National Government Services for New York and New Jersey Medicare Part
B will retire the Local Coverage Determinations (LCDs) listed below, effective
May 31, 2007. Based on analysis of their effectiveness, these LCDs are no
longer useful for prepay, postpay, or educational purposes.
All local policy rules, requirements, and limitations within these LCDs
will no longer be applied on a prepay basis, but as with any billed service,
will be subject to postpay review. All Centers for Medicare and Medicaid
Services national policy rules, requirements and limitations remain in effect.
LCD Title |
NY LCD Number |
NJ LCD Number |
Anesthesia for Anorectal Procedure |
L3031 |
L3767 |
Anesthesia Services Prior
to Postponement of Surgery |
L3032 |
L3132 |
Anesthesia with Gastrointestinal
Endoscopy |
L3033 |
L3764 |
Autonomic Nervous System Function
Testing |
L3134 |
L3118 |
Biofeedback Therapy |
L7784 |
L3760 |
Care Plan Oversight |
L3641 |
L3975 |
Collagen Crosslinks, Any Method |
L11624 |
L11608 |
Computer Corneal Topography |
L3658 |
L13967 |
Consultation and Report on
Referred Material |
L3056 |
L3108 |
Continuous Glucose Monitoring |
L3075 |
L3121 |
Critical Care |
L3080 |
L3496 |
Diagnostic Nasal Endoscopy |
L3474 |
L19478 |
Drug Screening |
L3497 |
L5323 |
Eye Procedures Done in Stages
or Sessions |
L3831 |
L3585 |
Hemophilia Clotting Factors |
L21710 |
L21712 |
Home Prothrombin Time International
Normalized Ratio (INR) Monitoring for Anticoagulation Management |
L4760 |
L4653 |
Human Immunodeficiency Virus
Testing (Prognosis Including Monitoring) |
L13072 |
L13060 |
Ibritumomab Tiuxetan Therapy |
L11952 |
L11602 |
Immunoassay for Bladder Cancer |
L13773 |
L3721 |
Implantable Cardiac Loop Recorder |
L9442 |
L3892 |
Interferon Beta-1A |
L11653 |
L11599 |
Intraoperative Neurophysiological
Testing |
L13092 |
L3591 |
Intravenous Antibiotic Therapy
for Lyme Disease |
L3091 |
L3682 |
Ionized Calcium |
L9679 |
L3716 |
Lidocaine, Intravenous |
L15392 |
L15399 |
Magnetic Imaging of the Heart
(Cardiac MRI) |
L11440 |
L11594 |
Magnetoencephalography (The
MEG Scan) |
L20442 |
L20446 |
Medically Necessary Removal
of Impacted Cerumen Requiring a Physician’s Skill |
L15851 |
L15893 |
Non-vascular Extremity Ultrasound |
L7501 |
L19511 |
Pachymetry of the Cornea |
L13094 |
L13046 |
PAP Smears |
L3801 |
L3530 |
Percutaneous Interventional
Procedures |
L3479 |
L19515 |
Physician Services for Certification
(and Recertification) of Medicare-Covered Home Health Services |
L3095 |
L3675 |
Radiofrequency Ablation in
the Upper Respiratory Tract |
L14096 |
L14091 |
Radiofrequency Ablation of
Bone Tumor(s) |
L17004 |
L17026 |
Serial Tonometry |
L3112 |
L4035 |
Superficial Radiation Treatment
(Grenz-Ray) |
L3480 |
L4214 |
Tilt Table Testing, Diagnostic |
L3486 |
L3991 |
Vagus Nerve Stimulation (VNS)
Therapy System for Depression |
L21552 |
L21554 |
Water Induced Thermotherapy |
L3488 |
L5273 |
