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Last Modified: 4/11/2024 Location: FL, PR, USVI Business: Part A, Part B

Update history: LCD and article updates

April 11

The following billing and coding articles have been revised:

April 4

The following billing and coding articles have been revised:

April 1

The following Local Coverage Determination (LCD) which was posted for notice on February 15 became effective on March 31.
The comment period is now closed for the Proposed LCDs listed below. Comments received will be reviewed by our Contractor Medical Directors. The Response to Comments Articles will be posted to our website when the final LCDs are posted for notice.

March 28

The following LCD and related billing and coding article have been retired.

March 18

The following article which was posted for notice on February 1 is now effective:
As a reminder, the comment period for the following proposed LCDs is currently open and will close on March 30. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Cervical Fusion (DL39799)
Facet Joint Interventions for Pain Management (DL33930)
Implantable Continuous Glucose Monitors (I-CGM) (DL38664)
Submit Comments

March 7

The following billing and coding articles have been revised:
Billing and Coding: Immune Globulin (A57778)
Billing and Coding: Mohs Micrographic Surgery (MMS) (A57767)
As a reminder, the comment period for the following proposed LCDs is currently open and will close on March 30. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Cervical Fusion (DL39799)
Facet Joint Interventions for Pain Management (DL33930)
Implantable Continuous Glucose Monitors (I-CGM) (DL38664)
Submit Comments

February 15

The following LCD which was posted for comment on September 28, 2023, has been posted for notice. The LCD will become effective March 31:
Allergen Immunotherapy (L37800)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response to Comments: Allergen Immunotherapy (A59575)
The following proposed LCDs have been posted for comment. The comment period will end on March 30; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for consideration. When submitting literature you MUST submit the full-text article(s).
Cervical Fusion (DL39799)
Billing and Coding: Cervical Fusion (DA59674)
Facet Joint Interventions for Pain Management (DL33930)
Billing and Coding: Facet Joint Interventions for Pain Management (DA57787)
Implantable Continuous Glucose Monitors (I-CGM) (DL38664)
Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (DA58136)
Submit Comments

February 1

The following article has been revised to reflect the 2024 annual CPT/HCPCS code updates effective for dates of service on and after January 1 and to reflect changes that will become effective March 17:
Self-Administered Drug Exclusion List (A52571)

January 29

The following Local Coverage Determination (LCD) which was posted for notice on December 14, 2023, is now effective. The related billing and coding article for this LCD is also now effective:
Peripheral Venous Ultrasound (L33693)
Billing and Coding: Peripheral Venous Ultrasound (A57125)

January 25

The following articles have been revised to reflect the 2024 annual CPT/HCPCS code updates effective for dates of service on and after January 1:
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
Billing and Coding: Botulinum Toxins (A57715)
Billing and Coding: Computerized Corneal Topography (A57699)
Billing and Coding: Destruction of Malignant Skin Lesions (A57638)
Billing and Coding: Genetic Testing for Cardiovascular Disease (A58797)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Molecular Pathology Procedures (A57451)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
Billing and Coding: Routine Foot Care (A57188)
Billing and Coding: Visual Field Examination (A57637)
Billing and Coding: Vitamin B12 Injections (A57755)
Billing and Coding: Wound Care (A55818)
The following LCD and related billing and coding article have been retired:
Non-Invasive Physiologic Studies of Upper or Lower Extremity Arteries (L33696)
Billing and Coding: Non-Invasive Physiologic Studies of Upper or Lower Extremity Arteries (A57126)

January 17, 2024

The following article, which was posted for notice on November 30, 2023, became effective on January 14:
Self-Administered Drug Exclusion List (A52571)

December 28

The following billing and coding article has been added:
Billing and Coding: Treatment of Abnormal Uterine Bleeding with Intrauterine Device (Hormone-Eluting) (A59619)
The following billing and coding article has been retired:
Billing and Coding: Complex Drug Administration Coding (A59074)

December 14

The following LCD that was posted for comment on August 3 has been posted for notice. The LCD and related billing and coding article will become effective January 28, 2024.
Peripheral Venous Ultrasound (L33693)
Billing and Coding: Peripheral Venous Ultrasound (A57125)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response to Comments: Peripheral Venous Ultrasound (A59602)
The following billing and coding article has been revised:
Billing and Coding: eVox System and Other Electroencephalograph Testing for Memory Loss (A59086)
The following LCD and related billing and coding article have been retired:
Bisphosphonates (Intravenous [IV] and Monoclonal Antibodies in the Treatment of Osteoporosis and Other Indications (L33270)
Billing and Coding: Bisphosphonates (Intravenous [IV] and Monoclonal Antibodies in the Treatment of Osteoporosis and Other Indications (A57603)

December 11

The following LCD that was posted for notice on October 26 became effective on December 10. The related billing and coding article for this LCD is also now effective:
Nerve Conduction Studies and Electromyography (L34859)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)

November 30

The following billing and coding articles have been revised:
Billing and Coding: Aortography and Peripheral Angiography (A57056)
Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A59049)
The following article has been revised and will become effective January 14, 2024:
Self-Administered Drug Exclusion List (A52571)

November 16

The following billing and coding articles have been revised:
Billing and Coding: Approved Drugs and Biologicals; Includes Cancer Chemotherapeutic Agents (A59576)
Billing and Coding: Epidural Steroid Injections for Pain Management (A56651)
Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS) (A56647)
Billing and Coding: Surgical Treatment of Nails (A57666)
The following LCD and related Billing and Coding Article have been retired:
Susceptibility Studies (L33755)
Billing and Coding: Susceptibility Studies (A57176)

November 13

The comment period is now closed for the proposed LCD listed below. Comments received will be reviewed by our Contractor Medical Directors. The Response to Comments Article will be posted to our website when the final LCD is posted for notice.
Allergen Immunotherapy (DL37800) 

November 9

The following billing and coding article has been revised:
Billing and Coding: Botulinum Toxins (A57715)

November 2

The following billing and coding article has been added:
Billing and Coding: Approved Drugs and Biologicals; Includes Cancer Chemotherapeutic Agents (A59576)
The following billing and coding article has been revised:
Billing and Coding: Botulinum Toxins (A57715)
The following LCD and related Billing and Coding Article have been retired:
Troponin (L33974)
Billing and Coding: Troponin (A57119)

October 26

The following LCD which posted for comment on June 1 has been posted for notice. The LCD and related billing and coding Article will become effective December 10.
Nerve Conduction Studies and Electromyography (L34859)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
The following response to comments article contains summaries of all comments received and First Coast responses:
Response to Comments: Nerve Conduction Studies and Electromyography (A59568)
As a reminder, the comment period for the following proposed LCD is currently open and will close on November 11. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Allergen Immunotherapy (DL37800) 
Submit Comments
The following billing and coding articles have been revised to reflect the Annual ICD-10-CM code updates effective for dates of service on and after October 1:
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
Billing and Coding: Aortography and Peripheral Angiography (A57056)
Billing and Coding: Bisphosphonates (Intravenous [IV]) and Monoclonal Antibodies in the Treatment of Osteoporosis and Their Other Indications (A57603)
Billing and Coding: B-Type Natriuretic Peptide (BNP) (A57649)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
Billing and Coding: Diagnostic Aerosol or Vapor Inhalation (A57058)
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
Billing and Coding: Duplex Scanning (A57636)
Billing and Coding: Electrocardiography (A57066)
Billing and Coding: Electroretinography (ERG) (A57677)
Billing and Coding: Injection of Trigger Points (A57114)
Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
Billing and Coding: Ionized Calcium (A57120)
Billing and Coding: Major Joint Replacement (Hip and Knee) (A57765)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation (A57115)
Billing and Coding: Parathormone (Parathyroid Hormone) (A57122)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Psychological and Neuropsychological Tests (A57780)
Billing and Coding: Sedimentation Rate, Erythrocyte (A57657)
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (A54926)
Billing and Coding: Somatosensory Testing (A57540)
Billing and Coding: Surgical Management of Morbid Obesity (A57145)
Billing and Coding: Transesophageal Echocardiogram (A57179)
Billing and Coding: Troponin (A57119)
Billing and Coding: Visual Field Examination (A57637)
Billing and Coding: Vitamin B12 Injections (A57755)
Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed (A56841)
The following LCD and related billing and coding article have been retired effective July 26:
Magnesium (L34014)
Billing and Coding: Magnesium (A57121)

October 19

The following LCD has been revised:
Epidural Steroid Injections for Pain Management (L33906)
The following billing and coding article has been revised:
Billing and Coding: Psychiatric Inpatient Hospitalization (A57726)

October 5

The following local coverage articles have been revised:
Billing and Coding: Hemophilia Factor Products (A56482)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Self-Administered Drug Exclusion List: (A52571)
A document note has been added to the following articles:
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)

