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Posting Date: 04/19/2021
Percutaneous Coronary Intervention
Percutaneous Coronary Intervention heart, angina, intracoronary L33623 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33623 A56823 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56823 92920, [...]
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Posting Date: 08/03/2022
Outpatient Physical and Occupational Therapy Services
Outpatient Physical and Occupational Therapy Services maintenance, restorative, skilled, modality, therapeutic, exercise, manual, cast, splint, biofeedback L33631 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33631 A56566 [...]
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Posting Date: 10/02/2022
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) retinal, retinopathy, chorioretinitis, vitreous L33567 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33567 A56726 [...]
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Posting Date: 07/27/2023
Nonvascular Extremity Ultrasound
Nonvascular Extremity Ultrasound clot, plantar fasciitis L33619 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33619 A56787 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56787 76881, 76882
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Posting Date: 08/31/2023
Noninvasive Vascular Studies
Noninvasive Vascular Studies NonInvasive, leg, clot, plethysmography, duplex scan, Doppler, cerebrovascular, arterial, venous, hemodialysis L33627 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33627 A56758 [...]
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Posting Date: 10/02/2022
Nerve Conduction Studies and Electromyography
Nerve Conduction Studies and Electromyography electrodiagnostic, neurologic, EMG, NCS, neuromuscular, motor, needle L35098 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35098 A57668 [...]
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Posting Date: 04/06/2023
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor
Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Tremor N/A L37421 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37421 A57435 https://www.cms.gov/medicare-coverage-database/view/article.aspx?art[...]
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Posting Date: 10/02/2022
Magnetic Resonance Angiography (MRA)
Magnetic Resonance Angiography (MRA) gadolinium, contrast, imaging L33633 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33633 A56747 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56747 70544, [...]
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Posting Date: 10/02/2022
Computed Tomographic (CT) Colonography for Diagnostic Uses
Computed Tomographic (CT) Colonography for Diagnostic Uses virtual colonoscopy L33562 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33562 A57026 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=5702[...]
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Posting Date: 02/14/2023
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) heart, calcium, congenital, bypass L33559 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33559 A56737 [...]
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Posting Date: 10/02/2022
Cardiac Catheterization and Coronary Angiography
Cardiac Catheterization and Coronary Angiography heart, circulatory L33557 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33557 A52850 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52850 36120, [...]
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Posting Date: 07/06/2023
Psychiatric Partial Hospitalization Programs
Psychiatric Partial Hospitalization Programs mental illness, family counseling, vocational training L33626 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33626 A56850 [...]
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Posting Date: 04/04/2023
Transcranial Magnetic Stimulation
Transcranial Magnetic Stimulation depression, major depressive disorder, magnetic field L33398 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33398 A57528 https://www.cms.gov/medicare-coverage-database/view/article.aspx?artic[...]
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Posting Date: 04/04/2023
Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures
Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures paronychia, skin, carbuncle, boil L33563 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33563 A56766 [...]
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Posting Date: 01/06/2023
Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases
Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases N/A L37606 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=37606 A56793 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56[...]
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Posting Date: 10/31/2022
Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
Drugs and Biologicals, Coverage of, for Label and Off-Label Uses administration, compendia, FDA L33394 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33394 A52855 [...]
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Posting Date: 10/26/2022
Osteopathic Manipulative Treatment
Osteopathic Manipulative Treatment somatic, skeletal, dysfunction L33616 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33616 A56954 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56954 A55318 [...]
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Posting Date: 10/02/2022
Psychiatric Inpatient Hospitalization
Psychiatric Inpatient Hospitalization active treatment L33624 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33624 A56865 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56865
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Posting Date: 10/02/2022
Frequency of Hemodialysis
Frequency of Hemodialysis dialysis, kidney disease, end stage renal disease L37475 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=37475 A55672 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55672 [...]
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Posting Date: 08/10/2022
Prostate Rectal Spacers
Prostate Rectal Spacers N/A L37485 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37485 A56539 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56539 A58100 [...]
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Posting Date: 07/31/2022
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)
Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG) L39189 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39189 A58921 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58921 A59078 [...]
