Medicare Administrative Contractor (MAC)
| Local Coverage Determinations (LCD) and Policy Articles
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CGS Administrators, LLC (CGS)
| - L34045 Non-Invasive Vascular Studies, updated on 11/02/2023 [1]
- A56697 Billing and Coding: Non-Invasive Vascular Studies, updated on 08/29/2024 [2]
- L34049 Outpatient Physical and Occupational Therapy Services, updated on 06/06/2024 [3]
- A57067 Billing and Coding: Outpatient Physical and Occupational Therapy Services, updated on 11/22/2023 [4]
- L36690 Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities, updated on 09/01/2022 [5]
- A56696 Billing and Coding: Wound Application of Cellular and/or Tissue Based Products (CTPs), Lower Extremities, updated on 12/28/2023 [6]
- A55276 Response to Comments: Wound Application of Cellular and/or Tissue Based products (CTPs), Lower Extremities [7]
- L34032 Debridement Services, updated on 10/03/2024 [8]
- A56459 Billing and Coding for Debridement Services, updated on 10/03/2024 [9]
- L33942 Physical Therapy - Home Health, updated on 06/27/2024 [10]
- A57311 Billing and Coding: Physical Therapy - Home Health, updated on 06/27/2024 [11]
- L33830 Pressure Reducing Support Surfaces - Group 1 [12]
- A52489 Pressure Reducing Support Surfaces - Group 1 - Policy Article [13]
- L33642 Pressure Reducing Support Surfaces - Group 2 [14]
- A52490 Pressure Reducing Support Surfaces - Group 2 - Policy Article [15]
- L33692 Pressure Reducing Support Surfaces - Group 3 [16]
- A52468 Local Coverage Article: Pressure Reducing Support Surfaces - Group 3 - Policy Article [17]
- L33829 Pneumatic Compression Devices, updated on 10/22/2023 [18]
- A52488 Pneumatic Compression Devices - Policy Article, updated on 10/22/2023 [19]
- A59219 Response to Comments: Pneumatic Compression Devices - DL33829 [20]
- L33821 Negative Pressure Wound Therapy Pumps, updated on 01/01/2024 [21]
- A52511 Negative Pressure Wound Therapy Pumps - Policy Article [22]
- L33831 Local Coverage Determination for Surgical Dressings, updated on 01/01/2024 [23]
- A54563 Surgical Dressings - Policy Article, updated on 01/01/2024 [24]
- A56175 Low frequency, non-contact, non-thermal ultrasound (CPT code 97610), updated on 03/07/2024 [25]
- A55426 Standard Documentation Requirements for All Claims Submitted to DME MACs, updated on 01/01/2024 [26]
- L34246 Routine Foot Care and Debridement of Nails, updated on 08/08/2024 [74]
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First Coast Service Options, Inc. (FCSO)
| - L37166 Wound Care [27]
- A55818 Billing and Coding: Wound Care, updated on 01/01/2024 [28]
- A55757 Wound care (L37166): Medicare Part A/B local coverage determination (LCD) comment summary [29]
- L36377 Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities [30]
- A57680 Billing and Coding: Application of Skin Substitute Grafts for Treatment of DFU and VLU of Lower Extremities [31]
- L33667 Duplex Scan Of Lower Extremity Arteries [32]
- L33693 Non-Invasive Evaluation of Extremity Veins, updated on 01/28/2024 [33]
- L33696 Noninvasive Physiologic Studies of Upper or Lower Extremity Arteries [34] - RETIRED
- A58810 Billing and Coding: Platelet Rich Plasma, updated on 07/01/2023 [76]
- L38720 Local Coverage Determination (LCD) Treatment of Chronic Venous Insufficiency of the Lower Extremities [35]
- L39071 Platelet Rich Plasma [77]
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National Government Services, Inc. (NGS)
| - L33563 Incision and Drainage (I & D) of Abscess of Skin, Subcutaneous and Accessory Structures [36]
- L33614 Debridement Services [37]
- A56617 Billing and Coding: Debridement Services, updated on 01/01/2024 [38]
- L33627 Non-Invasive Vascular Studies [39]
- L33631 Outpatient Physical and Occupational Therapy Services [40]
- A56566 Billing and Coding: Outpatient Physical and Occupational Therapy Services, updated on 01/01/2024 [41]
- A57759 Billing and Coding: Routine Foot Care and Debridement of Nail, updated on 08/22/2024 [42]
- L38937 Platelet Rich Plasma [78]
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Noridian
| - A53046 Wound Care and Debridement - Provided by a Therapist, Physician, NPP, or as Incident-to Service, updated on 01/01/2024 [43]
- A53296 Wound Care & Debridement – Provided by a Therapist, Physician, NPP or as Incident-to Services, updated on 01/01/2024 [44]
- A52959 Billing and Coding: Lymphedema Decongestive Treatment [45]
- A55710 Lymphedema Decongestive Treatment [46]
- A52918 Coverage of Foot Care Services [47]
- L33821 Negative Pressure Wound Therapy Pumps, updated on 01/01/2024 [ [21]