September 29

Please note: The Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (L36377/A57680) will not become effective on October 1.
A new Proposed LCD will be published for comment and presented at an Open Meeting in the near future.
In the meantime, current coverage has not changed. The following LCD and article remain in effect.
The First Coast medical policy team has evaluated all active local coverage articles for any impact in response to the 2024 annual ICD-10-CM code update. The following is a list of the impacted articles. The revised articles will be published to the MCD and on the First Coast website towards the end of October. Please continue to watch our website for updates.
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
Billing and Coding: Aortography and Peripheral Angiography (A57056)
Billing and Coding: Bisphosphonates (Intravenous [IV]) and Monoclonal Antibodies in the Treatment of Osteoporosis and Their Other Indications (A57603)
Billing and Coding: B-Type Natriuretic Peptide (BNP) (A57649)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
Billing and Coding: Diagnostic Aerosol or Vapor Inhalation (A57058)
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
Billing and Coding: Duplex Scanning (A57636)
Billing and Coding: Electrocardiography (A57066)
Billing and Coding: Electroretinography (ERG) (A57677)
Billing and Coding: Injection of Trigger Points (A57114)
Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
Billing and Coding: Ionized Calcium (A57120)
Billing and Coding: Major Joint Replacement (Hip and Knee) (A57765)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation (A57115)
Billing and Coding: Parathormone (Parathyroid Hormone) (A57122)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Psychological and Neuropsychological Tests (A57780)
Billing and Coding: Sedimentation Rate, Erythrocyte (A57657)
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (A54926)
Billing and Coding: Somatosensory Testing (A57540)
Billing and Coding: Surgical Management of Morbid Obesity (A57145)
Billing and Coding: Transesophageal Echocardiogram (A57179)
Billing and Coding: Troponin (A57119)
Billing and Coding: Visual Field Examination (A57637)
Billing and Coding: Vitamin B12 Injections (A57755)
Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed (A56841)

September 28

The following LCD and related Billing and Coding Article, which were posted for notice on August 3, will not become effective at this time. Please refer to below NOTE:
Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (L36377)
Billing and Coding: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A57680)
NOTE: Please refer to the current LCD and related Article located on our website:
Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities (L36377)
Billing and Coding: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities (A57680)
The following proposed LCD has been posted for comment. The comment period will end on November 11; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for consideration.
Allergen Immunotherapy (DL37800)
Submit Comments
The following billing and coding articles have been revised:
Billing and Coding: eVox® System and Other Electroencephalograph Testing for Memory Loss (A59086)
Billing and Coding: Mohs Micrographic Surgery (MMS) (A57767)
The following LCD and related Billing and Coding Article have been retired:
3D Interpretation and Reporting of Imaging Studies (L33256)
Billing and Coding: 3D Interpretation and Reporting of Imaging Studies (A56920)

September 18

The comment period is now closed for the following Proposed LCD. Comments received will be reviewed by our Contractor Medical Directors. The response to comments article and finalized billing and coding article will be related to the final LCD when it is posted for notice.
Peripheral Venous Ultrasound (DL33693) 

September 11

The comment period is now closed for the following Proposed LCD. Comments received will be reviewed by our Contractor Medical Directors. The response to comments article and finalized billing and coding article will be related to the final LCD when it is posted for notice.
Genetic Testing for Oncology (DL39367)

September 7

As a reminder, the comment period for the following proposed LCD is currently open and will close on September 16. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Peripheral Venous Ultrasound (DL33693) 

September 5

The following article which was posted for notice on July 20, became effective on September 3:
Self-Administered Drug Exclusion List (A52571)

August 31

As a reminder, the comment period for the following proposed LCD is currently open and will close on September 9. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Genetic Testing for Oncology (DL39367)
The following billing and coding articles have been revised:
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
The following LCD and related billing and coding article have been retired.
Serum Phosphorus (L34022)
Billing and Coding: Serum Phosphorus (A57650)

August 17

The following LCD and related billing and coding article have been retired:
Label and Off-label Coverage of Outpatient Drugs and Biologicals (L33915)
Billing and Coding: Label and Off-label Coverage of Outpatient Drugs and Biologicals (A56744)

August 3

The following LCD which posted for comment on April 14, 2022, and on August 11, 2022, has been posted for notice. The LCD and related billing and coding article will become effective September 17.
Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (L36377)
Billing and Coding: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A57680)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response to Comments: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A59518)
The following proposed LCD has been posted for comment. The comment period will end on September 16; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for consideration.
Peripheral Venous Ultrasound (DL33693)
Billing and Coding: Peripheral Venous Ultrasound (DA57125)
The following billing and coding articles have been revised:
Billing and Coding: Botulinum Toxins (A57715)
Billing and Coding: Complex Drug Administration Coding (A59074)
Billing and Coding: Serum Phosphorus (A57650)

July 27

The following proposed LCD has been posted for comment. The comment period will end on September 9; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for consideration.
Genetic Testing for Oncology (DL39367)
The following draft billing and coding article is related to the above proposed LCD.
Genetic Testing for Oncology (DA59123)

July 20

The following billing and coding articles have been revised:
Billing and Coding: Genetic Testing for Cardiovascular Disease (A58797)
Billing and Coding: Hemophilia Factor Products (A56482)
Billing and Coding: Immune Globulin (A57778)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS) (A56647)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Platelet Rich Plasma (A58810)
The following article has been revised to reflect the July CPT/HCPCS code quarterly updates and will become effective September 3:
Self-Administered Drug Exclusion List (A52571)

July 17

The comment period is now closed for the following proposed LCD. Comments received will be reviewed by our Contractor Medical Directors. The response to comments article and finalized billing and coding article will be related to the final LCD when it is posted for notice.
Nerve Conduction Studies and Electromyography (DL34859)

July 13

The following LCD and related billing and coding article have been retired:
Spinal Cord Stimulation for Chronic Pain (L36035)
Billing and Coding: Spinal Cord Stimulation for Chronic Pain (A57709)
As a reminder, the comment period for the following proposed LCD is currently open and will close on July 15. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Nerve Conduction Studies and Electromyography (DL34859)
Submit Comments

July 6

The following LCD and related billing and coding article, which was posted for notice on June 2, will not become effective on July 17 as previously communicated. A new proposed LCD will be published for comment and presented at an open meeting in the near future. Please continue to watch our website for updates.
Genetic Testing for Oncology (L39367)
Billing and Coding: Genetic Testing for Oncology (A59123)
The following LCDs and related billing and coding articles will remain in effect at this time:
Molecular Pathology Procedures (L34519)
Billing and Coding: Molecular Pathology Procedures (A57451)
Genetic Testing for Lynch Syndrome (L34912)
Billing and Coding: Genetic Testing for Lynch Syndrome (A57450)
BRCA1 and BRCA2 Genetic Testing (L36499)
Billing and Coding: BRCA1 and BRCA2 Genetic Testing (A57449)
The following billing and coding article has been revised:
Billing and Coding: Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (A57647)
As a reminder, the comment period for the following proposed LCD is currently open and will close on July 15. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Nerve Conduction Studies and Electromyography (DL34859)
Submit Comments

June 26

The following articles which were posted for notice on May 11 are now effective:
Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow (A57025)
Self-Administered Drug Exclusion List (A52571)

June 12

The following LCD, which was posted for notice on April 27 became effective on June 11. The related billing and coding article for this LCD is also now effective:
Ambulatory Electrocardiograph (AECG) Monitoring (L39492)
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
The following billing and coding article which was revised and published on June 8, is now effective:
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)

June 8

The following billing and coding article has been revised and will become effective June 11:
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
The following LCD and related billing and coding article has been retired:
Pulmonary Diagnostic Services (L33707)
Billing and Coding: Pulmonary Diagnostic Services (A57127)
The following LCD and related billing and coding article is being retired effective for dates of service on and after June 11:
Long-Term Wearable Electrocardiographic Monitoring (WEM) (L33380)
Billing and Coding: Long-Term Wearable Electrocardiographic Monitoring (WEM) (A57062)

June 2

The following LCD posted for comment on June 9, 2022, has been posted for notice. The LCD and related billing and coding article will become effective July 17.
Genetic Testing for Oncology (L39367)
Billing and Coding: Genetic Testing for Oncology (A59123)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response To Comments: Genetic Testing for Oncology (A59171)

June 1

The following proposed LCD has been posted for comment. The comment period will end on July 15; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for consideration.
Nerve Conduction Studies and Electromyography (DL34859)
Submit Comments
The following draft billing and coding Article is related to the above proposed LCD.
Billing and Coding: Nerve Conduction Studies and Electromyography (DA57123)
The following billing and coding article has been revised:
Billing and Coding: Immune Globulin (A57778)

May 22

Novitas and First Coast greatly appreciate the comments and evidence we received as a result of the multi-jurisdictional Contractor Advisory Committee (CAC) meeting that was held on February 28, 2023, regarding Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) for Non-implantable Devices.  After careful consideration, Novitas and First Coast will not develop an LCD for RPM and RTM for Non-implantable Devices. All the information and feedback received, along with any new evidence that becomes available, will be carefully considered if we decide to develop an LCD in the future.
Please keep in mind that Novitas and First Coast do not have a policy to match every procedure code, diagnosis code, or service reportable to Medicare. In some instances, we may have an LCD that is not applicable to all providers or services. In the absence of an LCD, NCD, or CMS Manual Instruction; reasonable and necessary guidelines still apply to any service reported to Medicare.

