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Local Coverage Determinations Part A
ID Title Effective Date Revision Effective Date End Date Last Approval / Revision Date
L25879Acid Phosphatase 12/1/2007N/AN/A 9/20/2007
L1281Acute Care: Inpatient, Observation and Treatment Room Services 6/1/2002 12/31/2005N/A 1/2/2008
L13243Adenosine (Adenocard) 9/30/2003 12/17/2005N/A 10/2/2007
L17635Alefacept Therapy 9/29/2004 9/29/2004N/A 10/30/2007
L2483Ambulance Services 9/30/2002 6/20/2006N/A 5/22/2006
L1290Anesthesia for Transvenous Pacemaker Insertion 12/27/1996 7/27/2005N/A 10/2/2007
L15332Audiological Testing; Audiological Services 3/10/2004 10/1/2007N/A 2/18/2008
L23482Audiology and Vestibular Function Tests 9/30/2006N/AN/A 2/18/2008
L1293Bacterial Culture 10/19/1997 1/29/2005N/A 9/17/2007
L1348Barium Swallow (Video/Cine) 10/16/1997 4/20/2006N/A 10/4/2007
L1002Barium Swallow Studies, Modified 11/1/1997 10/1/2007N/A 2/18/2008
L26003Biologic Products for Wound Treatment and Surgical Interventions 12/1/2007 3/1/2008N/A 2/19/2008
L1303Bladder Tumor Antigen 7/1/1997 12/8/2005N/A 10/2/2007
L1306Blepharoplasty 9/28/2000 12/9/2005N/A 10/2/2007
L2690Blepharoplasty 3/23/2002 10/1/2004N/A 6/8/2007
L2545Blepharoplasty 9/19/2001 10/1/2004N/A 10/26/2007
L24615Blepharoplasty/Blepharoptosis 6/26/2000 7/6/2007N/A 11/10/2007
L23285Blepharoplasty/Blepharoptosis 10/16/2006 7/6/2007N/A 11/10/2007
L26073BLOOD GLUCOSE Monitoring in a Skilled Nursing Facility (SNF) 9/27/2007N/AN/A 10/4/2007
L26071BLOOD GLUCOSE Monitoring in a Skilled Nursing Facility (SNF) 9/27/2007N/AN/A 10/4/2007
L1316Blood Glucose Testing 2/20/1997 7/23/2005N/A 2/18/2008
L1343Bone Density Measurement 1/1/1998 12/8/2005N/A 1/11/2007
L1321Botulinum Toxin Type A 12/27/1996 10/1/2006N/A 10/2/2007
L22904Botulinum Toxin Type A and B 10/16/2006 10/16/2006N/A 12/19/2006
L23309Botulinum Toxin Type A and B 10/16/2006 10/16/2006N/A 12/19/2006
L26046Cancer Chemotherapeutic Agents 9/27/2007 10/22/2007N/A 11/15/2007
L26044Cancer Chemotherapeutic Agents 9/27/2007 10/22/2007N/A 11/15/2007
L20721Carboplatin 9/30/2005 4/20/2006N/A 6/21/2007
L1068Cardiac Catheterization 3/15/1999 10/27/2006N/A 1/2/2008
L15908Cardiac Catheterization 7/2/2004 7/2/2006N/A 6/8/2007
L23480CARDIAC COMPUTED TOMOGRAPHY 9/30/2006 9/30/2006N/A 2/18/2008
L25907Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) 12/1/2007 3/1/2008N/A 2/14/2008
L912Cardiac Event Recorders 5/28/1997 5/15/2006N/A 2/18/2008
L25447Cardiac Output Measurement Thoracic Electrical Bioimpedance 12/1/2007 1/1/2008N/A 12/20/2007
L23499Cardiac Rehabilitation 9/30/2006 9/30/2006N/A 2/18/2008
L2650Cardiac Rehabilitation Services 8/10/2006 9/28/2006N/A 6/8/2007
L770Cardiovascular Stress Testing 6/26/2000 10/1/2007N/A 1/14/2008