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Posting Date: 07/31/2022
Multiplex Gastrointestinal Pathogen Panel (GPP) Tests for Acute Gastroenteritis (AGE)
Multiplex Gastrointestinal Pathogen Panel (GPP) Tests for Acute Gastroenteritis (AGE) L39226 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39226 A58963 https://www.cms.gov/medicare-coverage-database/view/article.aspx?article[...]
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Posting Date: 04/19/2021
Multimarker Serum Tests Related to Ovarian Cancer Testing
Multimarker Serum Tests Related to Ovarian Cancer Testing N/A L38371 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38371 A57020 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57020 A58112 [...]
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Posting Date: 04/19/2021
Varicose Veins of the Lower Extremity, Treatment of
Varicose Veins of the Lower Extremity, Treatment of telangiectasia, spider veins, cosmetic, ligation and stripping, Endovenous radiofrequency ablation, EFRA, laser ablation L33575 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdi[...]
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Posting Date: 06/15/2022
Platelet Rich Plasma
Platelet Rich Plasma N/A L38937 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38937 A58609 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58609 A58693 [...]
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Posting Date: 09/06/2021
Corneal Hysteresis
Corneal Hysteresis N/A L38014 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38014 A56528 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56248 A56529 [...]
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Posting Date: 02/10/2022
Hospice - Determining Terminal Status
Hospice - Determining Terminal Status Decline, life expectancy L33393 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33393 A52830 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52830
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Posting Date: 02/10/2022
Biomarker Testing for Neuroendocrine Tumors/Neoplasms
Biomarker Testing for Neuroendocrine Tumors/Neoplasms N/A L37851 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37851 A57059 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57059 A56247 [...]
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Posting Date: 02/10/2022
Select Minimally Invasive GERD Procedures
Select Minimally Invasive GERD Procedures N/A L35080 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=35080 A56863 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56863 A58614 [...]
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Posting Date: 09/06/2021
B-type Natriuretic Peptide (BNP) Testing
B-type Natriuretic Peptide (BNP) Testing congestive heart failure, acute dyspnea L33573 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33573 A56826 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56[...]
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Posting Date: 01/04/2022
Colon Capsule Endoscopy (CCE)
Colon Capsule Endoscopy (CCE) N/A L38571 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=38571 A58294 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58294 A58630 [...]
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Posting Date: 01/04/2022
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea N/A L38387 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=38387 A57092 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=5709[...]
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Posting Date: 01/04/2022
Thyroid Nodule Molecular Testing
Thyroid Nodule Molecular Testing N/A L38968 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38968 A58656 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58656 A58853 [...]
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Posting Date: 09/30/2021
Speech-Language Pathology
Speech-Language Pathology dysphagia, swallowing, communication L33580 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33580 A52866 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52866 31579, 92507, [...]
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Posting Date: 09/30/2021
RAST Type Tests
RAST Type Tests FAST, Radioallergosorbent, fluoroallergosorbent, antigen, allergen, IGE L33591 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33591 A56844 https://www.cms.gov/medicare-coverage-database/view/article.aspx?artic[...]
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Posting Date: 09/30/2021
Proton Beam Therapy
Proton Beam Therapy radiation, radiotherapy L35075 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=35075 A56827 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56827 A55124 [...]
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Posting Date: 09/30/2021
Heavy Metal Testing
Heavy Metal Testing metal toxicity, aluminum, arsenic, iron, lead, nickel, zinc, mercury L35074 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35074 A56767 https://www.cms.gov/medicare-coverage-database/view/article.aspx?arti[...]
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Posting Date: 04/19/2021
Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency
Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency CCSVI, multiple sclerosis, MS L35028 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35028 A56845 [...]
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Posting Date: 04/19/2021
Transrectal Ultrasound
Transrectal Ultrasound prostate, ultrasound, echography L33578 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33578 A57427 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57427 76872, 76873
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Posting Date: 04/19/2021
Total Joint Arthroplasty
Total Joint Arthroplasty Knee, TKA, Hip, THA L36039 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=36039 A57428 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57428 27130, 27132, 27134, 27137, [...]
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Posting Date: 09/06/2021
EEG - Ambulatory Monitoring
EEG – Ambulatory Monitoring electroencephalogram L33399 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33399 A57030 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57030 95700, 95705, 95706, 95707, [...]
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Posting Date: 09/06/2021
Debridement Services
Debridement Services N/A L33614 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33614 A56617 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56617 11000, 11001, 11042, 11043, 11044, 11045, 11046, [...]
