CorporateBusiness Services

March 23, 2016

ICD-9 Versions of CGS Local Coverage Determinations (LCDs)

ICD-9 versions of LCDs and corresponding articles no longer display on the CMS Medicare Coverage Database (MCD) since they were retired effective for dates of service on and after October 1, 2015. They are available only in the MCD Archive Database.

To locate ICD-9 versions of LCDs:

  • Go to the MCD Archive SiteExternal Website
  • Find the ICD-9 LCD ID below
  • Enter the ICD-9 LCD ID in the 'Have the Document ID?' search box and click GO
    Search box screenshot
  • When prompted, enter the Date of Service in the MM/DD/YYYY format and click Search Now
  • Archived LCDs will display with the following Contractor Name/Number:
    • CGS Administrators, LLC (15101) – Kentucky Part A
    • CGS Administrators, LLC (15201) – Ohio Part A
    • CGS Administrators, LLC (15102) – Kentucky Part B
    • CGS Administrators, LLC (15202) – Ohio Part B
    • CGS Administrators, LLC (15004) – Home Health & Hospice

ICD-9 LCDs and Articles no longer display on the CMS MCD since they were retired effective September 30, 2015. They are now only available in the MCD Archive Database. Use this link to view these documents. Find your LCD ID below, enter this in the 'Have the Document ID?' box and click go (you will be prompted to enter a Date of Service)

Contract LCD ID Title
        HHH/15004 L32015 Hospice Determining Terminal Status
        HHH/15004 L32016 Physical Therapy Home Health
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31826 Allergy Immunotherapy
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L33173 Application of Cellular and/or Tissue Based Products (CTPs) for Wounds of Lower Extremities
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31828 Blepharoplasty
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31855 Botulinum Toxins
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31856 Breast Imaging Mamography/Breast Echography (Sonography)/ Breast MRI/Ductography
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31827 B-type Natriuretic Peptide (BNP) Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31857 Capsule Opacification following Cataract Surgery: Discission and YAG Laser Capsulotomy
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31829 Cardiac Cath and Coronary Angiography
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31830 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31858 Cardiac Event Detection
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31831 Caridiovascular Nuclear Medicine
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31860 Cataract Extraction
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31832 Category III CPT Codes
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31861 Cerumen (Earwax) Removal
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31836 Chemotherapy and Biologicals
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31862 Chiropractic Services
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L32301 Circulating Tumor Cell Marker Assays
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31863 ColonoscopySigmoidoscopy/Proctosigmoidoscopy
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31864 Computerized Corneal Topography
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31834 Corneal Pachymetry
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35327 CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31835 Debridement Services
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31865 Dialysis Access Maintenance
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L34457 Drugs of Abuse Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31838 Endoscopy by Capsule
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31867 Erthropoiesis Stimulating Agents (ESA)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L34409 Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31870 Flow Cytometry
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35347 Genetic Testing for Lynch Syndrome
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31839 High Sensitivity C-Reactive Protein (hsCRP) Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31871 Human Papillomavirus (HPV) Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31873 Immunohistochemistry
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35768 Infectious Disease Molecular Diagnostic Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35730 Intravenous Immune Globulin
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31876 Laser Ablation of the Prostate
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L34404 Lumbar Epidural Steroid Injections (ESI)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31877 Mohs Micrographic Surgery
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35394 Molecular Diagnostic Tests (MDT)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35437 MoPath: GeneSight® Assay for Refractory Depression
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31878 Nasa Punctum-Nasolacrimal Duct Dialtion and Probing with or without Irrigation
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L34826 Nerve Blocks for Peripheral Neuropathy
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35737 Nerve Conduction Studies and Electromyography
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31841 Non-Invasive Vascular Studies
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35440 NRAS Genetic Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31880 Ocular Photography - External
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31882 Ophthalmic Angiography (Fluorescein and Indocyanine Green)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31883 Ophthalmic Biometry for Intraocular Lens Power Calculation
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31842 Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31886 Outpatient Physical & Occupational Therapy Services
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31887 Outpatient Psychiatry & Psychology Services
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31888 Panretinal (Scatter) Laser Photocoagulation
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31846 Polysomnography and Sleep Studies
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31889 Post-Void Residual Urine and/or Bladder Capacity by Ultrasound
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31890 Psychiatric Inpatient Hospitalization
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31891 Paychiatric Partial Hospitalization Programs
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31892 Psychological Services Coverage under the Indicient to Provision for Physicians & Non-physicians
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31894 RAST Type Tests
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31895 Removal of Benign Skin Lesions
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31896 Routine Foot Care and Debridement of Nails
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31897 Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L35739 Somatosensory Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31899 Speech-Language pathology
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31901 Stretta Procedure
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31904 Surveillance of Implantable or Wearable Cardioverter Defibrillators (ICDs): Office, Hospital, Web, or Non-web Based
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31906 Transcatheter Infusion Tehrapy
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31847 Transesophageal Echocradiography (TEE)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31907 Transtelephonic Spirometry
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31848 Transthoracic Echocardiography (TTE)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31908 Urodynamics
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31849 Varicose Veins of the Lower Extremity, Treatment of
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31850 Vertebroplasty & Vertebral Augmentation (Percutaneous)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31833 Virtual Colonoscopy (CT Colonography)
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31909 Visual Fields Testing
KYA/15101 KYB/15102 OHA/15201 OHB/15202   L31910 Vitamin D Assay Testing

Two Vantage Way, Nashville, TN 37228 ©2017 CGS Administrators, LLC. All Rights Reserved