- A52511 Negative Pressure Wound Therapy Pumps - Policy Article, updated on 08/15/2021 [22]
- L33830 Pressure Reducing Support Surfaces - Group 1 [12]
- A52489 Pressure Reducing Support Surfaces - Group 1 - Policy Article [13]
- L33642 Pressure Reducing Support Surfaces - Group 2 [14]
- A52490 Pressure Reducing Support Surfaces - Group 2 - Policy Article [15]
- L33692 Pressure Reducing Support Surfaces - Group 3 [16]
- A52468 Pressure Reducing Support Surfaces - Group 3 - Policy Article [17]
- L33829 Pneumatic Compression Devices, updated on 10/22/2023 [18]
- A52488 Pneumatic Compression Devices - Policy Article, updated on 10/22/2023 [19]
- L33831 Local Coverage Determination for Surgical Dressings, updated on 01/01/2024 [23]
- A59219 Response to Comments: Pneumatic Compression Devices - DL33829 [20]
- A54710 Response to Comments: Treatment of Varicose Veins of Lower Extremities [48]
- A54713 Response to Comments: Treatment of Varicose Veins of Lower Extremities [49]
- A54714 Response to Comments: Treatment of Varicose Veins of Lower Extremities [50]
- A54715 Response to Comments: Treatment of Varicose Veins of Lower Extremities [51]
- A54563 Surgical Dressings - Policy Article, updated on 01/01/2024 [24]
- A58565 Billing and Coding: Wound and Ulcer Care, updated on 10/01/2024 [79]
- A58567 Billing and Coding: Wound and Ulcer Care, updated on 10/01/2024 [80]
- A58903 Response to Comments: Wound and Ulcer Care [81]
- A58904 Response to Comments: Wound and Ulcer Care [82]
- L38902 Wound and Ulcer Care [83]
- L38904 Wound and Ulcer Care [84]
- A57957 Billing and Coding: Routine Foot Care, updated on 01/01/2024 [88]
- L35163 Plastic Surgery [89]
- A55932 Billing and Coding: JW and JZ Modifier Billing Guidelines [52]
- A53024 Billing and Coding: JW and JZ Modifier Billing Guidelines [53]
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Novitas Solutions, Inc.
| - L35125 Wound Care [54]
- A53001 Billing and Coding: Wound Care, updated on 01/01/2024 [55]
- L35041 Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds [56]
- A54117 Billing and Coding: Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds [57]
- A59517 Response to Comments: Skin Substitute Grafts/Cellular and/or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers, effective on 08/03/2023.[58]
- A58808 Billing and Coding: Platelet Rich Plasma [90]
- L39068 Platelet Rich Plasma [92]
- L34924 Local Coverage Determination (LCD) Treatment of Chronic Venous Insufficiency of the Lower Extremities [59]
- L34938 Removal of Benign Skin Lesions [93]
- L34887 Surgical Treatment of Nails [94]
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Palmetto | - L34428 Outpatient Physical Therapy [60]
- L34427 Outpatient Occupational Therapy [61]
- A53057 Billing and Coding: Home Health Occupational Therapy, updated on 10/01/2024 [62]
- A56731 Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy, updated on 01/01/2024 [63]
- A53065 Billing and Coding: Outpatient Physical Therapy, updated on 10/01/2024 [64]
- A53781 Billing and Coding: Spiracur SNaP® Wound Care System, updated on 01/01/2024 [65]
- A54555 Billing and Coding: Low frequency, non-contact, non-thermal ultrasound (CPT code 97610), updated on 01/01/2024 [66]
- A53064 Billing and Coding: Outpatient Occupational Therapy, updated on 10/01/2024 [67]
- A53773 Low frequency, non-contact, non-thermal ultrasound (CPT code 97610), updated on 01/01/2024 [68]
- A53058 Billing and Coding: Home Health Physical Therapy, updated on 10/01/2024 [95]
- L34560 Home Health Occupational Therapy [96]
- A56392 Response to Comments: Topical Oxygen Therapy [98]
- L37873 Topical Oxygen Therapy, updated on 05/04/2023 [99]
- L39121 Local Coverage Determination (LCD): Treatment of Varicose Veins of the Lower Extremities [69]
- A59001 Response to Comments: Treatment of Varicose Veins of the Lower Extremities [70]
- A59281 Response to Comments: Near-Infrared Spectroscopy in Wound and Flap Management [71]
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Wisconsin Physicians Service Insurance Corporation (WPS)
| - L37228 Wound Care [72]
- A55910 Response to Comments: Wound Care (DL37228) [73]
- A55909 Billing and Coding: Wound Care, updated on 10/01/2024 [74]
- L35761 Non-Invasive Peripheral Arterial Vascular Studies, updated on 10/26/2023 [75]
- A57593 Billing and Coding: Non-Invasive Peripheral Arterial Vascular Studies, updated on 10/1/2023 [76]
- A57846 Response to Comments: DL37228 Wound Care [100]
- A56232 Billing and Coding: Foot Care, updated on 10/01/2024 [77]
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