Reasonable and necessary provisions of an LMRP and,an LCD that contains only reasonable and necessary language.
| Anesthesia (1) |
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| CMS ID |
Name |
View |
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| L3462 |
Post-Operative Pain Management
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| Chiropractic (1) |
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| CMS ID |
Name |
View |
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| L3651 |
Chiropractic Services
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| Diagnostic Tests (39) |
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| CMS ID |
Name |
View |
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| L25275 |
Category III CPT® Codes
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| L3084 |
Audiologic/Vestibular Function Tests
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| L25907 |
Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
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| L3621 |
Cardiac Electrophysiology Services (EPS)
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| L26415 |
Cardiac Event Detection
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| L25447 |
Cardiac Output Measurement Thoracic Electrical Bioimpedance
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| L26404 |
Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
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| L26402 |
Colorectal Cancer Screening
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| L24153 |
Diagnostic Cardiac Catheterization
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| L26409 |
Dynamic Electrocardiography (EKG, ECG)
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| L3506 |
Electrocardiogram (ECG, EKG)
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| L22384 |
Endothelial Cell Count
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| L9426 |
Erectile Dysfunction, Evaluation and Treatment
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| L26394 |
Esophagogastroduodenoscopy (EGD)
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| L7858 |
General Ophthalmological Services
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| L3042 |
Gonioscopy
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| L12258 |
Helicobacter Pylori (H. Pylori) Testing
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| L26445 |
High-Sensitivity C-ReactiveHigh-Sensitivity C-Reactive Protein (hsCRP)
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| L9674 |
Interventional Cardiology
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| L25367 |
Magnetic Resonance Angiography (MRA)
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| L3737 |
Nerve Conduction Studies (NCS)/Electromyography (EMS)
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| L25563 |
Neuromuscular Junction Testing
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| L3743 |
Non-Invasive Vascular Diagnostic Studies
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| L26422 |
Ocular Blood Flow Tests
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| L20507 |
Ocular Photography, External
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| L25347 |
Ophthalmic Angiography (Fluorescein and Indocyanine Green)
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| L25466 |
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
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| L9223 |
Post-Void Residual Urine and/or Bladder Capacity by Ultrasound
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| L9149 |
Pulse Oximetry
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| L7082 |
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
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| L16383 |
Stress Echocardiography
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| L13100 |
Surveillance of Implantable Cardioverter Defibrillators (ICDs), Office, Web or Non-Web Based
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| L7761 |
Swallow Evaluation - Dysphagia
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| L3120 |
Transesophogeal Echocardiography TEE
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| L6988 |
Transrectal Ultrasound
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| L20450 |
Transtelephonic Spirometry
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| L3123 |
Transthoracic Echocardiography (TTE)
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| L3469 |
Urodynamics
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| L26367 |
Visual Fields Testing
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| Drugs and Biologicals (12) |
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| CMS ID |
Name |
View |
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| L3027 |
Allergy Immunotherapy
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| L8935 |
Baclofen Intrathecal Therapy
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| L26003 |
Biologic Products for Wound Treatment and Surgical Interventions
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| L15636 |
Bortezomib (Velcade) for Injection
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| L3454 |
Botulinum Toxin Type A and Type B
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| L8241 |
Chelation Therapy
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| L25820 |
Drugs and Biologicals Coverage for Label and Off-Label Uses
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| L25211 |
Erythropoietin Stimulating Agents
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| L7515 |
Filgrastim, Pegfilgrastim(e.g., Neupogen?, Neulasta TM)
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| L26369 |
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs
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| L26418 |
Nesiritide Infusion for Heart Failure
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| L3607 |
Thyrotropin Alfa (Thyrogen)
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| Evaluation and Management (E/M) Services (2) |
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| CMS ID |
Name |
View |
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| L13974 |
Health and Behavior Assessment/Intervention
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| L9433 |
Initial Hospital Visits
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| Foot Care (1) |
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| CMS ID |
Name |
View |
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| l26426 |
Routine Foot Care and Debridement of Nails
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| Medicine (3) |
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| CMS ID |
Name |
View |
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| L25468 |
Endoscopy by Capsule
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| L3042 |
Gonioscopy
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| L25204 |
Hyperbaric Oxygen Therapy (HBO)
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| Miscellaneous (2) |
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| CMS ID |
Name |
View |
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| L25714 |
Inpatient Rehabilitation Services Provided in an Inpatient Rehabilitation Facility (IRF)
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| L26428 |
Polysomnography and Sleep Studies
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| Nuclear Medicine (1) |
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| CMS ID |
Name |
View |
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| L3635 |
Cardiovascular Nuclear Medicine
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| Pathology and Laboratory (15) |
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| CMS ID |
Name |
View |
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| L25879 |
Acid Phosphatase
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| L26375 |
B-type Natriuretic Peptide (BNP) Testing
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| L25639 |
Erythrocyte Sedimentation Rate (ESR)
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| L7772 |
Flow Cytometry
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| L12258 |
Helicobacter Pylori (H. Pylori) Testing
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| L25650 |
Homocysteine Level, Serum
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| L9081 |
Immunocytochemistry
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| L3612 |
Lipid Profile/Cholesterol Testing
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| L23391 |
Morphometric Analysis
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| L3815 |
Parathormone (Parathyroid Hormone, PTH, Immunoreactive PTH)
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| L13076 |
Prostate Specific Antigen (PSA)
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| L21707 |
RAST Type Tests
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| L12931 |
Serum Magnesium Testing
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| L6997 |
Troponin Testing
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| L13077 |
Viral Hepatitis Serology Tests
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| Physical Medicine and Rehabilitation (5) |
|
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| CMS ID |
Name |
View |
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| L13927 |
Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Indications
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| L23612 |
Low Level Laser Therapy (LLLT)/Cold Laser Therapy
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| L3041 |
Physical Medicine and Rehabilitation
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| L11902 |
Rehabilitation for Patients with Visual Impairment
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| L18652 |
Respiratory Therapy Services
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| Psychiatric (3) |
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| CMS ID |
Name |
View |
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| L3671 |
Mental Health Services
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| L25507 |
Psychiatric Inpatient Hospitalization
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| L26398 |
Psychiatric Partial Hospitalization Programs
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| Radiation Therapy (4) |
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| CMS ID |
Name |
View |
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| L3484 |
Brachytherapy
|
|
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| L5110 |
Intensity Modulated Radiation Therapy (IMRT)
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| L9485 |
Intravascular Brachytherapy
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| L3587 |
Radiation Therapy
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| Radiology (6) |
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| CMS ID |
Name |
View |
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| L3021 |
Abdominal Ultrasound
|
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| L26385 |
Bone Mass Measurement
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| L3500 |
Breast Imaging: Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
|
|
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| L25233 |
Computed Tomographic (CT) Colonography
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| L3662 |
Computed Tomography (CT Scans)
|
|
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| L8960 |
Pelvic and Transvaginal Ultrasound Procedures
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| |
| Surgery (29) |
|
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| CMS ID |
Name |
View |
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| L13918 |
Bariatric Surgery
|
|
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| L26448 |
Blepharoplasty
|
|
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| L26404 |
Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
|
|
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| L3096 |
Debridement Services
|
|
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| L25468 |
Endoscopy by Capsule
|
|
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| L7423 |
Epidural/Intrathecal Injections
|
|
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| L9426 |
Erectile Dysfunction, Evaluation and Treatment
|
|
|
| L26394 |
Esophagogastroduodenoscopy (EGD)
|
|
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| L18650 |
Facet Joint Nerve Block
|
|
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| L9126 |
Implanted Catheter/P |
