Update history: LCD and article updates

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)

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December 19

The following LCD and related billing and coding article has been retired:

• Intensity Modulated Radiation Therapy (IMRT) (L36773)
  • Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746) 

December 2

The following LCD which was posted for notice on October 17 became effective on December 1. The related billing and coding article for this LCD is also now effective:

• Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (L39877)
  • Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764)

November 25

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.

• Botulinum Toxins (DL33274) 

November 21

The following article has been revised and will become effective December 1:

• Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764) 

November 14

The following LCD, which was posted for comment on April 25, has been posted for notice. The LCD and related billing and coding article will become effective February 12, 2025.

• 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) 

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 Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (A59824) 

The following article has been revised:

• Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services (A57520) 

As a reminder, the comment period for the following proposed LCD is currently open and will close on November 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.

• Botulinum Toxins (DL33274) 

November 7

The following billing and coding articles have been revised.

• Billing and Coding: Cervical Fusion (A59674)
• Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807) 

October 31

The following article has been revised: 

• Self-Administered Drug Exclusion List (A52571) 

October 24

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: Allergy Testing (A57531)
• Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
• Billing and Coding: Cosmetic and Reconstructive Surgery (A58573)
• Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
• Billing and Coding: Diagnostic Colonoscopy (A55937)
• Billing and Coding: Electroretinography (ERG) (A57677)
• Billing and Coding: Genetic Testing for Lynch Syndrome (A57450)
• Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
• Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
• Billing and Coding: Peripheral Nerve Blocks (A57788)
• Billing and Coding: Peripheral Venous Ultrasound (A57125)
• 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: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (A57804)
• Billing and Coding: Sedimentation Rate, Erythrocyte (A57657)
• Billing and Coding: Surgical Management of Morbid Obesity (A57145)
• Billing and Coding: Transesophageal Echocardiogram (A57179)
• Billing and Coding: Visual Field Examination (A57637) 

The following billing and coding article has been revised.

• Billing and Coding: Molecular Pathology and Genetic Testing (A58918) 

October 17

The following LCD which was posted for comment on June 6, has been posted for notice. The LCD and related billing and coding article will become effective December 1. 

• Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (L39877)
  • Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59764) 

The following response to comments article contains summaries of all comments received and First Coast’s responses.

• Response to Comments:  Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (A59893) 

The following billing and coding article has been revised.

• Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (A54926) external.gif

October 14

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.

• Transurethral Waterjet Ablation of the Prostate (DL38726) 

October 10

The following proposed LCD has been posted for comment. The comment period will end on November 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 consideration. When submitting literature, you MUST submit the full-text article(s).

• Botulinum Toxins (DL33274)
  • Billing and Coding: Botulinum Toxins (DA57715) 

October 3

As a reminder, the comment period for the following proposed LCD is currently open and will close on October 12. Please consider including literature / evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.

• Transurethral Waterjet Ablation of the Prostate (DL38726) 

The following billing and coding article has been revised:

• Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring (A59270) 

October 1

The First Coast medical policy team has evaluated all active local coverage articles for any impact in response to the 2025 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: Allergy Testing (A57531)
• Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (A57077)
• Billing and Coding: Cosmetic and Reconstructive Surgery (A58573)
• Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy (A57063)
• Billing and Coding: Diagnostic Colonoscopy (A55937)
• Billing and Coding: Electroretinography (ERG) (A57677)
• Billing and Coding: Genetic Testing for Lynch Syndrome (A57450)
• Billing and Coding: Intensity Modulated Radiation Therapy (IMRT) (A56746)
• Billing and Coding: Nerve Conduction Studies and Electromyography (A57123)
• Billing and Coding: Peripheral Nerve Blocks (A57788)
• Billing and Coding: Peripheral Venous Ultrasound (A57125)
• 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: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) (A57804)
• Billing and Coding: Sedimentation Rate, Erythrocyte (A57657)
• Billing and Coding: Surgical Management of Morbid Obesity (A57145)
• Billing and Coding: Transesophageal Echocardiogram (A57179)
• Billing and Coding: Visual Field Examination (A57637)

September 26

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

• Trastuzumab - Trastuzumab Biologics (L34026)
  • Billing and Coding:  Trastuzumab - Trastuzumab Biologics (A56660) 

September 19

The following billing and coding articles have been revised:

• Billing and Coding: Duplex Scan of Lower Extremities (A57064)
• Billing and Coding: Esketamine (A59250)
• Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
• Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807) 

September 3

The following article which was posted for notice on July 18, became effective on September 1:

• Self-Administered Drug Exclusion List (A52571)

August 29

The following proposed LCD has been posted for comment. The comment period will end on October 12; 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).

• Transurethral Waterjet Ablation of the Prostate (DL38726) 

August 22

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

• Electrocardiography (L33669)
  • Billing and Coding: Electrocardiography (A57066) 

August 12

The following LCDs and related billing and coding articles which were posted for notice on June 27 became effective August 11:

• Cervical Fusion (L39799)
  • Billing and Coding: Cervical Fusion (A59674)
• Facet Joint Interventions for Pain Management (L33930)
  • Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
• Implantable Continuous Glucose Monitors (I-CGM) (L38664)
  • Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136) 

August 1

The following article has been revised:

• Billing and Coding: Allergy Testing (A57531) 

July 26

First Coast is considering all the feedback received from interested parties regarding the Genetic Testing for Oncology LCD. An extension has been granted by CMS in order for all comments to be considered thoroughly. Future updates will be published to this website and the Medicare Coverage Database. Please watch our website and consider subscribing to our mailing list for the most timely updates: Subscribe to our mailing list.