May 11

Although not required, First Coast is providing a 45-day notice of the revisions to the following article before the changes become effective on June 25. 
Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow (A57025)
The following article has been revised and will become effective June 25:
Self-Administered Drug Exclusion List (A52571)
The following LCDS and related billing and coding articles have been retired:
Vascular Stenting of Lower Extremity Arteries (L33763)
Billing and Coding: Vascular Stenting of Lower Extremity Arteries (A57180)
Pegfilgrastim (L33747)
Billing and Coding: Pegfilgrastim (A57725)
G-CSF Filgrastim (L34002)
Billing and Coding: G-CSF Filgrastim (A57789)

May 4

The following proposed LCD and related draft billing and coding article have been retired and will not be finalized. Please refer to the current LCD and related article located on our website:
Nerve Stimulators for Chronic Intractable Pain (DL39406)
Billing and Coding: Nerve Stimulators for Chronic Intractable Pain (DA59190)

April 27

The following LCD, which posted for comment on October 13, 2022, has been posted for notice. The LCD and related billing and coding article will become effective June 11.
Ambulatory Electrocardiograph (AECG) Monitoring (L39492)
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response to Comments: Ambulatory Electrocardiograph (AECG) Monitoring (A59367)
The following billing and coding article has been revised to become effective June 11.
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
The following billing and coding article has been revised
Billing and Coding: Pharmacogenomics Testing (A58812)
The following LCDs and related billing and coding articles have been retired:
Anorectal Manometry and Electromyography (EMG) of the Urinary and Anal Sphincters (L37943)
Billing and Coding: Anorectal Manometry and Electromyography (EMG) of the Urinary and Anal Sphincters (A56657)
Biofeedback (L33615)
Billing and Coding: Biofeedback (A57635)
Flow Cytometry (L33661)
Billing and Coding: Flow Cytometry (A57716)

April 20

The following billing and coding articles have been revised:
Billing and Coding: Botulinum Toxins (A57715)
Billing and Coding: Complex Drug Administration Coding (A59074)
Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (A56638)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)

April 13

The following billing and coding article has been revised:
Billing and Coding: Surgical Treatment of Nails (A57666)
The following LCDs and related billing and coding articles have been retired:
Therapy Services billed by Physicians/Nonphysician Practitioners (L33961)
Billing and Coding: Therapy Services billed by Physicians/Nonphysician Practitioners (A57700)
Viscosupplementation Therapy for Knee (L33767)
Billing and Coding: Viscosupplementation Therapy for Knee (A57256)
The following proposed LCD and related draft billing and coding article have been retired and will not be finalized. Please refer to the current LCD and related Article located on our website.
Controlled Substance Monitoring and Drugs of Abuse Testing (DL36393)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (DA57077)

April 6

The following billing and coding articles have been revised:
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
The following LCDs and related billing and coding articles have been retired:
Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing (L34518)
Billing and Coding: Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing (A57768)
Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (L33410)
Billing and Coding: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (A57275)
Therapy and Rehabilitation Services (L33413)
Billing and Coding: Therapy and Rehabilitation Services (A57156)
The following billing and coding article has been retired:
Billing and Coding: Information Regarding Uses, Including Off-Label Uses of Anti-Vascular Endothelial Growth Factor (anti-VEGF), for The Treatment of Ophthalmological Diseases (A56716)

March 27

The following local coverage article, which was posted for notice on February 9, is now effective:
Self-Administered Drug Exclusion List (A52571)

March 23

The following article has been revised:
Billing and Coding: Non-Invasive Evaluation of Extremity Veins (A57125)
The following articles have been retired:
Billing and Coding: Rezum® Procedure (A59038)
Laboratory Panels – Coding and Billing (A56486)

March 9

The following billing and coding articles have been revised.
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Viscosupplementation Therapy for Knee (A57256)
The following LCD and related billing and coding article have been retired:
Transthoracic Echocardiography (TTE) (L33768)
Billing and Coding: Transthoracic Echocardiography (TTE) (A57182)

February 23

The following billing and coding articles have been revised:
Billing and Coding: Allergy Testing (A57531)
Billing and Coding: Information Regarding Uses, Including Off-Label Uses, of Anti-Vascular Endothelial Growth Factor (anti-VEGF), for The Treatment of Ophthalmological Diseases (A56716)
The following LCD has been retired:
Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases (L36962)
The following LCD and related billing and coding article have been retired:
Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries (L33282)
Billing and Coding: Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries (A57061)

February 9

The following article has been revised and will become effective March 27:
Self-Administered Drug Exclusion List (A52571)
The following billing and coding article has been revised:
Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
The following LCDs and related billing and coding articles have been retired:
Emergency and Non-Emergency Ground Ambulance Services (L37697)
Billing and Coding: Emergency and Non-Emergency Ground Ambulance Services (A57674)
Erythropoiesis Stimulating Agents (L36276)
Billing and Coding: Erythropoiesis Stimulating Agents (A57628)
Posterior Tibial Nerve Stimulation (PTNS) (L33406)
Billing and Coding: Posterior Tibial Nerve Stimulation (PTNS) (A57770)

February 6

The following LCD which was posted for notice on December 22, 2022, became effective on February 5.  The related billing and coding article for this LCD is also now effective:
Immune Globulin (L34007)
Billing and Coding: Immune Globulin (A57778)

January 26

The following articles have been revised to reflect the 2023 annual CPT/HCPCS code updates effective for dates of service on and after January 1:
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: Complex Drug Administration Coding (A59074)
Billing and Coding: Endovenous Stenting (A56644)
Billing and Coding: eVox System and Other Electroencephalograph Testing for Memory Loss (A59086)
Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
Billing and Coding: Frequency of Hemodialysis (A56666)
Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions (A57654)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Molecular Pathology Procedures (A57451)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
Billing and Coding: Urodynamic Services - Non-invasive (A58543)
Billing and Coding: Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases (A56716)
Eclipse system for the treatment of fecal incontinence in adult women clarification regarding the device technology and correct billing (A55582)
The following article has been revised:
Billing and Coding: Wound Care (A55818)
The following LCD and related article have been retired effective for dates of service on and after January 1:
Evaluation and Management Services Provided in a Nursing Facility (L36230)
Billing and Coding: Evaluation and Management Services Provided in a Nursing Facility (A57724)

December 30

The First Coast medical policy team has evaluated all active local coverage articles for any impact in response to the 2023 annual HCPCS/CPT code update. The following is a list of the impacted articles. The revised articles will be published to the Medicare Coverage Database and on our website in January. Please continue to watch our website for updates.
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: Complex Drug Administration Coding (A59074)
Billing and Coding: Endovenous Stenting (A56644)
Billing and Coding: eVox System and Other Electroencephalograph Testing for Memory Loss (A59086)
Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
Billing and Coding: Frequency of Hemodialysis (A56666)
Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions (A57654)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Molecular Pathology Procedures (A57451)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
Billing and Coding: Urodynamic Services - Non-invasive (A58543)
Billing and Coding: Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases (A56716)
Eclipse system for the treatment of fecal incontinence in adult women clarification regarding the device technology and correct billing (A55582)

December 22

The following LCD posted for comment on August 11 has been posted for notice. The LCD and related billing and coding article will become effective February 5, 2023.
Immune Globulin (L34007)
Billing and Coding: Immune Globulin (A57778)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response to Comments: Immune Globulin (A59285)
The following billing and coding articles have been revised:
Billing and Coding: Allergen Immunotherapy (A57678)
Billing and Coding: Transthoracic Echocardiography (TTE) (A57182)

December 12

The following LCD which was posted for notice on October 27 is now effective. The related billing and coding article for this LCD is also now effective:
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (L34522)
Billing and Coding: Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (A57647)
The following LCD and related billing and coding article which posted for notice of retirement on October 27 are now retired:
Special Histochemical Stains & Immunohistochemical Stains (L36234)
Billing and Coding: Special Histochemical Stains & Immunohistochemical Stains (A57708)

December 8

The following billing and coding articles have been revised:
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Intravenous Immune Globulin (A57778)
Billing and Coding: Routine Foot Care (A57188)
The following LCDs and related billing and coding articles have been retired:
Health and Behavior Assessment/Intervention (L33834)
Billing and Coding: Health and Behavior Assessment/Intervention (A57754)
Humanitarian Use Device (HUD) and Humanitarian Device Exemption (HDE) process (L36238)
Billing and Coding: Humanitarian Use Device (HUD) and Humanitarian Device Exemption (HDE) process (A57659)

November 28

The comment period is now closed for the following proposed LCDs. Comments received will be reviewed by our contractor medical directors. The response to comments articles and finalized billing and coding articles will be related to the final LCDs when they are posted for notice.
Ambulatory Electrocardiograph (AECG) Monitoring (DL39492)
Controlled Substance Monitoring and Drugs of Abuse Testing (DL36393)  

November 18

As a reminder, the comment period for the following proposed LCDs is currently open and will close on November 26. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Ambulatory Electrocardiograph (AECG) Monitoring (DL39492)
Controlled Substance Monitoring and Drugs of Abuse Testing (DL36393)
Submit comments

November 17

The following billing and coding article has been revised.
Billing and Coding: eVox® System and Other Electroencephalograph Testing for Memory Loss (A59086)
The following LCDs and related billing and coding articles have been retired:
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (L33685)
Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (A57655)
Osteopathic Manipulative Treatment (L33929)
Billing and Coding: Osteopathic Manipulative Treatment (A57786)
Incision and Drainage of Abscess of Skin, Subcutaneous and Accessory Structures (L33909)
Billing and Coding: Incision and Drainage of Abscess of Skin, Subcutaneous and Accessory Structures (A57783)

November 14

The following articles which were posted for notice on September 29 became effective November 14.
Billing and Coding: Esketamine (A59250)
Self-Administered Drug Exclusion List (A52571)