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Posting Date: 09/06/2021
Corneal Pachymetry
Corneal Pachymetry cornea, ophthalmology, eyes L33630 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33630 A56548 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56548 76514, 92499
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Posting Date: 09/06/2021
Computed Tomography Cerebral Perfusion Analysis (CTP)
Computed Tomography Cerebral Perfusion Analysis (CTP) N/A L38667 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=38667 A58152 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58152 A58327 [...]
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Posting Date: 04/19/2021
Cataract Extraction
Cataract Extraction eyes, ophthalmology, complex, epinephrine L33558 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33558 A56544 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56544 A55257 [...]
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Posting Date: 09/06/2021
Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography ultrasound, non-palpable masses, palpable masses L33585 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33585 A52849 [...]
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Posting Date: 04/19/2021
Posterior Tibial Nerve Stimulation for Voiding Dysfunction
Posterior Tibial Nerve Stimulation for Voiding Dysfunction overactive bladder, urinary urgency, urinary frequency, urinary incontinence, percutaneous electrical stimulation L33396 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDI[...]
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Posting Date: 04/19/2021
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)
Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF) compression, spine, fracture L33569 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33569 A56178 [...]
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Posting Date: 04/19/2021
Panretinal (Scatter) Laser Photocoagulation
Panretinal (Scatter) Laser Photocoagulation N/A L33628 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33628 A56550 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56550 67228
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Posting Date: 04/19/2021
Ophthalmic Biometry for Intraocular Lens Power Calculation
Ophthalmic Biometry for Intraocular Lens Power Calculation cataract, biometry, eyes L33621 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33621 A56549 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId[...]
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Posting Date: 04/19/2021
Minimally-invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint
Minimally-invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint iFuse L36406 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=36406 A57431 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57431 27279
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Posting Date: 04/06/2022
Tips to Find Local Coverage Determinations and Billing and Coding Instructions (REVISED 4/6/2022)
Tips to Find Local Coverage Determinations and Billing and Coding Instructions (REVISED 4/6/2022) We often receive suggestions through our website surveys to make it easier to find LCDs and the associated Billing and Coding articles. All [...]
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Posting Date: 04/30/2021
Tips to Find Local Coverage Determinations and Billing and Coding Instructions
Tips to Find Local Coverage Determinations and Billing and Coding Instructionssp We frequently receive suggestions through our website surveys to make it easier to find LCDs and the associated Billing and Coding articles. All LCDs and [...]
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Posting Date: 02/22/2023
New Local Coverage Determination for Sacroiliac Joint Injections and Procedures
New Local Coverage Determination for Sacroiliac Joint Injections and Procedures National Government Services, as your MAC, is bringing to your attention a newly created LCD policy change that will effect providers who render and bill for [...]
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Posting Date: 01/13/2021
Local Coverage Determination Open Meeting Announcement
Local Coverage Determination Open Meeting Announcement Jurisdiction 6/Jurisdiction K Part A/Part B MAC Open Meeting Date Meeting Time Meeting Location Wednesday, 2/24/2021 12:00‒4:00 p.m. CT 1:00‒5:00 p.m. ET [...]
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Posting Date: 02/10/2022
National Government Services Proposed LCDs for Comment
National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 2/10/2022 through 3/26/2022. These [...]
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Posting Date: 02/09/2023
National Government Services Proposed LCDs For Comment
National Government Services Proposed LCDs For Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 2/2/2023 through 3/18/2023. These [...]
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Posting Date: 04/01/2021
Revised Coverage Policies for Facet Joint Interventions for Pain Management
Revised Coverage Policies for Facet Joint Interventions for Pain Management FUTURE Local Coverage Determination (LCD) Facet Joint Interventions for Pain Management (L35936) Billing and Coding: Facet Joint Interventions for Pain Management [...]
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Posting Date: 11/13/2023
The Great American Smokeout is Thursday 11/16/2023 - Let's Talk About Tobacco Counseling
The Great American Smokeout is Thursday 11/16/2023 - Let's Talk About Tobacco Counseling Do you treat Medicare beneficiaries/patients who are nicotine dependent? Did you know Medicare has a preventive service for tobacco cessation that allows [...]
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