L22312Cardiovascular Stress Testing 6/15/2006 10/1/2007N/A 1/14/2008
L2611Cardiovascular Stress Testing 9/30/2002 10/1/2004N/A 11/10/2007
L13652CATARACT Surgery 9/29/2003 9/27/2007N/A 9/27/2007
L23307CATARACT Surgery 10/16/2006 9/27/2007N/A 9/27/2007
L2514Cataract Surgery 6/15/2002 10/1/2004N/A 6/11/2007
L25275Category III CPT ® Codes 12/1/2007 12/1/2007N/A 2/18/2008
L1081Chest X-Ray 6/20/1996 7/20/2005N/A 2/18/2008
L15235Chest X-Ray 5/29/2004 5/29/2004N/A 2/18/2008
L20620Clinically Complex Resourse Utilization Group ( RUG III) Category: Medicare Skilled Nursing Facility (SNF) 9/30/2005 6/10/2006N/A 6/18/2007
L1116Colonoscopy 12/27/1996 12/7/2005N/A 9/10/2007
L18329Colonoscopy, Diagnostic and Screening 9/15/2004 10/1/2004N/A 8/29/2006
L25965Complex Cataract Extraction 9/27/2007N/AN/A 10/4/2007
L25939Complex Cataract Extraction 9/27/2007N/AN/A 10/4/2007
L23356Computed Coronary Tomography Angiography 9/30/2006 9/30/2006N/A 11/10/2007
L25233Computed Tomographic (CT) Colongraphy 12/1/2007N/AN/A 9/17/2007
L24079Computed Tomographic Angiography of the Chest 2/22/2007 12/20/2007N/A 1/14/2008
L24107Computed Tomographic Angiography of the Chest 2/22/2007 12/20/2007N/A 1/14/2008
L934Computerized Axial Tomography of the Abdomen 2/15/2000 10/1/2007N/A 2/18/2008
L14312Computerized Tomography (CT) Scans of the Abdomen and Pelvis 9/13/2003 9/12/2007N/A 9/12/2007
L16266Cranial Computerized Tomography (CCT) Scans 9/1/2004 10/1/2007N/A 10/15/2007
L23478CT Colonography (Virtual Colonoscopy) 9/30/2006N/AN/A 10/30/2007
L5658Dental Services 8/2/2002 10/1/2004N/A 9/4/2007
L1130Diagnostic Mammogram 10/16/1997 2/6/2007N/A 9/10/2007
L13302Dialysis Frequency 9/30/2003 12/14/2005N/A 6/27/2007
L25820Drugs and Biologicals, Coverage of, for Label and Off-Label Uses 12/1/2007 3/1/2008N/A 2/21/2008
L2603Dysphagia 12/12/2000 7/10/2006N/A 4/5/2007
L1137Electrocardiogram 4/1/1998 12/8/2005N/A 2/18/2008
L1241Electrocardiographic Monitoring for 24 Hours (Holter Monitoring) 7/12/2000 12/9/2005N/A 2/18/2008
L14293Electrocardiographic Services (EKG/ECG) 9/13/2003 10/1/2004N/A 2/18/2008
L14225Electroconvulsive Therapy (ECT) 9/13/2003 10/1/2004N/A 6/12/2007
L1139Electrophysiology Studies (EPS) 12/27/1996 7/27/2005N/A 1/2/2008
L25468Endoscopy by Capsule 12/1/2007N/AN/A 2/18/2008
L1938Epoetin Alfa (Epogen, EPO, Erythropoietin) 9/29/2002 12/9/2005N/A 9/28/2007
L25639Erythrocyte Sedimentation Rate (ESR) 12/1/2007N/AN/A 9/20/2007
L22886Erythropoiesis Stimulating Agents (ESAs) 10/16/2006 10/1/2007N/A 1/14/2008
L19875Erythropoiesis Stimulating Agents (ESAs) 9/19/2005 10/1/2007N/A 1/14/2008
L23363Erythropoietic Agents 9/29/2006N/AN/A 4/2/2007
L1942Erythropoietin Analogs (Aranesp, Darbepoetin) 9/29/2002 5/9/2006N/A 2/18/2008