October 27

The following LCD posted for comment on June 9 has been posted for notice. The LCD and related billing and coding article will become effective December 11.
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (L34522)
Billing and Coding: Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (A57647)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response To Comments: Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (A59263)
The following LCD posted for comment on June 9 has been posted for notice of retirement. The LCD and related billing and coding article will be retired effective December 11.
Special Histochemical Stains & Immunohistochemical Stains (L36234)
Billing and Coding: Special Histochemical Stains & Immunohistochemical Stains (A57708)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response to Comments: Special Histochemical Stains and Immunohistochemical Stains (A59241)

October 20

The following billing and coding articles have been revised to reflect the Annual ICD-10 Code updates effective for dates of service on and after October 1:
Billing and Coding: Aortography and Peripheral Angiography (A57056)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries (A57061)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
Billing and Scanning: Duplex Scanning (A57636)
Billing and Coding: Electrocardiography (A57066)
Billing and Coding: Erythropoiesis Stimulating Agents (A57628)
Billing and Coding: Flow Cytometry (A57716)
Billing and Coding: Frequency of Hemodialysis (A56666)
Billing and Coding: Hepatic (Liver) Function Panel (A57802)
Billing and Coding: Ionized Calcium (A57120)
Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
Billing and Coding: Long-Term Wearable Electrocardiographic Monitoring (WEM) (A57062)
Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (A57655)
Billing and Coding: Magnesium (A57121)
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A59049)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries (A57126)
Billing and Coding: Parathormone (Parathyroid Hormone) (A57122)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
Billing and Coding: Psychological and Neuropsychological Tests (A57780)
Billing and Coding: Serum Phosphorus (A57650)
Billing and Coding: Susceptibility Studies (A57176)
Billing and Coding: Transesophageal Echocardiogram (A57179)
Billing and Coding: Transthoracic Echocardiography (TTE) (A57182)
Billing and Coding: Troponin (A57119)
Billing and Coding: Ultrasound, Soft Tissues of Head and Neck (A57029)
The following billing and coding article has been revised effective for dates of service on and after October 1:
Billing and Coding: Hemophilia Clotting Factors (A56482)
The following LCD has been retired effective October 1:
Hemophilia Clotting Factors (L33684)

October 17   

The following LCD which was posted for notice on September 1 became effective October 16. The related billing and coding article for this LCD is also effective:
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Amplification Techniques (NAATs) (L38227)
Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (A56638)

October 13

The following proposed LCDs have been posted for comment. The comment period will end on November 26; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for the First Coast contractor medical directors to consider.
Ambulatory Electrocardiograph (AECG) Monitoring (DL39492)
Controlled Substance Monitoring and Drugs of Abuse Testing (DL36393)
Submit comments
The following draft billing and coding articles are related to the above Proposed LCDs.
Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (DA59270)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (DA57077)
The following billing and coding article has been revised.
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
The following LCD and related billing and coding article have been retired:
Bone Mineral Density Studies (L36356)
Billing and Coding: Bone Mineral Density Studies (A56484)

October 6

The following billing and coding articles have been revised:
Billing and Coding: G-CSF Filgrastim (A57789)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)

September 29

The following billing and coding article has been added to become effective November 14:
Billing and Coding: Esketamine (A59250)
The following article has been revised and will become effective November 14:
Self-Administered Drug Exclusion List (A52571)
The following billing and coding article has been revised:
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)

September 27

The First Coast medical policy team has evaluated all active local coverage articles for any impact in response to the 2023 annual ICD-10 code update. The following is a list of the impacted articles. The revised articles will be published to the MCD and on the First Coast website in the middle of October. Please continue to watch our website for updates.
Billing and Coding: Aortography and Peripheral Angiography (A57056)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries (A57061)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
Billing and Scanning: Duplex Scanning (A57636)
Billing and Coding: Electrocardiography (A57066)
Billing and Coding: Erythropoiesis Stimulating Agents (A57628)
Billing and Coding: Flow Cytometry (A57716)
Billing and Coding: Frequency of Hemodialysis (A56666)
Billing and Coding: Hepatic (Liver) Function Panel (A57802)
Billing and Coding: Ionized Calcium (A57120)
Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
Billing and Coding: Long-Term Wearable Electrocardiographic Monitoring (WEM) (A57062)
Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (A57655)
Billing and Coding: Magnesium (A57121)
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A59049)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries (A57126)
Billing and Coding: Parathormone (Parathyroid Hormone) (A57122)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
Billing and Coding: Psychological and Neuropsychological Tests (A57780)
Billing and Coding: Serum Phosphorus (A57650)
Billing and Coding: Susceptibility Studies (A57176)
Billing and Coding: Transesophageal Echocardiogram (A57179)
Billing and Coding: Transthoracic Echocardiography (TTE) (A57182)
Billing and Coding: Troponin (A57119)
Billing and Coding: Ultrasound, Soft Tissues of Head and Neck (A57029)

September 26

The comment period is now closed for the following proposed LCDs. Comments received will be reviewed by our Contractor Medical Directors. The response to comments articles and finalized billing and coding articles will be related to the final LCDs when they are posted for notice.
Immune Globulin (DL34007)
Nerve Stimulators for Chronic Intractable Pain (DL39406)
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377)

September 19 

The following local coverage article which was posted for notice on August 4 is now effective:
Self-Administered Drug Exclusion List (A52571)

September 16

As a reminder, the comment period for the following proposed LCDs is currently open and will close on September 24. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Immune Globulin (DL34007)
Nerve Stimulators for Chronic Intractable Pain (DL39406)
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377)
Submit comments

September 6

The comment period is now closed for the following proposed LCD. Comments received will be reviewed by our contractor medical directors. The response to comments article and finalized billing and coding article will be related to the final LCD when it is posted for notice.
Genetic Testing for Oncology (DL39367)

September 1

The following LCD posted for comment on April 14 has been posted for notice. The LCD and related Billing and Coding Article will become effective October 16.
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (L38227)
Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (A56638)
The following Response to Comments Article contains summaries of all comments received and First Coast’s responses:
Response to Comments: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (A59195)
The following LCD posted for comment on April 14 was reposted for comment on August 11. The comment period will end on September 24.
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377)
comments
The following Draft Billing and Coding Article is related to the above Proposed LCD.
Billing and Coding: Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DA57680)

August 26

As a reminder, the comment period for the following proposed LCD is currently open and will close on September 6. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Genetic Testing for Oncology (DL39367)
Submit comments

August 25

The following billing and coding article has been revised:
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)

August 11

The following proposed LCDs have been posted for comment. The comment period will end on September 24; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for the First Coast contractor medical directors to consider.
Immune Globulin (DL34007)
Nerve Stimulators for Chronic Intractable Pain (DL39406)
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377)
Submit comments
The following draft billing and coding articles are related to the above proposed LCDs.
Billing and Coding: Immune Globulin (DA57778)
Billing and Coding: Nerve Stimulators for Chronic Intractable Pain (DA59190)
Billing and Coding: Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DA57680)
The following billing and coding articles have been revised:
Billing and Coding: Complex Drug Administration Coding (A59074)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)

August 4

The following Billing and Coding articles have been revised to reflect the July CPT/HCPCS Code Quarterly updates and/or in response to inquiries:
Billing and Coding: Duplex Scan of Lower Extremity Arteries (A57064) – This was in response to an inquiry.
Billing and Coding: G-CSF Filgrastim (A57789)
Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (A57655) - This was in response to an inquiry.
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A59049)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
Billing and Coding: Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases (A56716)
The following Article has been revised effective for dates of service on and after September 19:
Self-Administered Drug Exclusion List: (A52571)

July 28

As indicated on July 25, the comment period for Genetic Testing for Oncology has been extended until September 6 due to changes that are being made to the final billing and coding article. Detailed information regarding the changes to the article is now visible on the document notes at the top of the proposed LCD and Draft Article.
Please refer to the Related Local Coverage Documents section at the bottom of the Proposed LCD for changes made to the draft article (DA59123, Billing and Coding: Genetic Testing for Oncology).
Genetic Testing for Oncology (DL39367)
Billing and Coding: Genetic Testing for Oncology (DA59123)
Submit comments

July 25

The comment period for the following Proposed LCD has been extended until September 6, due to changes that will be made to the final related billing and coding article.  The change in the comment end date along with detailed information regarding the changes to the article will be visible on the Medicare Coverage Database (MCD) and our website on July 28.  The information will be located on the document note at the top of the proposed LCD and on the document note at the top of the draft article.  Please check our website on July 28, for this information.
Please do not re-submit comments already submitted, but we welcome additional comments related to the changes.
• Genetic Testing for Oncology (DL39367)
The comment period is now closed for the following proposed LCDs. Comments received will be reviewed by our Contractor Medical Directors. The response to comments articles and finalized billing and coding articles will be related to the final LCDs when they are posted for notice.
• Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (DL34522)
• Special Histochemical Stains and Immunohistochemical Stains (being considered for retirement) (DL36234)

July 14

As a reminder, the comment period for the following proposed LCDs is currently open and will close on July 23. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Genetic Testing for Oncology (DL39367)  
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder ((DL34522)
Special Histochemical Stains and Immunohistochemical Stains (DL36234)
Submit comments

June 30

The following billing and coding article has been revised.
Billing and Coding: Duplex Scanning (A57636)
As a reminder, the comment period for the following proposed LCDs is currently open and will close on July 23. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Genetic Testing for Oncology (DL39367)  
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder ((DL34522)
Special Histochemical Stains and Immunohistochemical Stains (DL36234)
Submit comments