July 25

The following article has been revised:

• Billing and Coding: Somatosensory Testing (A57540) 

July 22

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.

• Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (DL39877) 

July 18

The following Billing and Coding articles have been revised to reflect the July 2024 CPT/HCPCS Code Quarterly updates effective for dates of service on and after July 1:

• Billing and Coding: Allergy Testing (A57531)
• 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) 

The following Article has been revised to reflect the July 2024 CPT/HCPCS Code Quarterly updates and will become effective September 1:

• Self-Administered Drug Exclusion List: (A52571) 

The comment period for the following proposed LCD will close on July 20. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.

• Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (DL39877) 

July 1

The following article which was posted for notice on May 16 became effective on June 30.

• Self-Administered Drug Exclusion List (A52571) 

June 27

The following LCDs which were posted for comment on February 15, have been posted for notice. The LCDs and related billing and coding articles will become effective August 11. The following response to comments articles contain summaries of all comments received and First Coast’s responses.

• Cervical Fusion (L39799)
  • Billing and Coding: Cervical Fusion (A59674)
    • Response to Comments: Cervical Fusion (A59803)
• Facet Joint Interventions for Pain Management (L33930)
  • Billing and Coding: Facet Joint Interventions for Pain Management (A57787)
    • Response to Comments: Facet Joint Interventions for Pain Management (A59829)
• Implantable Continuous Glucose Monitors (I-CGM) (L38664)
  • Billing and Coding: Implantable Continuous Glucose Monitors (I-CGM) (A58136)
    • Response to Comments: Implantable Continuous Glucose Monitors (I-CGM) (A59833) 

The comment period for Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non Wound (DL39877) is currently open and will close on July 20.

If you already submitted comments for this proposed LCD and did not receive an acknowledgement, please re-submit them so that we can make sure they are taken into consideration.  

Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.

June 20

The following article has been revised:

• Billing and Coding: Surgical Treatment of Nails (A57666) 

June 13

The following article has been revised:

• Billing and Coding: Surgical Treatment of Nails (A57666) 

June 10

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.

• Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377) 

June 6

The following proposed LCD has been posted for comment. The comment period will end on July 20; 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).

• Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (DL39877)
  • Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (DA59764)

The comment period for the following proposed LCD will close on June 8. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.

• Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377) 

The following billing and coding article has been revised:

• Billing and Coding: 4Kscore Test Algorithm (A56287) 

May 30

As a reminder, the comment period for the following proposed LCD is currently open and will close on June 8. Please consider including literature / evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.

Skin Substitute Grafts / Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377) 

May 23

The following article has been revised:

• Billing and Coding: Aortography and Peripheral Angiography (A57056) 

The following LCD and related article have been retired:

• Computerized Corneal Topography (L33810)
  • Billing and Coding: Computerized Corneal Topography (A57699) 

As a reminder, the comment period for the following proposed LCD is currently open and will close on June 8. Please consider including literature/evidence in support of your request with your comments. We encourage you to submit your comments as soon as possible.

• Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377) 

May 16

The following billing and coding article has been revised:

• Billing and Coding: Polysomnography and Sleep Testing (A57496) 

The following Article has been revised and will become effective June 30:

• Self-Administered Drug Exclusion List (A52571) 

April 25

The following proposed LCD has been posted for comment. The comment period will end on June 8; 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).

• Skin Substitute Grafts / Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers (DL36377)
  • Billing and Coding: Skin Substitute Grafts / Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers (DA57680) 

The following billing and coding article has been revised:

• Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807) 

April 11

The following billing and coding articles have been revised:

• Billing and Coding: Major Joint Replacement (Hip and Knee) (A57765)
• Billing and Coding: Transesophageal Echocardiogram (A57179) 

April 4

The following billing and coding articles have been revised:

• Billing and Coding: Allergy Testing (A57531)
• Billing and Coding: Botulinum Toxins (A57715)
• Billing and Coding: Independent Diagnostic Testing Facility (IDTF) (A57807)
• Billing and Coding: Molecular Pathology and Genetic Testing (A58918)
• Billing and Coding: Vitamin B12 Injections (A57755) 

April 1

The following Local Coverage Determination (LCD) which was posted for notice on February 15 became effective on March 31.

• Allergen Immunotherapy (L37800) 

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.

• Cervical Fusion (DL39799)
• Facet Joint Interventions for Pain Management (DL33930)
• Implantable Continuous Glucose Monitors (I-CGM) (DL38664) 

March 28

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

• Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions (L33382)
  • Billing and Coding: Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions (A57654) 

March 18

The following article which was posted for notice on February 1 is now effective:

• Self-Administered Drug Exclusion List (A52571) 

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) 

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) 

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) 

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)

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