L25211Erythropoietin Stimulating Agents (ESA) 12/1/2007 3/1/2008N/A 2/29/2008
L986Erythropoietin Use in non-ESRD patients (non-dialysis) 6/1/1999 10/1/2007N/A 2/18/2008
L20622Extensive Services Resource Utilization Group (RUG III) Category: Medicare Skilled Nursing Facility (SNF) 9/30/2005 6/10/2006N/A 6/18/2007
L13281Extracorporeal Shock-Wave Therapy for Musculoskeletal Problems 9/30/2003 12/17/2005N/A 10/5/2007
L998Eyelid and Brow Surgical Procedures 8/15/2001 7/17/2007N/A 10/1/2007
L13232Ferrlecit and Venofer 9/30/2003 12/14/2005N/A 10/2/2007
L1004Filgrastim (G-CSF), (Neupogen) 6/1/1999 7/17/2007N/A 2/18/2008
L1009Flow Cytometry 11/1/1997 10/1/2007N/A 2/18/2008
L1140Flow Cytometry 12/27/1996 12/7/2005N/A 9/10/2007
L1162Ground Ambulance Services 6/1/2002 9/17/2007N/A 12/27/2007
L1565HCG - Human chorionic gonadotropin-Tumor Antigen by Immunoassay, Qualitative 7/1/1997 12/8/2005N/A 10/5/2007
L1029Helicobacter Pylori (H. pylori) 6/1/1999 7/17/2007N/A 2/18/2008
L1641Hepatitis B (Serologic Testing) 7/22/1995 2/8/2006N/A 2/18/2008
L25650Homocysteine Level, Serum 12/1/2007N/AN/A 9/19/2007
L22362Human Decellularized Dermal Matrix and Gel 6/3/2006 9/28/2007N/A 9/28/2007
L1944Human Skin Equivalent (HSE) 9/29/2002 1/25/2008N/A 2/18/2008
L25204Hyperbaric Oxygen Therapy (HBO) 12/1/2007N/AN/A 9/19/2007
L1242Ifosfamide (Ifex) 2/20/1997 7/27/2005N/A 2/18/2008
L20616Impaired Cognition/Behavior/Reduced Physical Functions Resource Utilization Group (RUG III) Category: Medicare Skilled Nursing Facility (SNF) 9/30/2005 6/10/2006N/A 6/18/2007
L1243Impotency Treatment 12/27/1996 8/4/2005N/A 9/17/2007
L1244Indocyanine Green Angiography 12/27/1996 12/7/2005N/A 9/17/2007
L1948Infliximab 9/29/2002 12/9/2005N/A 6/21/2007
L25178Infrared Coagulation (IRC) of Hemorrhoids (R1) 12/1/2007 1/1/2008N/A 1/2/2008
L1247Injectable Iron Preparation 12/27/1996 7/19/2005N/A 2/18/2008
L1248Injection, Tendon Sheath, Ligament, Trigger Points or Ganglion Cyst 12/27/1996 8/4/2005N/A 10/2/2007
L18183Inpatient Psychiatric Services 11/15/2004 9/3/2005N/A 9/28/2007
L18887Inpatient Rehabilitation 1/1/2005 7/17/2007N/A 10/1/2007
L19890Inpatient Rehabilitation Services 5/14/2005 9/28/2006N/A 9/4/2007
L25714Inpatient Rehabilitation Services Provided in an Inpatient Rehabilitation Facility (IRF) 12/1/2007 12/1/2007N/A 11/6/2007
L13228Intensity Modulated Radiation Therapy (IMRT) 9/30/2003 4/25/2006N/A 10/2/2007
L1249Interventional Cardiology 12/27/1996 12/7/2005N/A 10/2/2007
L1063Intravenous Immune Globulin (IVIG) 8/15/2001 7/17/2007N/A 10/1/2007
L19866Intravenous Immune Globulin (IVIg) 8/31/2005 8/29/2006N/A 9/4/2007
L1253Intravenous Immunoglobulin (IVIG) 6/1/2002 1/1/2006N/A 2/18/2008
L23528Intravenous Inotropic Therapy Administered in the Outpatient Setting 11/1/2006 7/17/2007N/A 10/1/2007