June 13

The following proposed LCDs have been posted for comment. The comment period ends July 23; however, you are encouraged to submit your comments as soon as possible. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations for the First Coast contractor medical directors to consider.
Genetic Testing for Oncology (DL39367)
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder ((DL34522)
The following draft billing and coding articles are related to the above proposed LCDS.
Billing and Coding: Genetic Testing for Oncology (DA59123)
Billing and Coding: Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (DA57647)
The following proposed LCD is being considered for retirement and has been posted for comments. The comment period ends on July 23.
Special Histochemical Stains and Immunohistochemical Stains (DL36234)
The following draft billing and coding article is related to the above Proposed LCD.
Billing and Coding: Special Histochemical Stains and Immunohistochemical Stains (DA57708)
Submit comments

June 9

The following proposed LCDs have been posted for comment. The comment period ends July 23.
Genetic Testing for Oncology (DL39367)
Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder ((DL34522)
The following draft billing and coding articles are related to the above proposed LCDS.
Billing and Coding: Genetic Testing for Oncology (DA59123)
Billing and Coding: Transcranial Magnetic Stimulation (TMS) in the Treatment of Adults with Major Depressive Disorder (DA57647)
The following proposed LCD is being considered for retirement and has been posted for comments. The comment period ends on July 23.
Special Histochemical Stains and Immunohistochemical Stains (DL36234)
The following draft billing and coding article is related to the above Proposed LCD.
Billing and Coding: Special Histochemical Stains and Immunohistochemical Stains (DA57708)
Submit comments

June 2

The following articles have been revised and will become effective June 6:
Billing and Coding: Complex Drug Administration Coding (A59074)
Billing and Coding: Surgical Treatment of Nails (A57666)
Self-Administered Drug Exclusion List (A52571)

May 31

The comment period is now closed for the following proposed LCDs. Comments received will be reviewed by our contractor medical directors. The response to comments articles and finalized billing and coding articles will be related to the final LCDs when they are posted for notice.
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (DL38227) 
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377) 

May 19

The following LCDs have been revised:
Cosmetic and Reconstructive Surgery (L38914)
Implantable Continuous Glucose Monitors (I-CGM) (L38664)
As a reminder, the comment period for the following proposed LCDs is currently open and will close on May 28. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (DL38227)
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377)
Submit Comments

May 5

The following billing and coding article has been added:
Billing and Coding: eVox® System and Other Electroencephalograph Testing for Memory Loss (A59086)
The following billing and coding articles have been revised:
Billing and Coding: Aortography and peripheral angiography (A57056)
Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (A56638)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
Billing and Coding: Therapy and Rehabilitation Services (A57156)
Billing and Coding: Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases (A56716)
Please refer to the sticky note on the following for revisions:
Self-Administered Drug Exclusion List (effective 6/6/2022) (A52571)

April 22

The following billing and coding article is now effective:
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A59049)

April 21

The following LCD has been revised:
Implantable Continuous Glucose Monitors (I-CGM) (L38664)
The following billing and coding article has been added and will become effective June 6:
Billing and Coding: Complex Drug Administration Coding (A59074)
The following local coverage article has been revised effective for dates of service on and after June 6:
Self-Administered Drug Exclusion List (A52571)

April 14

The following Proposed Local Coverage Determinations (LCDs) have been posted for comments. The comment period will end on May 28, however, you are encouraged to submit your comments as soon as possible.
Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (DL38227)
Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377)
Submit Comments
The following Draft Billing and Coding Articles are related to the above Proposed LCDS.
Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (DA56638)
Billing and Coding: Skin Substitutes for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DA57680)

March 24

The following billing and coding article has been revised:
Billing and Coding: Aortography and peripheral angiography (A57056)
The following billing and coding article has been retired:
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A58826)
The following billing and coding article has been added and will become effective April 22:
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A59049)

March 10

The following billing and coding article has been added:
Billing and Coding: Rezum® Procedure (A59038)
The following billing and coding articles have been revised:
Billing and Coding: Wireless Capsule Endoscopy (A56704)
Billing and Coding: Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases (A56716)
The following article has been retired:
Rezum® System for use in the management of benign prostatic hypertrophy clarification regarding the system technology and correct billing (A55477)

March 1

We welcome any feedback regarding the following LCD retirements scheduled for March 25. If you would like to provide feedback, please submit it to LCDretirement@guidewellsource.com.
Amniotic Membrane - Sutureless Placement on the Ocular Surface (L36237)
Biventricular Pacing/ Cardiac Resynchronization Therapy (L33271)
Omalizumab (L33924)

February 24

The following billing and coding article has been revised:
Billing and Coding: Epidural Steroid Injections for Pain Management (A56651)
The following LCDs and their related billing and coding articles will be retired effective 3/25/2022:
Amniotic Membrane - Sutureless Placement on the Ocular Surface (L36237)
Billing and Coding: Amniotic Membrane - Sutureless Placement on the Ocular Surface (A57679)
Biventricular Pacing/ Cardiac Resynchronization Therapy (L33271)
Billing and Coding: Biventricular Pacing/ Cardiac Resynchronization Therapy (A57634)
Omalizumab (L33924)
Billing and Coding: Omalizumab (A57658)

February 17

The following billing and coding articles have been revised:
Billing and Coding: Allergy Testing (A57531)
Billing and Coding: Aortography and peripheral angiography (A57056)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: Surgical Management of Morbid Obesity (A57145)

February 10

The following billing and coding articles have been revised:
Billing and Coding: Botulinum Toxins (A57715)
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A58826)
Billing and Coding: Platelet Rich Plasma (A58810)

January 31

The following Local Coverage Determinations (LCDs) which were posted for notice on December 16, 2021 are now effective. The related billing and coding articles for these LCDs are also now effective:
Genetic Testing for Cardiovascular Disease (L39084)
Billing and Coding: Genetic Testing for Cardiovascular Disease (A58797)
Surgical Treatment of Nails (L33833)
Billing and Coding: Surgical Treatment of Nails (A57666)

January 27

The following billing and coding articles have been revised:
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A58826)
Billing and Coding: Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF) (A57872)

January 20

The following articles have been revised to reflect the 2022 Annual CPT/HCPCS Code updates effective for dates of service on and after January 1:
Billing and Coding: Allergy Testing (A57531)
Billing and Coding: Colon Capsule Endoscopy (CCE) (A58410)
Billing and Coding: Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries (A57061)
Billing and Coding: Endovenous Stenting (A56644)
Billing and Coding: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (A56953)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions (A57654)
Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS) (A56647)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Molecular Pathology Procedures (A57451)
Billing and Coding: Pegfilgrastim (A57725)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
Billing and Coding: Transthoracic Echocardiography (TTE) (A57182)
Billing and Coding: Wireless Capsule Endoscopy (A56704)
Rezum® System for use in the management of benign prostatic hypertrophy clarification regarding the system technology and correct billing (A55477)
The following LCD has been revised:
Epidural Steroid Injections for Pain Management (L33906)
The following article has been retired:
Percutaneous electrical nerve stimulation (PENS) and percutaneous neuromodulation therapy (PNT) (A54794) January 13
The following billing and coding articles have been revised:
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A58826)
Billing and Coding: Omalizumab (A57658)

December 30, 2021

The following billing and coding article has been revised:
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)

December 28, 2021

The First Coast Service Option’s Medical Policy team has evaluated all active Local Coverage Articles for any impact in response to the 2022 Annual HCPCS/CPT Code Update. The following is a list of the impacted Articles. The revised Articles will be published to the Medicare Coverage Database and on our Website in January. Please continue to watch our website for updates.
Billing and Coding: Allergy Testing (A57531)
Billing and Coding: Colon Capsule Endoscopy (CCE) (A58410)
Billing and Coding: Computed Tomographic Angiography of the Chest, Heart and Coronary Arteries (A57061)
Billing and Coding: Endovenous Stenting (A56644)
Billing and Coding: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (A56953)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions (A57654)
Billing and Coding: Micro-Invasive Glaucoma Surgery (MIGS) (A56647)
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
Billing and Coding: Molecular Pathology Procedures (A57451)
Billing and Coding: Pegfilgrastim (A57725)
Billing and Coding: Pharmacogenomics Testing (A58812)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
Billing and Coding: Transthoracic Echocardiography (TTE) (A57182)
Billing and Coding: Wireless Capsule Endoscopy (A56704)
Rezum® System for use in the management of benign prostatic hypertrophy clarification regarding the system technology and correct billing (A55477)

December 16, 2021

The following LCDs posted for comment on July 29 have been posted for notice. The LCDs and related billing and coding articles will become effective January 30, 2022:
Genetic Testing for Cardiovascular Disease (L39084)
Billing and Coding: Genetic Testing for Cardiovascular Disease (A58797)
Surgical Treatment of Nails (L33833)
Billing and Coding: Surgical Treatment of Nails (A57666)
The following response to comments articles contain summaries of all comments received and First Coast’s responses:
Response to Comments: Genetic Testing for Cardiovascular Disease (A58956)
Response to Comments: Surgical Treatment of Nails (A58960)
The following LCD has been revised:
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (L33751)

