain Management of Peripheral Nerves by Injection

L35107

N/A

20526, 20550, 20551, 28899, 64450, 64455

Pharmacokinetic (PK) Testing for Chemotherapy Dosing

L35679

N/A

84999

Prepackaged Kits

N/A

A54515

J3490

Prolonged Drug and Biological Infusions Started Incident To a Physician’s Service Using an External Pump

N/A

A55134

96379, G0498

Prostate Mapping Biopsy

L35009

N/A

55700, 55706

Psychiatric Codes

L35101

N/A

90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90853, 90865, 90870, 90880, 90889, 90899, 96101, 96102, 96103, 96105, 96111, 96116, 96118, 96119, 96120, G0451

Pulmonary Function Testing

L35360

N/A

94010, 94014, 94015, 94016, 94060, 94070, 94150, 94200, 94250, 94375, 94400, 94450, 94680, 94681, 94690, 94726, 94727, 94728, 94729, 94750, 94770

Real-Time, Outpatient Cardiac Telemetry

L34997

A52995

93228, 93229

Removal of Benign Skin Lesions

L34938

N/A

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, 46900, 46916, 54050, 54055, 54056, 54057, 54060, 54065, 56501, 56515

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

L34998

N/A

90867, 90868, 90869

Routine Foot Care

L35138

A52996

11055, 11056, 11057, 11305, 11306, 11307, 11308, 11719, 11720, 11721, G0127

Sacral Nerve Stimulation

L35449

N/A

64561, 64581, 64585, A4290

Scanning Computerized Ophthalmic Diagnostic Imaging

L35038

N/A

92132, 92133, 92134

Self-Administered Drug Exclusion List

N/A

A53127

C9399, J0135, J0270, J0275, J0364, J0630, J0800, J1324, J1438, J1559, J1595, J1744, J1815, J1817, J1830, J2170, J2212, J2354, J2940, J2941, J3030, J3110, J3355, J3490, J3590, J9212, J9213, J9216, J9218, Q0515

Services That Are Not Reasonable and Necessary

L35094

N/A

0042T, 0051T, 0052T, 0053T, 0054T, 0055T, 0058T, 0071T, 0072T, 0075T, 0076T, 0085T, 0095T, 0098T, 0100T, 0101T, 0102T, 0106T, 0107T, 0108T, 0109T, 0110T, 0111T, 0126T, 0159T, 0163T, 0164T, 0165T, 0174T, 0175T, 0178T, 0179T, 0180T, 0182T, 0184T, 0188T, 0189T, 0190T, 0191T, 0195T, 0196T, 0198T, 0200T, 0201T, 0202T, 0205T, 0206T, 0207T, 0208T, 0209T, 0210T, 0211T, 0212T, 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0219T, 0220T, 0221T, 0222T, 0228T, 0229T, 0230T, 0231T, 0232T, 0234T, 0235T, 0236T, 0237T, 0238T, 0247T, 0249T, 0253T, 0254T, 0255T, 0262T, 0263T, 0264T, 0265T, 0266T, 0267T, 0268T, 0269T, 0270T, 0271T, 0272T, 0273T, 0274T, 0275T, 0278T, 0290T, 0293T, 0294T, 0295T, 0296T, 0297T, 0298T, 0299T, 0300T, 0301T, 0302T, 0303T, 0304T, 0305T, 0306T, 0307T, 0308T, 0309T, 0310T, 0311T, 0312T, 0313T, 0314T, 0315T, 0316T, 0317T, 0329T, 0330T, 0331T, 0332T, 0333T, 0335T, 0337T, 0338T, 0339T, 0340T, 0341T, 0342T, 0345T, 0346T, 0347T, 0348T, 0349T, 0350T, 0351T, 0352T, 0353T, 0354T, 0355T, 0356T, 0357T, 0358T, 0359T, 0360T, 0361T, 0362T, 0363T, 0364T, 0365T, 0366T, 0367T, 0368T, 0369T, 0370T, 0371T, 0372T, 0373T, 0374T, 0375T, 0377T, 0378T, 0379T, 0380T, 0381T, 0382T, 0383T, 0384T, 0385T, 0386T, 0387T, 0388T, 0389T, 0390T, 0391T, 0392T, 0393T, 0396T, 0397T, 0398T, 0399T, 0400T, 0401T, 0402T, 0403T, 0404T, 0405T, 0406T, 0407T, 0408T, 0409T, 0410T, 0411T, 0412T, 0413T, 0414T, 0415T, 0416T, 0417T, 0418T, 0419T, 0420T, 0421T, 0422T, 0423T, 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T, 0434T, 0435T, 0436T, 0437T, 0438T, 0439T, 0440T, 0441T, 0442T, 0443T, 0444T, 0445T, 0446T, 0447T, 0448T, 0451T, 0452T, 0453T, 0454T, 0455T, 0456T, 0457T, 0458T, 0459T, 0460T, 0461T, 0462T, 0463T, 0464T, 0465T, 0466T, 0467T, 0468T, 0469T, 0470T, 0471T, 0475T, 0476T, 0477T, 0478T, 28890, 33477, 43284, 43285, 51727, 51728, 51729, 52441, 52442, 53899, 55899, 82172, 83719, 93050, 95999, 99199, Q2043