L2422Intravenous Iron Therapy 6/15/2002 10/1/2004N/A 9/28/2007
L19503Intravenous Nesiritide (BNP) Infusion Therapy 9/1/2005 7/17/2007N/A 10/1/2007
L2463Intravenous Vitamin D Analogues Usage for Dialysis Patients 6/15/2002 10/1/2004N/A 9/19/2007
L1257Ionized Calcium 2/20/1997 5/10/2005N/A 2/18/2008
L1951Kyphoplasty 9/29/2002 12/9/2005N/A 6/21/2007
L22552Kyphoplasty 6/3/2006 6/3/2006N/A 9/19/2007
L1264Laser Assisted Uvulopalatoplasty (LAUP) 11/27/1996 8/4/2005N/A 10/2/2007
L897Leuprolide Acetate and Goserelin Acetate 8/10/1997 7/17/2007N/A 10/1/2007
L1266Leuprolide/Goserelin 10/16/1997 12/7/2005N/A 10/2/2007
L13187Levocarnitine 8/30/2001 10/1/2004N/A 6/18/2007
L1326Lumbar Spine MRI 12/27/1996 7/27/2005N/A 2/18/2008
L1338Lumbosacral Spine X-Ray 12/27/1996 7/27/2005N/A 2/18/2008
L1329Magnesium 5/1/1999 7/17/2007N/A 2/18/2008
L1340Magnesium 2/20/1997 7/27/2005N/A 9/17/2007
L25367Magnetic Resonance Angiography (MRA) 12/1/2007N/AN/A 9/19/2007
L13225Mohs Micrographic Surgery (MMS) 9/30/2003 12/9/2005N/A 10/4/2007
L12324Monoclonal Antibody Therapy; Ibritumomab Tiuxetan Therapeutic Regimen 1/18/2003 10/1/2004N/A 6/18/2007
L1005Myocardial Perfusion Imaging 8/10/1997 10/1/2007N/A 11/10/2007
L19826Natrecor® (Neseritide) Usage in the Treatment of Congestive Heart Failure 8/31/2005 8/5/2006N/A 9/28/2007
L13239Neupogen (Filgrastim) and Neulasta (Pegfilgrastim) 9/30/2003 12/14/2005N/A 10/2/2007
L25563Neuromuscular Junction Testing 12/1/2007 12/1/2007N/A 9/28/2007
L13202Non-Covered Services 9/30/2003 4/24/2006N/A 2/18/2008
L23336Non-invasive Cerebrovascular Arterial Studies 11/30/2006 10/1/2007N/A 1/14/2008
L22315Non-invasive Cerebrovascular Arterial Studies 6/15/2006 10/1/2007N/A 1/14/2008
L14311Non-Invasive Pulse Oximetry for Oxygen Saturation 9/13/2003 10/1/2004N/A 8/9/2007
L1524Noninvasive Vascular Studies 5/1/1995 10/1/2007N/A 2/18/2008
L1352Noninvasive Vascular Studies 12/27/1996 12/7/2005N/A 2/18/2008
L2415Non-Invasive Vascular Studies for End Stage Renal Disease (ESRD) Patients 6/15/2002 9/15/2005N/A 9/19/2007
L1363Occult Blood, Feces Testing 10/16/1997 4/13/2007N/A 1/2/2008
L17637Occupational Therapy 9/30/2005 9/11/2006N/A 11/10/2007
L13121Off-Label Coverage of FDA Approved Drugs and Biologicals 9/30/2003 1/1/2007N/A 2/18/2008
L25347Ophthalmic Angiography (Fluorescein and Indocyanine Green) 12/1/2007 12/1/2007N/A 2/19/2008
L25466Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) 12/1/2007N/AN/A 2/18/2008
L15815Outpatient Hospital Based Psychiatric Services 6/1/2004 10/1/2006N/A 10/26/2007
L14319Outpatient Observation Services 8/13/2003 9/19/2006N/A 11/10/2007
L2267Outpatient Occupational Therapy 2/1/1997 9/29/2006N/A 11/10/2007