December 13, 2021

The following LCDs which were posted for notice on October 28 are now effective. The related billing and coding articles are also now effective.
Epidural Steroid Injections for Pain Management (L33906)
Billing and Coding: Epidural Steroid Injections for Pain Management (A56651)
Pharmacogenomics Testing (L39073)
Billing and Coding: Pharmacogenomics Testing (A58812)
Platelet Rich Plasma (L39071)
Billing and Coding Platelet Rich Plasma (A58810)

December 9, 2021

The following LCDs and related articles have been revised and will become effective December 12:
Molecular Pathology Procedures (L34519)
Billing and Coding: Molecular Pathology Procedures (A57451)
Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing (L34518)
Billing and Coding: Molecular Pathology Procedures for Human Leukocyte Antigen (HLA) Typing (A57768)
The following billing and coding articles have been revised and will become effective December 12:
Billing and Coding Epidural Steroid Injections for Pain Management (A56651)
Billing and Coding: Pharmacogenomics Testing (A58812)
The following LCD and related article will be retired effective December 12:
CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing (L35698)
Billing and Coding: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing (A57704)
The following billing and coding article has been revised
Billing and Coding: Biventricular Pacing/Cardiac Resynchronization Therapy (A57634)

November 18, 2021

The following billing and coding article has been revised:
Billing and Coding: Allergy Testing (A57531)

November 11, 2021

The following LCDs have been revised:
Hepatic (Liver) Function Panel (L33907)
Parathormone (Parathyroid Hormone) (L34018)
Serum Phosphorus (L34022)
The following billing and coding articles have been revised:
Billing and Coding: Diagnostic Colonoscopy (A55937)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
The following billing and coding article has been revised and will become effective on December 12:
Billing and Coding: Platelet Rich Plasma (A58810)

November 8, 2021                     

The following billing and coding article is now effective:
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)

November 4, 2021                     

The following billing and coding article has been revised and will become effective 11/8.
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)

October 28, 2021

The following LCDs posted for comment on June 10 have been posted for notice. The LCDs and related billing and coding articles will become effective December 12.
Epidural Steroid Injections for Pain Management (L33906)
Billing and Coding: Epidural Steroid Injections for Pain Management (A56651)
Pharmacogenomics Testing (L39073)
Billing and Coding: Pharmacogenomics Testing (A58812)
Platelet Rich Plasma (L39071)
Billing and Coding: Platelet Rich Plasma (A58810)
The following response to comments articles contain summaries of all comments received and First Coast’s responses:
Response to Comments: Epidural Steroid Injections for Pain Management (A58928)
Response to Comments: Pharmacogenomics Testing (A58922)
Response to Comments: Platelet Rich Plasma (A58924)
The following LCD has been revised:
Erythropoiesis Stimulating Agents (L36276)
The following billing and coding articles have been revised:
Billing and Coding: Aortography and peripheral angiography (A57056)
Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow (A57025)
Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (A57804)

October 21, 2021

The following billing and coding articles have been revised:
Billing and Coding: Allergy Testing (A57531)
Billing and Coding: Botulinum Toxins (A57715)
The following article has been revised:
Self-Administered Drug Exclusion List: (A52571)

October 14, 2021

The following Billing and Coding Articles have been revised to reflect the Annual ICD-10 Code Updates effective for dates of service on and after October 1.
Billing and Coding: BRCA1 and BRCA2 Genetic Testing (A57449)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
Billing and Coding: Diagnostic Aerosol or Vapor Inhalation (A57058)
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
Billing and Coding: Duplex Scanning (A57636)
Billing and Coding: Electrocardiography (A57066)
Billing and Coding: Epidural (A56651)
Billing and Coding: Erythropoiesis Stimulating Agents (A57628)
Billing and Coding: Flow Cytometry (A57716)
Billing and Coding: Genetic Testing for Lynch Syndrome (A57450)
Billing and Coding: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (A56953)
Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
Billing and Coding: Ionized Calcium (A57120)
Billing and Coding: Magnesium (A57121)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Non-Invasive Evaluation of Extremity Veins (A57125)
Billing and Coding: Parathormone (Parathyroid Hormone) (A57122)
Billing and Coding: Pegfilgrastim (A57725)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Proton Beam Radiotherapy (A57669)
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
Billing and Coding: Psychological and Neuropsychological Tests (A57780)
Billing and Coding: Pulmonary Diagnostic Services (A57127)
Billing and Coding: Routine Foot Care (A57188)
Billing and Coding: Sedimentation Rate, Erythrocyte (A57657)
Billing and Coding: Serum Phosphorus (A57650)
Billing and Coding: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (A57275)
Billing and Coding: Surgical Management of Morbid Obesity (A57145)
Billing and Coding: Therapy and Rehabilitation Services (A57156)
Billing and Coding: Trastuzumab – Trastuzumab Biologics (A56660)
Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed (A56841)
In addition to the ICD-10-CM revisions, the following billing and coding article has been revised in response to an inquiry.
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)

October 7, 2021

The following billing and coding article has been added and will become effective November 8:
Billing and Coding: Molecular Pathology and Genetic Testing (A58918)

September 30, 2021

The First Coast medical policy team has evaluated all active LCDs and local coverage articles for any impact in response to the 2022 annual ICD-10 code update. The following is a list of the impacted articles. The revised articles will be published to the Medicare Coverage Database and on the First Coast website in the middle of October. Please continue to watch our website for updates.
Billing and Coding: BRCA1 and BRCA2 Genetic Testing (A57449)
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
Billing and Coding: Diagnostic Aerosol or Vapor Inhalation (A57058)
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
Billing and Coding: Duplex Scanning (A57636)
Billing and Coding: Electrocardiography (A57066)
Billing and Coding: Epidural (A56651)
Billing and Coding: Erythropoiesis Stimulating Agents (A57628)
Billing and Coding: Flow Cytometry (A57716)
Billing and Coding: Genetic Testing for Lynch Syndrome (A57450)
Billing and Coding: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (A56953)
Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
Billing and Coding: Ionized Calcium (A57120)
Billing and Coding: Magnesium (A57121)
Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
Billing and Coding: Non-Invasive Evaluation of Extremity Veins (A57125)
Billing and Coding: Parathormone (Parathyroid Hormone) (A57122)
Billing and Coding: Pegfilgrastim (A57725)
Billing and Coding: Peripheral Nerve Blocks (A57788)
Billing and Coding: Proton Beam Radiotherapy (A57669)
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
Billing and Coding: Psychological and Neuropsychological (A57780)
Billing and Coding: Pulmonary Diagnostic Services (A57127)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
Billing and Coding: Routine Foot Care (A57188)
Billing and Coding: Sedimentation Rate, Erythrocyte (A57657)
Billing and Coding: Serum Phosphorus (A57650)
Billing and Coding: Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) (A57275)
Billing and Coding: Surgical Management of Morbid Obesity (A57145)
Billing and Coding: Therapy and Rehabilitation Services (A57156)
Billing and Coding: Trastuzumab – Trastuzumab Biologics (A56660)
Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed (A56841)

September 13, 2021

The comment period is now closed for the following proposed LCDs. Comments received will be reviewed by our Contractor Medical Directors. The response to comments articles and finalized billing and coding articles will be related to the final LCDs when they are posted for notice.
Genetic Testing for Cardiovascular Disease (DL39084)
Surgical Treatment of Nails (DL33833)

September 9, 2021

The following LCDs have been revised:
Cataract Extraction (including Complex Cataract Surgery) (L38926)
Health and Behavior Assessment/Intervention (L33834)
The following billing and coding articles have been revised:
Billing and Coding: Health and Behavior Assessment/Intervention (A57754)
Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
Billing and Coding: Polysomnography and Sleep Testing (A57496)

September 7, 2021

As a reminder, the comment period for the following LCDs is currently open and will close on September 11. We encourage you to submit your comments as soon as possible.
Genetic Testing for Cardiovascular Disease (DL39084)
Surgical Treatment of Nails (DL33833)
Submit Comments

August 19, 2021

The following local coverage article has been retired:
Destruction of Paravertebral Facet Joint Nerve(s) (A55714)

August 12, 2021

The following billing and coding articles have been revised:
Billing and Coding: Diagnostic Colonoscopy (A55937)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A58826)
The following billing and coding article has been added and will become effective September 13:
Billing and Coding: Tetanus Immunization (A58873)
The following billing and coding article has been retired:
Billing and Coding: Implantable Automatic Defibrillators (A56341)
The following LCD and related billing and coding article will be retired effective September 30
Infliximab (L33704)
Billing and Coding: Infliximab (A57653)
Please note: Generally, drugs and biologicals are covered when they meet the definition of such and are administered according to the U.S. Food and Drug and Administration (FDA) label. Information regarding the coverage for label and off-label drugs and biologicals is available in the Centers for Medicare and Medicaid Services’ (CMS’) Internet-Only Manuals. Please submit any concerns regarding the retirement of this redundant LCD and article to LCDretirement@guidewellsource.com by September 17.

