Medicare (CMS) Local Coverage Determination (LCD) Updates – June 2021

Medicare (CMS) Local Coverage Determination (LCD) Updates »

June 2021 Medicare (CMS) LCD Updates:

• A54186                    Billing and Coding: MolDX: AlloMap
• A53099                    Billing and Coding: MolDX: AlloMap
• A55140                    Billing and Coding: MolDX: AlloMap
• A57167                    Billing and Coding: MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts               
• A58387                    Billing and Coding: MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts               
• A57096                    Billing and Coding: MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts               
• A57859                    Billing and Coding: MolDX: Prospera™      
• A57825                    Billing and Coding: MolDX: Prospera™      
• A57981                    Billing and Coding: MolDX: Prospera™      
• A57446                    Billing and Coding: MolDX: TruGraf Blood Gene Expression Test                                                           
• A57350                    Billing and Coding: MolDX: TruGraf Blood Gene Expression Test                                                           
• A57629                    Billing and Coding: MolDX: TruGraf® Blood Gene Expression Test                                      
• L38255                    MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts                  
• L38059                    MolDX: Prospera     
• L38041                    MolDX: Prospera™ 
• L38174                    MolDX: Prospera™ 
• L38053                    MolDX: TruGraf Blood Gene Expression Test       
• L38039                    MolDX: TruGraf Blood Gene Expression Test       
• L38160                    MolDX: TruGraf® Blood Gene Expression Test    
• L38272                    MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts                  
• L38439                    MolDX: AlloSure® or Equivalent Cell-Free DNA Testing for Kidney and Heart Allografts                  
• L33422                    Brain Natriuretic Peptide (BNP) Level         
• L34410                    B-type Natriuretic Peptide (BNP) Testing   
• DL39073                    Pharmacogenomics Testing 
• DL39063                    Pharmacogenomics Testing 
• L33930                    Facet Joint Interventions for Pain Management   
• L34892                    Facet Joint Interventions for Pain Management   
• A55937                    Billing and Coding: Diagnostic Colonoscopy         
• A58428                    Billing and Coding: Diagnostic Colonoscopy         
• DL33906                    Epidural Procedures for Pain Management           
• DL36920                    Epidural Procedures for Pain Management           
• L38937                    Platelet Rich Plasma  
• A58609                    Billing and Coding: Platelet Rich Plasma   
• A58819                    Response to Comments: Platelet Rich Plasma    
• DL39071                    Platelet Rich Plasma  
• DL39068                    Platelet Rich Plasma  
• A57188                    Billing and Coding: Routine Foot Care        
• A53252                    Billing and Coding: Independent Diagnostic Testing Facility (IDTF)                                                       
• A57715                    Billing and Coding: Botulinum Toxins         
• A58423                    Billing and Coding: Botulinum Toxins         
• L37379                    Echocardiography  
• A54689                    Billing and Coding: MolDX: Myriad’s BRACAnalysis CDx®                                                                   
• A56971                    Billing and Coding: MolDX: BRCA1 and BRCA2 Genetic Testing                                                     
• L38649                    MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer                                      
• A58749                    Response to Comments: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer                               
• L38647                    MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer                                      
• L38678                    MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                                             
• A58748                    Response to Comments: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer                               
• A56774                    Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)                       
• A58181                    Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer                               
• A58187                    Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer                               
• A58792                    Response to Comments: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                                 
• A58205                    Billing and Coding: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                
• L37733                    Biomarker Testing (Prior to Initial Biopsy) for Prostate Cancer Diagnosis                                                
• L38051                    MolDX: Pigmented Lesion Assay    
• A58693                    Response to Comments: Biomarker Testing (Prior to Initial Biopsy) for Prostate Cancer Diagnosis                                  
• L38566                    MolDX: Phenotypic Biomarker Detection in Circulating Tumor Cells                                                         
• A58728                    Response to Comments: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                                 
• A58021                    Billing and Coding: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                
• L34419                    Homocysteine Level, Serum 
• L38584                    MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                                             
• A58063                    Billing and Coding: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                
• A58743                    Response to Comments: MolDX: Phenotypic Biomarker Detection from Circulating Tumor Cells                                 
• A56463                    Billing and Coding: Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy   
• L34433                     Somatosensory Testing          
• L37826                     Lumbar Artificial Disc Replacement  
• L33431                     HbA1c    
• A52535                    Process for Determining Self-Administered Drug Exclusions – Medical Policy Article                           
• A52470                    Billing and Coding: Venipuncture Necessitating Physician’s Skill for Specimen Collection – Supplemental Instructions Article    
• A56818                    Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing                       
• L36029                     Controlled Substance Monitoring and Drugs of Abuse Testing                                    
• A58028                    Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer          
• A58527                    Billing and Coding: Complex Drug Administration Coding
• A56732                    Billing and Coding: Mohs Micrographic Surgery (MMS)    
• A57021                    Billing and Coding: Cervical Disc Replacement      
• A56695                    Billing and Coding: Implantable Infusion Pump      
• A56784                    Billing and Coding: Pulmonary Stress Testing        
• A56836                    Billing and Coding: Mohs Micrographic Surgery     
• DL39060                      Platelet Rich Plasma Injections for Non-Wound Injections                                                                        
• DL39058                      Platelet Rich Plasma Injections for Non-Wound Injections                                                                        
• L38158                         MolDX: Next-Generation Sequencing for Solid Tumors                                                                        
• L37919                         MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test                             
• L33718                         Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea                      
• A52467                         Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea – Policy Article                                
• A58824                         Response to Comments: Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea – DL33718 
• A52517                         Respiratory Assist Devices – Policy Article        
• L33800                         Respiratory Assist Devices          
