Update history: LCD and article updates
2026
July 9
The following proposed LCD has been posted for comment. The comment period will end on August 22; however, you are encouraged to submit your comments as soon as possible. All comments submitted during the open comment period will be considered during finalization of the LCD. To facilitate an efficient and focused review process, commenters are encouraged to limit their submissions to issues, concerns, or recommendations directly related to the proposed revisions. Comments regarding portions of the LCD that are unchanged or otherwise unaffected by the current revision are outside the scope of this reconsideration. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations. Literature submissions must be in the form of full-text articles.
June 29
The comment period is now closed for the proposed LCD listed below. Comments received during the open comment period 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.
June 25
The following billing and coding article has been revised:
June 18
As a reminder, the comment period for the following proposed LCD is currently open and will close on June 27. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
- Urine-based Biomarkers in Patients with Microhematuria (DL40380)
Submit Comments
June 15
The following article, which was posted for notice on April 30, is now effective:
- Self-Administered Drug Exclusion List (A52571) – Effective for dates of service on and after June 15
May 18
The following LCD and related billing and coding article, which were posted for notice on April 2, are now effective:
- Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (L40289) – Effective for dates of service on and after May 17
- Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (A60318) – Effective for dates of service on and after May 17
May 14
The following proposed LCD has been posted for comment. The comment period will end on June 27; however, you are encouraged to submit your comments as soon as possible. All comments submitted during the open comment period will be considered during finalization of the LCD. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations. Literature submissions must be in the form of full-text articles.
- Urine-based Biomarkers in Patients with Microhematuria (DL40380)
- Billing and Coding: Urine-based Biomarkers in Patients with Microhematuria (DA60426)
Submit Comments
The following LCD and related billing and coding article have been retired effective for dates of service on and after May 17:
- Duplex Scan of Lower Extremity Arteries (L33667)
- Billing and Coding: Duplex Scan of Lower Extremity Arteries (A57064)
April 30
The following billing and coding articles have been revised to reflect the April 2026 CPT/HCPCS Code Quarterly updates:
- Billing and Coding: Immune Globulin (A57778) – Effective for dates of service on and after April 1
- Billing and Coding: Molecular Pathology and Genetic Testing (A58918) - Effective for dates of service on and after April 1
The following article has been revised:
- Self-Administered Drug Exclusion List (A52571) – Effective for dates of service on and after June 15
April 9
The following LCD has been revised:
- Epidural Steroid Injection for Pain Management (L33906)
The following billing and coding articles have been revised:
- Billing and Coding: Diagnostic Colonoscopy (A55937)
- Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
April 6
The comment period is now closed for the proposed LCD listed below. Comments received during the open comment period 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.
- Trigger Point Injections (DL33912)
April 2
The following LCD, which was posted for comment on September 11, 2025, has been posted for notice. The LCD and related billing and coding article will become effective May 17.
- Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (L40289)
- Billing and Coding: Non-Invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (A60318)
The following response to comments article contains summaries of all comments received and First Coast’s responses.
- Response to Comments: Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (A60342)
March 30
As a reminder, the comment period for the following proposed LCD is currently open and will close on April 4. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
- Trigger Point Injections (DL33912)
Submit Comments
March 5
The following billing and coding article has been revised:
- Billing and Coding: Immune Globulin (A56786)
February 26
The following billing and coding article has been revised:
- Billing and Coding: Transesophageal Echocardiogram (A57179)
February 19
The following proposed LCD has been posted for comment. The comment period will end on April 4; however, you are encouraged to submit your comments as soon as possible. All comments submitted during the open comment period will be considered during finalization of the LCD. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations. Literature submissions must be in the form of full-text articles.
- Trigger Point Injections (DL33912)
- Billing and Coding: Trigger Point Injections (DA57114)
Submit Comments
February 12
The following billing and coding articles have been revised:
- Billing and Coding: Cosmetic and Reconstructive Surgery (A58573) – Effective for dates of service on and after November 17, 2025
- Billing and Coding: Non-invasive Extracranial Arterial Studies (A57670) – Effective for dates of service on and after December 1, 2025
February 5
The following billing and coding article has been revised:
- Billing and Coding: Duplex Scan of Lower Extremity Arteries (A57064) – Effective for dates of service on and after December 1, 2025
January 29
The following articles have been revised to reflect the 2026 annual HCPCS/CPT code updates effective for dates of service on and after January 1:
- Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764)
- Billing and Coding: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities (A57680)
- Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
- Billing and Coding: Immune Globulin (A57778)
- Billing and Coding: Injection of Trigger Points (A57114)
- Billing and Coding: Major Joint Replacement (Hip and Knee) (A57765)
- Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
- Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation (A57115)
- Billing and Coding: Pharmacogenomics Testing (A58812)
- Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
- Billing and Coding: Surgical Management of Morbid Obesity (A57145)
- Billing and Coding: Surgical Treatment of Nails (A57666)
- 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: Wound Care (A55818)
- Self-Administered Drug Exclusion List (A52571)
January 2, 2026
The First Coast medical policy team has evaluated all active local coverage articles for any impact in response to the 2026 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 later this month. Please continue to watch our website for updates.
- Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764)
- Billing and Coding: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities (A57680)
- Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing (A56952)
- Billing and Coding: Immune Globulin (A57778)
- Billing and Coding: Injection of Trigger Points (A57114)
- Billing and Coding: Major Joint Replacement (Hip and Knee) (A57765)
- Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
- Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation (A57115)
- Billing and Coding: Pharmacogenomics Testing (A58812)
- Billing and Coding: Respiratory Pathogen Panel Testing (A58577)
- Billing and Coding: Surgical Management of Morbid Obesity (A57145)
- Billing and Coding: Surgical Treatment of Nails (A57666)
- 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: Wound Care (A55818)
- Self-Administered Drug Exclusion List (A52571)
2025
December 29
The following billing and coding article has been retired:
- Billing and Coding: Urodynamic Services – Non-invasive (A58543) – Retired effective for dates of service on and after December 25
December 18
The following billing and coding article has been retired:
- Billing and Coding: Esketamine (A59250) - Retired effective for dates of service on and after December 18
The following LCD and related billing and coding article have been retired:
- Hepatic (Liver) Function Panel (L33907) - Retired effective for dates of service on and after December 18
- Billing and Coding: Hepatic (Liver) Function Panel (A57802) - Retired effective for dates of service on and after December 18
The following billing and coding articles have been revised:
- Billing and Coding: Parathormone (Parathyroid Hormone) (A57122) – Effective for dates of service on and after September 15
- Billing and Coding: Peripheral Nerve Blocks (A57788) – Effective for dates of service on and after October 30
December 11
The following billing and coding article has been retired:
- Billing and Coding: Screening for Cervical Cancer with Human Papillomavirus (HPV) (A58232) - Retired effective for dates of service on and after December 11
The following billing and coding article has been revised:
- Billing and Coding: Botulinum Toxins (A57715) - Effective for dates of service on and after November 9
December 4
The following billing and coding articles have been retired:
- Billing and Coding: Hemophilia Factor Products (A56482) – Retired effective for dates of service on and after December 4
- Billing and Coding: Treatment of Abnormal Uterine Bleeding with Intrauterine Device (Hormone-Eluting) (A59619) – Retired effective for dates of service on and after December 4
The following billing and coding article has been revised:
- Billing and Coding: Allergy Testing (A57531) - Effective for dates of service on and after October 7
November 20
The following billing and coding article has been retired:
- Billing and Coding: Approved Drugs and Biologicals; Includes Cancer Chemotherapeutic Agents (A59576) – Retired effective for dates of service on and after November 20
November 13
The following billing and coding articles have been retired.
- Billing and Coding: Chiropractic Services (A58412) – Retired effective for dates of service on and after November 13
- Billing and Coding: eVox System and other Electroencephalograph Testing for Memory Loss (A59086) – Retired effective for dates of service on and after November 13
November 10
The following LCD and related billing and coding article which were posted for notice on September 25 are now effective:
- Botulinum Toxins (L33274) – Effective for dates of service on and after November 9
- Billing and Coding: Botulinum Toxins (A57715) – Effective for dates of service on and after November 9
October 30
The following billing and coding article has been retired:
- Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)– Retired effective for dates of service on and after October 30
The following billing and coding article has been revised:
- Billing and Coding: Immune Globulin (A57778) – Effective for dates of service on and after October 30
October 27
The comment period is now closed for the proposed LCD listed below. Comments received during the open comment period 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.
- Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (DL40289)
October 16
The following billing and coding articles have been revised:
- Billing and Coding: Hemophilia Factor Products (A56482) – Effective for dates of service on and after 10/01/2025
- Billing and Coding: Molecular Pathology and Genetic Testing (A58918) – Effective for dates of service on and after 10/01/2025
As a reminder, the comment period for the following proposed LCD is currently open and will close on October 25. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
- Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (DL40289)
Submit Comments
October 9
The following billing and coding article has been revised:
- Billing and Coding: Aortography and Peripheral Angiography (A57056) - effective for dates of service on and after August 19
As a reminder, the comment period for the following proposed LCD is currently open and will close on October 25. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.
- Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (DL40289)
Submit Comments
October 2
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: Allergen Immunotherapy (A57678)
- Billing and Coding: Allergy Testing (A57531)
- Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764)
- Billing and Coding: BRCA1 and BRCA2 Genetic Testing (A57449)
- Billing and Coding: Cataract Extraction (including Complex Cataract Surgery) (A58592)
- Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
- Billing and Coding: Diagnostic Colonoscopy (A55937)
- Billing and Coding: Duplex Scanning (A57636)
- Billing and Coding: Endovenous Stenting (A56644)
- Billing and Coding: Genetic Testing for Lynch Syndrome (A57450)
- Billing and Coding: Hepatic (Liver) Function Panel (A57802)
- Billing and Coding: Immune Globulin (A57778)
- Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
- Billing and Coding: Parathormone (Parathyroid Hormone) (A57122)
- Billing and Coding: Peripheral Nerve Block (A57788)
- Billing and Coding: Pharmacogenomics Testing (A58812)
- Billing and Coding: Proton Beam Radiotherapy (A57669)
- Billing and Coding: Psychological and Neuropsychological Tests (A57780)
- Billing and Coding: Routine Foot Care (A57188)
- Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (A57804)
- Billing and Coding: Somatosensory Testing (A57540)
- Billing and Coding: Surgical Management of Morbid Obesity (A57145)
- Billing and Coding: Tetanus Immunization (A58873)
- Billing and Coding: Visual Field Examination (A57637)
September 25
The following LCD which was posted for comment on October 10, 2024, has been posted for notice. The LCD and related billing and coding article will become effective November 9.
- Botulinum Toxins (L33274)
- Billing and Coding: Botulinum Toxins (A57715)
The following response to comments article contains summaries of all comments received and First Coast’s responses.
- Response to Comments: Botulinum Toxins (A60162)
The following billing and coding article has been revised:
- Billing and Coding: Independent Diagnostic Testing Facility (A57807) - effective for dates of service on and after April 29, 2025.
September 11
The following proposed LCD has been posted for comment. The comment period will end on October 25; however, you are encouraged to submit your comments as soon as possible. All comments submitted during the open comment period will be considered during finalization of the LCD. When submitting your comments, we encourage you to submit literature/evidence supporting your recommendations. Literature submissions must be in the form of full-text articles.
- Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (DL40289)
- Billing and Coding: Non-invasive Arterial Duplex Ultrasound of the Upper and Lower Extremities (DA60318)
September 2
The following article, which was posted for notice on July 17, is now effective:
- Self-Administered Drug Exclusion List (A52571) – Effective for dates of service on and after August 31
July 17
The following billing and coding articles have been revised to reflect the July 2025 CPT/HCPCS Code Quarterly updates:
- Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) (A56638) - Effective for dates of service on and after July 1
- Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807) - Effective for dates of service on and after July 1
- Billing and Coding: Molecular Pathology and Genetic Testing (A58918) - Effective for dates of service on and after July 1
- Billing and Coding: Respiratory Pathogen Panel Testing (A58577) - Effective for dates of service on and after July 1
The following article has been revised to reflect the July 2025 CPT/HCPCS Code Quarterly updates:
- Self-Administered Drug Exclusion List: (A52571) – Effective for dates on and after August 31
July 3
The following billing and coding article has been revised:
- Billing and Coding: Aortography and Peripheral Angiography (A57056) – Effective for dates of service on and after May 19
June 26
The following LCD and related billing and coding article have been retired:
- Ionized Calcium (L34011) – Retired effective for dates of service on and after June 26
- Billing and Coding: Ionized Calcium (A57120) – Retired effective for dates of service on and after June 26
June 2
The following article, which was posted for notice on April 17, is now effective:
- Self-Administered Drug Exclusion List (A52571) – Effective for dates of service on and after June 1
May 15
The following billing and coding article has been revised:
- Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (A54926) – Effective for dates of service on and after February 10
April 25
The following items which were posted for notice on January 9 are now effective:
- Genetic Testing in Oncology: Specific Tests (L39367) – Effective for dates of service on and after April 24
- Billing and Coding: Genetic Testing in Oncology: Specific Tests (A59123) – Effective for dates of service on and after April 24
April 17
The following articles have been revised:
- Billing and Coding: Amniotic and Placental Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764) – Effective for dates of service on and after April 1
- Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136) – Effective for dates of service on and after April 1
- Billing and Coding: Independent Diagnostic Testing Facility (A57807) – Effective for dates of service on and after April 1
- Self-Administered Drug Exclusion List (A52571) – Effective for dates of service on and after June 1
The following LCDs and billing and coding articles have retired:
- Diagnostic Aerosol or Vapor Inhalation (L33969) – Retired effective for dates of service on and after April 10
- Billing and Coding: Diagnostic Aerosol or Vapor Inhalation (A57058) – Retired effective for dates of service and after April 10
- High Sensitivity C-Reactive Protein (hsCRP) (L33908) – Retired effective for dates of service on and after April 10
- Billing and Coding: High Sensitivity C-Reactive Protein (hsCRP) (A57803) – Retired effective for dates of service on and after April 10
April 15
The following articles revised on April 10, are now displaying on the Medicare Coverage Database (MCD) and our website:
- Billing and Coding: Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor (A57884)
- Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
The effective date for the following LCD, related Billing and Coding Article, and Response to Comments Article has changed to January 1, 2026.
- Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (L36377)
- Billing and Coding: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A57680)
- Response to Comments: Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A59824)
April 7
The following LCD which was posted for notice on February 20 became effective on April 6.
- Transurethral Waterjet Ablation of the Prostate (L38726)
March 20
The following LCDs have been revised:
- BRCA1 and BRCA2 Genetic Testing (L36499)
- Cardiology Non-emergent Outpatient Stress Testing (L38396)
- Cystatin C Measurement (L37561)
- High Sensitivity C-Reactive Protein (hsCRP) (L33908)
- Platelet Rich Plasma (L39071)
- Surgical Treatment of Nails (L33833)
March 17
The following article which was posted for notice became effective on March 16:
- Self-Administered Drug Exclusion List (A52571)
February 20
The following LCD, which was posted for comment on August 29, 2024, has been posted for notice. The LCD will become effective April 6.
- Transurethral Waterjet Ablation of the Prostate (L38726)
The following response to comments article contains summaries of all comments received and First Coast’s responses.
- Response to Comments: Transurethral Waterjet Ablation of the Prostate (A59932)
February 3
Please note: We have become aware that the CPT/HCPCS codes may not be appearing on the articles below. We are working to resolve the issue.
The following articles have been revised to reflect the 2025 annual CPT/HCPCS code updates effective for dates of service on and after January 1:
- Billing and Coding: Allergy Testing (A57531)
- Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
- Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow (A57025)
- Billing and Coding: BRCA1 and BRCA2 Genetic Testing (A57449)
- Billing and Coding: Cosmetic and Reconstructive Surgery (A58573)
- Billing and Coding: Genetic Testing for Cardiovascular Disease (A58797)
- Billing and Coding: Immune Globulin (A57778)
- Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136)
- Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
- Billing and Coding: Magnetic Resonance Angiography (MRA) (A57779)
- Billing and Coding: Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor (A57884)
- Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
- 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: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (A57804)
- Billing and Coding: Transcranial Doppler Studies (A57633)
- Billing and Coding: Treatment of Chronic Venous Insufficiency of the Lower Extremities (A58250)
- Billing and Coding: Wound Care (A55818)
The following article has been revised and will become effective March 16:
- Self-Administered Drug Exclusion List (A52571)
The following billing and coding article has also been revised:
- Billing and Coding: Cervical Fusion (A59674)
January 9
The following LCD, which was posted for comment on July 27, 2023, has been posted for notice. The LCD and related billing and coding article will become effective February 23.
- Genetic Testing in Oncology: Specific Tests (L39367)
- Billing and Coding: Genetic Testing in Oncology: Specific Tests (A59123)
The following response to comments article contains summaries of all comments received and First Coast’s responses.
- Response to Comments: Genetic Testing in Oncology: Specific Tests (A59967)
The following LCD has been revised.
- Cervical Fusion (L39799)
January 3, 2025
The First Coast medical policy team has evaluated all active local coverage articles for any impact in response to the 2025 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 later this month. Please continue to watch our website for updates.
- Billing and Coding: Allergy Testing (A57531)
- Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270)
- Billing and Coding: Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow (A57025)
- Billing and Coding: BRCA1 and BRCA2 Genetic Testing (A57449)
- Billing and Coding: Cosmetic and Reconstructive Surgery (A58573)
- Billing and Coding: Genetic Testing for Cardiovascular Disease (A58797)
- Billing and Coding: Immune Globulin (A57778)
- Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136)
- Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
- Billing and Coding: Magnetic Resonance Angiography (MRA) (A57779)
- Billing and Coding: Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor (A57884)
- Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
- 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: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (A57804)
- Billing and Coding: Transcranial Doppler Studies (A57633)
- Billing and Coding: Treatment of Chronic Venous Insufficiency of the Lower Extremities (A58250)
- Billing and Coding: Wound Care (A55818)
- Self-Administered Drug Exclusion List (A52571)