July 29, 2021

The following proposed LCDs have been posted for comments. The comment period will end on September 11; however, you are encouraged to submit your comments as soon as possible.
Genetic Testing for Cardiovascular Disease (DL39084)
Surgical Treatment of Nails (DL33833)
Submit Comments
The following draft billing and coding articles are related to the above proposed LCDs.
Billing and Coding: Genetic Testing for Cardiovascular Disease (DA58797)
Billing and Coding: Surgical Treatment of Nails (DA57666)

July 26, 2021

The comment period is now closed for the following proposed LCDs. Comments received will be reviewed by our Contractor Medical Directors. The response to comments articles and finalized billing and coding articles will be related to the final LCDs when they are posted for notice.
Epidural Procedures for Pain Management (DL33906)
Pharmacogenomics Testing (DL39073) 
Platelet Rich Plasma (DL39071)

July 19, 2021

As a reminder, the comment period for the following LCDs is currently open and will close on July 24, 2021. We encourage you to submit your comments as soon as possible.
Epidural Procedures for Pain Management (DL33906)
Pharmacogenomics Testing (DL39073) 
Platelet Rich Plasma (DL39071)  
Submit Comments

July 12, 2021

The following LCDs and related billing and coding articles, as applicable, are now effective:
Allergen Immunotherapy (L37800)
Billing and Coding: Allergen Immunotherapy (A57678)
Allergy Testing (L33261)
Billing and Coding: Allergy Testing (A57531)
Cataract Extraction (including Complex Cataract Surgery) (L38926)
Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) (A58592)
Cosmetic and Reconstructive Surgery (L38914)
Billing and Coding: Cosmetic and Reconstructive Surgery (A58573)
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF) (L34976)
Respiratory Pathogen Panel Testing (L38918)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)

July 8, 2021

The following LCDs have been revised:
Psychiatric Inpatient Hospitalization (L33975)
The following billing and coding articles have been revised:
Billing and Coding: Aortography and peripheral angiography (A57056)
Billing and Coding: Diagnostic Colonoscopy (A55937) 
The following billing and coding article has been added:
Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A58826)
The following LCDs have been retired:
E&M Home and Domiciliary Visits (L33817)
Reduction Mammaplasty (L33939)
The following articles have been retired:
Billing and Coding: E&M Home and Domiciliary Visits (A56520)
Billing and Coding: National Noncovered Services (A57742)
Billing and Coding: Reduction Mammaplasty (A57538)
Coding article for positron emission tomography (PET) scans used for oncological indications (A55411)
Insertion of anterior segment aqueous drainage device – Current Procedural Terminology (CPT) codes 0191T, 0474T and 0449T (A56179)

June 29, 2021

As a reminder, the comment period for the following LCDs is currently open and will close on July 24, 2021. We encourage you to submit your comments as soon as possible.
Epidural Procedures for Pain Management (DL33906)
Pharmacogenomics Testing (DL39073)
Platelet Rich Plasma (DL39071)

June 10, 2021

The following proposed LCDs have been posted for comments. The comment period will end on July 24; however, you are encouraged to submit your comments as soon as possible.
Epidural Procedures for Pain Management (DL33906)
Pharmacogenomics Testing (DL39073)
Platelet Rich Plasma (DL39071)
The following draft billing and coding articles are related to the above proposed LCDs.
Billing and Coding: Epidural Procedures for Pain Management (DA56651)
Billing and Coding: Pharmacogenomics Testing (DA58812)
Billing and Coding: Platelet Rich Plasma (DA58810)
The following LCD has been revised:
Facet Joint Interventions for Pain Management (L33930)
The following billing and coding articles have been revised:
Billing and Coding: Botulinum Toxins (A57715)
Billing and Coding: Diagnostic Colonoscopy (A55937)
Billing and Coding: Routine Foot Care (A57188)

May 27, 2021

The following LCDs posted for comment on January 14 have been posted for notice. The LCDs and related billing and coding articles, as applicable, will become effective July 11:
Allergen Immunotherapy (L37800)
Billing and Coding: Allergen Immunotherapy (A57678)
Allergy Testing (L33261)
Billing and Coding: Allergy Testing (A57531)
Cataract Extraction (including Complex Cataract Surgery) (L38926)
Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) (A58592)
Cosmetic and Reconstructive Surgery (L38914)
Billing and Coding: Cosmetic and Reconstructive Surgery (A58573)
Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF) (L34976)
Respiratory Pathogen Panel Testing (L38918)
Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
The following response to comments articles contain summaries of all comments received and First Coast’s responses:
Response to Comments: Allergen Immunotherapy (A58757)
Response to Comments: Allergy Testing (A58751)
Response to Comments: Cataract Extraction (including Complex Cataract Surgery) (A58765)
Response to Comments: Cosmetic and Reconstructive Surgery (A58772)
Response to Comments: Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF) (A58686)
Response to Comments: Respiratory Pathogen Panel Testing (A58770)
The following billing and coding articles have been revised:
Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow (A57025)
Billing and Coding: Facet Joint Interventions for Pain Management (A57787)

May 13, 2021

The following LCD has been revised:
Independent Diagnostic Testing Facility (IDTF) (L33910)
The following billing and coding article has been revised:
Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520)
The following local coverage article is being retired for dates of service on and after May 13, 2021:
Administration of Certain Biological Response Modifiers (A52603)

April 26, 2021

The following LCDs and related billing and coding articles are now effective:
Cardiology Non-emergent Outpatient Stress Testing (L38396)
Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
Facet Joint Interventions for Pain Management (L33930) (formerly titled Paravertebral Facet Joint Nerve Blocks)
Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
The following LCD and related billing and coding article are now retired:
Destruction of Paravertebral Facet Joint Nerve(s) (L33814)
Billing and Coding: Destruction of Paravertebral Facet Joint Nerve(s) (A57639)

April 22, 2021

The following future LCD and related billing and coding article, which become effective April 25, have been revised:
Facet Joint Interventions for Pain Management (L33930)
Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
The following billing and coding articles have been revised:
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
Billing and Coding: Viscosupplementation Therapy for Knee (A57256)
The following LCD and related billing and coding article are being retired for dates of service on and after April 25, 2021:
Destruction of Paravertebral Facet Joint Nerve(s) (L33814)
Billing and Coding: Destruction of Paravertebral Facet Joint Nerve(s) (A57639)

April 5, 2021

The following local coverage article that was revised and posted on February 18 is now effective:
Self-administered drug exclusion list (A52571)

April 1, 2021

The following billing and coding article has been revised:
Billing and coding: Independent diagnostic testing facility (IDTF) (A57807)

March 29, 2021

The following LCD that was posted for notice on February 11 is now effective. The related billing and coding article for this LCD is also now effective.
Colon capsule endoscopy (CCE) (l38805)
Billing and coding: Colon capsule endoscopy (CCE) (A58410)

March 22, 2021

The following LCDs that were posted for notice on February 4 are now effective. The related billing and coding articles for these LCDs are also now effective:
Blepharoplasty, blepharoptosis repair and surgical procedures of the brow (L34028)
Billing and coding: Blepharoplasty, blepharoptosis repair and surgical procedures of the brow (A57025)
Botulinum toxins (L33274)
Billing and coding: Botulinum toxins (A57715)
Diagnostic colonoscopy (L33671)
Billing and coding: Diagnostic colonoscopy (A55937)

March 18, 2021

The following billing and coding article has been revised:
Billing and coding: Sedimentation rate, Erythrocyte (A57657)

March 1, 2021

The comment period is now closed for the following proposed local coverage determinations. Comments received will be reviewed by our contractor medical directors. The response to comments article and finalized billing and coding article will be related to the final LCD when it is posted for notice.
Allergen immunotherapy (DL37800)
Allergy testing (DL33261)
Cataract extraction (including complex cataract surgery) (DL38926)
Cosmetic and reconstructive surgery (DL38914)
Percutaneous vertebral augmentation (PVA) for vertebral compression fracture (VCF) (DL34976)
Respiratory pathogen panel testing (DL38918)

February 25, 2021

The following LCDs have been revised:
G-CSF Filgrastim (L34002)
Vitamin B12 injections (L33967)
The following billing and coding articles have been revised:
Billing and coding: Electrocardiography (A57066)
Billing and coding: Non-invasive evaluation of extremity veins (A57125)

February 18, 2021

The following billing and coding article has been revised:
Billing and coding: Nerve conduction studies and electromyography (a57123)
The following local coverage article has been revised effective for dates of service on and after April 5:
Self-administered drug exclusion list (A52571)
As a reminder, the comment period for the following proposed LCDs is currently open and will close on February 27. We encourage you to submit your comments as soon as possible.
Allergen immunotherapy (DL37800)
Allergy testing (DL33261)
Cataract extraction (including complex cataract surgery) (DL38926)
Cosmetic and reconstructive surgery (DL38914)
Percutaneous vertebral augmentation (PVA) for vertebral compression fracture (VCF) (DL34976)
Respiratory pathogen panel testing (DL38918)
Submit comments

February 11, 2021

The following LCD which was posted for comment on August 27, 2020, has been posted for notice. The LCD and related billing and coding article will become effective March 28.
Colon capsule endoscopy (CCE) (L38805)
Billing and coding: Colon capsule endoscopy (CCE) (A58410)
The following response to comments article contains summaries of all comments received and First Coast’s responses:
Response to comments: Colon capsule endoscopy (A58619)
The following LCD and related article has been revised to reflect the 2021 Annual CPT / HCPCS Code updates effective for dates of service on and after January 1, 2021:
Pegfilgrastim (L33747)
Billing and coding: Pegfilgrastim (A57725)
The following articles have been revised to reflect the 2021 Annual CPT / HCPCS Code updates effective for dates of service on and after January 1, 2021:
Billing and coding: Epidural (A56651)
Billing and coding: Genetic testing for lynch syndrome (A57450)
Billing and coding: Hemophilia clotting factors (A56482)
Billing and coding: Independent diagnostic testing facility (IDTF) (A57807)
Billing and coding: Long-term wearable electrocardiographic monitoring (WEM) (A57062)
Billing and coding: Major joint replacement (hip and knee) (A57765)
Billing and coding: Molecular pathology procedures (A57451)
Billing and coding: Peripheral nerve blocks (A57788)
Billing and coding: Pulmonary diagnostic services (A57127)
Billing and coding: Reduction mammaplasty (A57538)
Billing and coding: Trastuzumab – Trastuzumab BIOlogics (A56660)