L2695Outpatient Physical Therapy 8/18/2001 9/29/2006N/A 11/10/2007
L26219Outpatient Pulmonary Rehabilitation 2/1/2008N/AN/A 12/13/2007
L2627Outpatient Pulmonary Rehabilitation 11/1/1999 1/1/2008N/A 12/26/2007
L23526Oxaliplatin 11/1/2006 11/1/2006N/A 2/18/2008
L17632Oxaliplatin for Injection (Eloxatin™) 7/15/2003 11/24/2004N/A 10/30/2007
L989Parathormone 5/28/1997 10/1/2007N/A 2/18/2008
L1379Partial Hospitalization 7/19/1995 7/27/2005N/A 11/29/2007
L2403Partial Hospitalization Program 2/10/1995 10/1/2004N/A 9/19/2007
L1457Partial Psychiatric Hospitalization Program 8/21/1991 7/17/2007N/A 10/1/2007
L1406Patient Education 1/25/1995 7/26/2005N/A 2/18/2008
L1412Pelvic Echography for Prostate Follow-up 12/27/1996 8/4/2005N/A 10/5/2007
L1413Percutaneous Transluminal Angioplasty in Renal Disease 12/27/1996 12/7/2005N/A 5/24/2007
L1959Percutaneous Vertebroplasty 9/29/2002 12/9/2005N/A 6/21/2007
L17639Physical Medicine and Rehabilitation Modalities 9/30/2004 5/10/2007N/A 6/22/2007
L24618PHYSICAL Medicine and Rehabilitation Services, PT and OT 7/6/2007 10/1/2007N/A 2/18/2008
L19471PHYSICAL Medicine and Rehabilitation Services, PT and OT 6/20/2005 10/1/2007N/A 2/18/2008
L1642Potassium (Serum) 12/27/1996 7/28/2005N/A 2/18/2008
L1426PRN Orders for Skilled Nursing Facilities 4/1/1998 12/8/2005N/A 10/5/2007
L1428Prostatic Acid Phosphatase (PAP) 10/16/1997 12/8/2005N/A 10/5/2007
L19783Psychiatric Inpatient Hospitalization 9/1/2005 7/17/2007N/A 10/1/2007
L13725Psychiatric Inpatient Hospitalization 12/6/2003 12/15/2005N/A 9/28/2007
L25507Psychiatric Inpatient Hospitalization 12/1/2007 12/1/2007N/A 9/21/2007
L12225Psychiatric Partial Hospitalization Programs 3/1/1999 10/1/2006N/A 10/26/2007
L1372Psychiatric Services-Outpatient Hospital based 9/28/2000 12/9/2005N/A 1/2/2008
L1593Psychiatry and Psychology Services 12/27/1996 1/1/2006N/A 1/2/2008
L1507Pulmonary Function Studies 5/28/1997 10/1/2007N/A 2/18/2008
L1594Pulmonary Perfusion Imaging 12/27/1996 8/6/2005N/A 9/27/2007
L1605Pulmonary Rehabilitation 5/20/2002 12/31/2005N/A 1/9/2007
L5738Pulmonary Rehabilitation Services 9/9/2001 10/28/2004N/A 9/18/2007
L1468Qualitative Drug Screen 2/15/2000 12/15/2006N/A 2/18/2008
L22562Rehabilitation, Plus Extensive Services: Medicare Skilled Nursing Facility (SNF) 4/21/2006 4/21/2006N/A 8/8/2007
L20618Rehabilitative Services Resource Utilization Group (RUG III) Category: Medicare Skilled Nursing Facility (SNF) 9/30/2005 6/10/2006N/A 8/8/2007
L1597Removal Impacted Cerumen 12/27/1996 7/28/2005N/A 10/30/2007
L1508Removal of Benign or Premalignant Skin Lesions 5/28/1997 7/17/2007N/A 11/10/2007
L1865Removal of Benign Skin Lesions 12/27/1996 3/31/2004N/A 1/2/2008
L13295Renal and Iliac Angiography and Aortography 9/30/2003 12/14/2005N/A 1/2/2008