Single Chamber and Dual Chamber Permanent Cardiac Pacemakers - Coding and Billing

N/A

A54982

33206, 33207, 33208, 33227, 33228, 33229, 33233

Speech-Language Pathology (SLP) Services: Communication Disorders

L35070

A54111

92507, 92508, 92521, 92522, 92523, 92524, 92597, 92607, 92608, 92609, 96105, 96110, 96111, 96125, 97110, 97530, 97532, 97533, 97535

Speech-Language Pathology (SLP) Services: Dysphagia, Includes VitalStim® Therapy

L34891

N/A

92526, 92610

Spinal Cord Stimulation (Dorsal Column Stimulation)

L35450

N/A

63650, 63655, 63661, 63662, 63663, 63664, 63685, 95970, 95971, 95972, L8681, L8682, L8683, L8685, L8686, L8687, L8688, L8689, L8695, L8699, M47.21, M47.22, M47.23, M47.24, M47.25, M47.26, M47.27

Strapping

L36423

N/A

29200, 29240, 29260, 29280, 29520, 29530, 29540, 29550

Surgery: Blepharoplasty

L35004

N/A

15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908

Surgery: Posterior Tibial Nerve Stimulation (PTNS) for Urinary Control

L35011

N/A

64566

Surgical Treatment of Nails

L34887

A52998

11719, 11720, 11721, 11730, 11732, 11750, 11755, 11765, G0127

Therapy and Rehabilitation Services (PT, OT)

L35036

N/A

95992, 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, 97532, 97533, 97535, 97537, 97542, 97545, 97546, 97597, 97598, 97750, 97755, 97760, 97761, 97762, 97799, G0281, G0282, G0283

Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography

L35035

N/A

36120, 36200, 36215, 36216, 36217, 36218, 36222, 36223, 36224, 36225, 36226, 36227, 36228, 75605, 75710, 75716

Thrombolytic Agents

L35428

A55237

36593, 37195, 37211, 37212, 37213, 37214, 61645, 92975, 92977, J0350, J2993, J2995, J2997, J3101, J3364, J3365

Transesophageal Echocardiography (TEE)

L35016

N/A

93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, 93355, C8925, C8926, C8927, Q9955, Q9956, Q9957

Transoral Incisionless Fundoplication

L34999

N/A

43210, 43280, 43281, 43282, 43499, 43659

Treatment of Varicose Veins and Venous Stasis Disease of the Lower Extremities

L34924

A55229

36468, 36470, 36471, 36473, 36474, 36475, 36476, 36478, 36479, 37500, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37785, 76937, 76942, 76998, 93970, 93971

Trigger Point Injections

L35010

N/A

20552, 20553, M0076

Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)

L35350

N/A

43191, 43192, 43193, 43194, 43195, 43196, 43197, 43198, 43200, 43201, 43202, 43204, 43205, 43206, 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, 43257, 43259, 43260, 43261, 43262, 43263, 43264, 43265, 43266, 43270, 43274, 43275, 43276, 43277, 43278

Ventricular Assist Device (VAD) Supply or Accessory

N/A

A54910

Q0508, Q0509

Vertebroplasty Vertebral Augmentation (Kyphoplasty) Percutaneous

L35130

N/A

0200T, 0201T, 22510, 22511, 22512, 22513, 22514, 22515

Vestibular and Audiologic Function Studies

L35007

N/A

92537, 92538, 92540, 92541, 92542, 92544, 92545, 92546, 92547, 92550, 92552, 92553, 92555, 92556, 92557, 92561, 92562, 92563, 92564, 92565, 92567, 92568, 92570, 92571, 92572, 92575, 92576, 92577, 92579, 92582, 92583, 92584, 92585, 92586, 92587, 92588, 92601, 92602, 92603, 92604, 92620, 92621

Wireless Capsule Endoscopy

L35089

N/A

91110, 91111

Wound Care

L35125

A53001

11042, 11043, 11044, 11045, 11046, 11047, 16020, 16025, 16030, 97597, 97598, 97602, 97605, 97606, 97607, 97608, 97610, G0281, G0239


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Last modified:  11/09/2017