February 4, 2021

The following LCDs posted for comment on September 24, 2020, have been posted for notice. The LCDs and related billing and coding articles will become effective March 21:
Blepharoplasty, blepharoptosis repair and surgical procedures of the brow (L34028)
Billing and coding: Blepharoplasty, blepharoptosis repair and surgical procedures of the brow (A57025)
Botulinum toxins (L33274)
Billing and coding: Botulinum toxins (A57715)
Diagnostic colonoscopy (L33671)
Billing and Coding: Diagnostic Colonoscopy (A55937)
The following response to comments articles contain summaries of all comments received and First Coast’s responses:
Response to comments: Blepharoplasty, blepharoptosis repair and surgical procedures of the brow (A58587)
Response to comments: Botulinum toxins (A58585)
Response to comments: Diagnostic colonoscopy (a58610)
The following article has been retired effective February 4, 2021:
Billing and coding information for prostate biopsies (A52575)

January 21, 2021

The following LCD has been revised:
Bisphosphonates (intravenous [IV]) and monoclonal antibodies in the treatment of osteoporosis and their other indications (L33270)
A note has been added to the following article for clarification:
Self-administered drug exclusion list (A52571)

January 7, 2021

The following LCD has been revised:
Autonomic function tests (L33609)
The following billing and coding article has been revised:
Billing and coding: Scanning computerized ophthalmic diagnostic imaging (SCODI) (A57804)
The following article has been revised:
Self-administered drug exclusion list (A52571)

December 29, 2020

Due to extenuating circumstances, the annual HCPCS/CPT code update has been delayed. The following is a preliminary list of billing and coding articles and an LCD that will be revised in response to the update. Due to the delay, it is anticipated that the revisions will be published to the Medicare coverage database (MCD) and our website in early February. Please continue to watch our website for further updates.
Billing and coding articles:
Billing and coding: Genetic testing for lynch syndrome (A57450)
Billing and coding: Hemophilia clotting factors (A56482)
Billing and coding: Independent diagnostic testing facility (IDTF) (A57807)
Billing and coding: Long-term wearable electrocardiographic monitoring (WEM) (A57062)
Billing and coding: Molecular pathology procedures (A57451)
Billing and coding: Pegfilgrastim (A57725)
Billing and coding: Psychiatric diagnostic evaluation and psychotherapy services (A57520)
Billing and coding: Pulmonary diagnostic services (A57127)
Billing and coding: Trastuzumab – Trastuzumab biologics (A56660)
LCD
Pegfilgrastim (L33747)

December 28, 2020

The following LCDs that were posted for notice on November 12 are now effective.
Endovenous stenting (L38231)
Transurethral waterjet ablation of the prostate (L38726)
Treatment of chronic venous insufficiency of the lower extremities (L38720)
The following billing and coding articles are now effective.
Billing and coding: Transurethral waterjet ablation of the prostate (A58264)
Billing and coding: Treatment of chronic venous insufficiency of the lower extremities (A58250)
Billing and coding: Non-invasive evaluation of extremity veins (A57125)
The following LCD and related billing and coding article have been retired:
Treatment of varicose veins of the lower extremity (L33762)
Billing and coding: Treatment of varicose veins of the lower extremity (A57781)

December 17, 2020

The following LCD has been revised:
Non-Invasive evaluation of extremity veins (L33693)
The following billing and coding article has been revised and will become effective December 27:
Billing and coding: Non-invasive evaluation of extremity veins (A57125)
The following LCD and related billing and coding article will retire on December 26:
Treatment of varicose veins of the lower extremity (L33762)
Billing and Coding: Treatment of varicose veins of the lower extremity (A57781)

December 10, 2020

The following LCD and related billing and coding article have been revised:
BRCA1 and BRCA2 genetic testing (L36499)
Billing and coding: BRCA1 and BRCA2 genetic testing (A57449)-

November 12, 2020

The following local coverage determination (LCDs) posted for comment on June 25 have been posted for notice. The LCDs and related billing and coding article will become effective December 27.
Transurethral waterjet ablation of the prostate (L38726)
Billing and coding: Transurethral waterjet ablation of the prostate (a58264)
Treatment of Chronic Venous Insufficiency of the lower extremities (L38720)
Billing and coding: Treatment of chronic venous insufficiency of the lower extremities (A58250)
The following LCD posted for comment on June 25 has been posted for notice. It will become effective December 27.
Endovenous Stenting (L38231)
The following response to comments articles contain summaries of all comments received and First Coast’s responses:
Response to comments: Endovenous stenting (A58531)
Response to comments: Transurethral waterjet ablation of the prostate (A58537)
Response to comments: Treatment of chronic venous insufficiency of the lower extremities (A58530)
The following billing and coding article has been added:
Billing and coding: Urodynamic services - non-invasive (A58543)

October 29, 2020

The following proposed LCDs have been posted for comments. The comment period will end on December 12, 2020; however, you are encouraged to submit your comments as soon as possible.
Cardiology non-emergent outpatient stress testing (DL38396)
Facet joint interventions for pain management (DL33930)
Submit comments
The following draft billing and coding articles are related to the above proposed LCDs.
Billing and coding: Cardiology non-emergent outpatient stress testing (DA56952)
Billing and coding: Facet joint interventions for pain management (DA57787)
The following LCDs have been revised.
Diagnostic colonoscopy (L33671)
Vitamin D; 25 hydroxy, includes fraction(s), if performed (L33771)
The following billing and coding article has been revised:
Billing and coding: Molecular pathology procedures (A57451)
As a reminder, the comment period for the following proposed LCDs is currently open and will close on November 7, 2020. We encourage you to submit your comments as soon as possible
Blepharoplasty and surgical procedures of the brow (DL34028)
Botulinum toxins (DL33274)
Diagnostic colonoscopy (DL33671)
Submit comments

October 15, 2020

The following local coverage determination (LCD) has been revised:
Treatment of varicose veins of the lower extremity (L33762)

October 14, 2020

The following LCD which was posted for notice on August 27 became effective October 11. The companion article for this LCD is also now effective:
Implantable continuous glucose monitors (I-CGM) (L38664)
Billing and coding: implantable continuous glucose monitors (I-CGM) (A58136)
The comment period is now closed for the following proposed local coverage determination. Comments received will be reviewed by our contractor medical directors. The response to comments and finalized billing and coding articles will be in the associated documents section of the final LCD when it is posted for notice.
Colon capsule endoscopy (DL38805)
Billing and coding: Colon capsule endoscopy (da58410)

October 1, 2020

The following billing and coding articles have been revised to reflect the annual ICD-10-CM code update effective for dates of service on and after October 1, 2020.
Allergy testing (A57531)
Bisphosphonates (intravenous [IV]) and monoclonal antibodies in the treatment of osteoporosis and their other indications (a57603)
Cardiology non-emergent outpatient stress testing (A56952)
Computerized corneal topography (A57699)
Controlled substance monitoring and drugs of abuse testing (A57077)
Cystatin C measurement (A57682)
Diagnostic aerosol or vapor inhalation (A57058)
Diagnostic and therapeutic esophagogastroduodenoscopy (A57063)
Diagnostic colonoscopy (A55937)
Duplex scanning (A57636)
Electrocardiography (A57066)
Erythropoiesis stimulating agents (A57628)
Flow cytometry (A57716)
Hepatic (liver) function panel (A57802)
Hypoglossal nerve stimulation for the treatment of obstructive sleep apnea (A56953)
Incision and drainage of abscess of skin, subcutaneous and accessory structures (a57783)
Infliximab (A57653)
Intravenous immune globulin (A57778)
Ionized calcium (A57120)
Magnesium (A57121)
Nerve conduction studies and electromyography (A57123)
Noninvasive physiologic studies of upper or lower extremity arteries (A57126)
Parathormone (parathyroid hormone) (A57122)
Paravertebral facet joint blocks (A57787)
Peripheral nerve blocks (A57788)
Psychiatric diagnostic evaluation and psychotherapy services (A57520)
Psychological and neuropsychological tests (A57780)
Pulmonary diagnostic services (A57127
Routine foot care (A57188)
Scanning computerized ophthalmic diagnostic imaging (SCODI) (A57804)
Sedimentation rate, erythrocyte (A57657)
Serum phosphorus (A57650)
Somatosensory testing (A57540)
Special EEG tests (A57667)
Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) (A57275)
Surgical management of morbid obesity (A57145)
Therapy and rehabilitation services (a57156)
Visual field examination (a57637)
Vitamin D; 25 hydroxy, includes fraction(s), if performed (A56841)
The following LCD and related billing and coding article have been retired:
Chiropractic services (L36617)
Chiropractic services (A57681)
The following billing and coding article that was published on August 27, 2020, is now effective:
Chiropractic services (a58412)
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.