• A58822                         Response to Comments: Respiratory Assist Devices – DL33800                                                       
• A52512                         Oral Appliances for Obstructive Sleep Apnea – Policy Article                                                            
• L33611                         Oral Appliances for Obstructive Sleep Apnea  
• A58823                         Response to Comments: Oral Appliances for Obstructive Sleep Apnea – DL33611                            
• L33438                         Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)                        
• L33446                         Respiratory Therapy and Oximetry Services    
• A56380                         Billing and Coding: Rituximab     
• A56531                         Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)  
• L37905                         MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test                             
• L38067                         MolDX: Next-Generation Sequencing for Solid Tumors                                                                        
• A56518                         Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next-Generation Sequencing Testing in Cancer    
• A55624                         Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next-Generation Sequencing Testing in Cancer    
• A56743                         Billing and Coding: Cardiovascular Nuclear Medicine
• L38045                         MolDX: Next-Generation Sequencing for Solid Tumors                                                                        
• A54901                         Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next Generation Sequencing Testing in Cancer    
• A54795                         Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next-Generation Sequencing Testing in Cancer    
• A57831                         Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors                                          
• L38920                         Off-label Use of Rituximab and Rituximab Biosimilars
• A58727                         Response to Comments: Off-label Use of Rituximab and Rituximab Biosimilars                                 
• A58582                         Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars                                 
• A58533                         Billing and Coding: Complex Drug Administration Coding                                                                        
• A58532                         Billing and Coding: Complex Drug Administration Coding                                                                        
• DL38016                      MolDX: Melanoma Risk Stratification Molecular Testing                                                                        
• DL38997                      MolDX: Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer                            
• DL39038                      MolDX: Multiplex Nucleic Acid Amplification Test (NAAT) Panels for Infectious Disease Testing     
• DL39017                      MolDX: Next-Generation Sequencing Lab-Developed Tests for Inherited Cancer Syndromes    
• DL39023                      Platelet Rich Plasma Injections for Non-Wound Injections                                                                        
• DL39015                      Epidural Procedures for Pain Management      
• DL38992                      Electroretinography (ERG)           
• A57858                         Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors                                          
• A57568                         Billing and Coding: MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test                          
• A55197                         Billing and Coding: MolDX: Targeted and Comprehensive Genomic Profile Next Generation Sequencing Testing in Cancer    
• A56663                         Billing and Coding: Dental Services       
• L37857                         MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test                             
• A56717                         Billing and Coding: Respiratory Therapy (Respiratory Care)                                                              
• A58061                         Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection                           
• A56851                         Billing and Coding: MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels                             
• A56898                         Billing and Coding: MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test                          
• A58817                    Billing and Coding: Influenza Diagnostic Tests          
• L36117                     MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease              
• L34434                     Upper Gastrointestinal Endoscopy and Visualization
• A56985                    Billing and Coding: MolDX: Envisia™, Veracyte™, Idiopathic Pulmonary Fibrosis Diagnostic Test       
• A57870                    Billing and Coding: MolDX: Next-Generation Sequencing for Solid Tumors      
• A52452                    Billing and Coding: Rituximab, biosimilars and Rituximab and hyaluronidase human (Rituxan Hycela™)         
• A54548                    Billing and Coding: Eculizumab
• A52448                    Billing and Coding: Omalizumab           
• A58620                    Billing and Coding: Complex Drug Administration Coding   
• L36044                     MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease              
• A56342                    Billing and Coding: Implantable Automatic Defibrillators      
• A56340                    Billing and Coding: Implantable Automatic Defibrillators      
• A58061                    Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection                             
• A58019                    Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection                             
• A56959                    Billing and Coding: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease      
• L33436                     Mohs Micrographic Surgery (MMS)      
• A56684                    Billing and Coding: Intraoperative Radiation Therapy           
• A58207                    Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection                             
• A57880                    Billing and Coding: MolDX: Testing of Multiple Genes          
• A57594                    Billing and Coding: Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies 
• A57579                    Billing and Coding: MolDX: Multiplex Nucleic Acid Amplified Tests for Respiratory Viral Panels 
• A56795                    Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)                             
• A58211                    Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer        
• A53497                    Billing and Coding: Oral Maxillofacial Prosthesis       
• A57422                    Billing and Coding: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease      
• A57570                    Billing and Coding: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease      
• A57421                    Billing and Coding: MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease      
• A56468                    Billing and Coding: Ambulance Services         
• A58544                    Billing and Coding: Complex Drug Administration Coding   
• L38213                     Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF)          
• L35751                     Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies  
• A52527                    Self-Administered Drug Exclusion List: and Biologicals Excluded from Coverage – Medical Policy Article  
• L34633                     Erythropoiesis Stimulating Agents (ESAs)      
• L36815                     MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease              
• A56718                    Billing and Coding: Intravenous Immunoglobulin (IVIG)       
• A57503                    Billing and Coding: MolDX: Testing of Multiple Genes          
• A58028                    Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer        
• A58065                    Billing and Coding: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer        
• A57910                    Billing and Coding: MolDX: Testing of Multiple Genes          
• L37485                     Prostate Rectal Spacers 

Medicare (CMS) Local Coverage Determination (LCD) Updates »

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