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LCD ID LCD Title   Effective Date Revision Effective Date End Date Last Approval / Revision Date
L24615
L23285
Blepharoplasty/
Blepharoptosis
 
  06/26/2000 07/06/2007 N/A 11/10/2007
Procedure Codes: 15820 15821 15822 15823 67900 67901 67902 67903 67904 67906 67908 92081 92082 92083 92285 92499
L26073
L26071
Blood Glucose Monitoring in a Skilled Nursing Facility (SNF)    09/27/2007 N/A N/A 10/04/2007
Procedure Code: 82962
L22904
L23309
Botulinum Toxin Type A and B    10/16/2006 10/16/2006 N/A 12/19/2006
Procedure Codes: J0585 J0587
L26046
L26044
Cancer Chemotherapeutic Agents    09/27/2007 10/22/2007 N/A 11/15/2007
Procedure Codes: J9000 J9001 J9010 J9015 J9017 J9020 J9025 J9027 J9031 J9035 J9040 J9041 J9045 J9050 J9055 J9060 J9062 J9065 J9070 J9080 J9090 J9091 J9092 J9093 J9094 J9095 J9096 J9097 J9098 J9100 J9110 J9120 J9130 J9140 J9150 J9151 J9160 J9165 J9170 J9175 J9178 J9181 J9182 J9185 J9190 J9200 J9201 J9202 J9206 J9208 J9209 J9211 J9212 J9213 J9214 J9215 J9216 J9217 J9218 J9219 J9225 J9226 J9230 J9245 J9250 J9260 J9261 J9263 J9264 J9265 J9266 J9268 J9270 J9280 J9290 J9291 J9293 J9300 J9303 J9305 J9310 J9320 J9340 J9350 J9355 J9357 J9360 J9370 J9375 J9380 J9390 J9395 J9600 J9999
L770
L22312
Cardiovascular Stress Testing    06/26/2000 01/01/2008 N/A 04/19/2008
Procedure Codes: 93015 93016 93017 93018 93320 93325 93350 A9700 J0152 J1245 J1250 C8928
L13652
L23307
Cataract Surgery    09/29/2003 09/27/2007 N/A 09/27/2007
Procedure Codes: 66830 66840 66850 66852 66920 66930 66940 66983 66984
L25965
L25939
Complex Cataract Extraction    09/27/2007 N/A N/A 10/04/2007
Procedure Code: 66982
L24079
L24107
Computed Tomographic Angiography of the Chest    02/22/2007 12/20/2007 N/A 01/14/2008
Procedure Codes: 71275 0146T 0147T 0148T 0149T 0151T
L22886
L19875
Erythropoiesis Stimulating Agents (ESAs)    10/16/2006 01/01/2008 N/A 04/16/2008
Procedure Codes: J0881 J0885
L23336
L22315
Non-invasive Cerebrovascular Arterial Studies    11/30/2006 10/01/2007 N/A 01/14/2008
Procedure Codes: 93880 93882 93886 93888 93890 93892 93893
L24618
L19471
Physical Medicine and Rehabilitation Services, PT and OT    07/06/2007 10/01/2007 N/A 02/18/2008
Procedure Codes: 97001 97002 97003 97004 97010 97012 97014 97016 97018 97022 97024 97026 97028 97032 97033 97034 97035 97036 97039 97110 97112 97113 97116 97124 97139 97140 97150 97530 97532 97533 97535 97537 97542 97545 97546 97750 97755 97760 97761 97762 97799 G0283
L24627
L12904
Sleep Disorders Testing   07/06/2007 N/A N/A 06/25/2007
Procedure Codes: 95805 95806 95807 95808 95810 95811 95822
L24624
L19830
Speech-Language Pathology (SLP) Services    07/06/2007 10/01/2007 N/A 02/18/2008
Procedure Codes: 92506 92507 92508 92597 92607 92608 92609 96105 96110 96111 97110 97530 97532 97533 97535
L23348
L24115
Transesophageal Echocardiography (TEE)    11/30/2006 01/01/2008 N/A 04/19/2008
Procedure Codes: 93312 93313 93314 93315 93316 93317 93320 93321 93325 A9700 Q9955 Q9956 Q9957 C8925 C8926 C8927
L12914
L22340
Transthoracic Echocardiography (TTE)    06/27/2003 01/01/2008 N/A 04/19/2008
Procedure Codes: 93303 93304 93307 93308 93320 93321 93325 A9700 Q9955 Q9956 Q9957 C8921 C8922 C8923 C8924
L758
L19843
Treatment of Dysphagia (Swallowing Disorders), General; Includes VitalStim ® Therapy    03/13/2000 01/10/2008 N/A 02/18/2008
Procedure Code: 92526
L17543
L17777
Wound Care    09/30/2004 09/27/2007 N/A 02/18/2008
Procedure Codes: 11000 11001 11040 11041 11042 11043 11044 97022 97597 97598 97602 97605 97606
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