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Crosswalk to CPT/HCPCS Codes and Associated Coverage Determinations

The following table lists the Coverage Determinations that WPS Medicare currently has available and the CPT/HCPCS codes that can be found within each document. This list assists you with determining whether a procedure code has local coverage limits. All codes are also subject to National Coverage rules, medical necessity and other regulations such as CCI, MUE, ASC, National Lab restrictions, documentation/ signature requirements and other provisions. If a code is available on this list, the Coverage Determination that is associated with the code will present guidance on coverage. This listing is intended to be a helpful tool for search and document retrieval.

If you are unable to find the code(s) you are specifically looking for, please review the CMS Coverage Center Website to research additional resources they have available.

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LCD Title CMS ID# Coverage Determination Type Associated CPT/HCPCS Codes
Ablative Therapy
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30312
 

L34527
ICD-9 Version Retired 09/30/15
Local
0071T, 0072T, 19105, 19499, 20982, 20983, 20999, 32998, 32999, 47370, 47371, 47380, 47381, 47382, 47393, 50250, 50542, 50592, 50593, 76940, 77013, 77022
Allergy Testing and Allergy Immunotherapy
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30471
 

L34597
ICD-9 Version Retired 09/30/15
Local
82785, 86003, 86005, 95004, 95017, 95018, 95024, 95027, 95028, 95044, 95052, 95056, 95060, 95065, 95076, 95078, 95079, 95115, 95117, 95120, 95125, 95130, 95131, 95132, 95133, 95134, 95144, 95145, 95146, 95147, 95148, 95149, 95165, 95170, 95180, 95199
Application of Bioengineered Skin Substitutes
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30135
 

L34593
ICD-9 Version Retired 09/30/15
Local
11042, 11043, 11044, 11045, 11046, 11047, 15002, 15003, 15004, 15005, 15271, 15272, 15273, 15274, 15275, 15276, 15277, 15278, 49568, 97597, 97598, 97602, Q4100, Q4101, Q4102, Q4103, Q4104, Q4105, Q4106, Q4107, Q4108, Q4110, Q4111, Q4112, Q4113, Q4114, Q4115, Q4116, Q4117, Q4118, Q4119, Q4120, Q4121, Q4122, Q4123, Q4124, Q4125, Q4126, Q4127, Q4128, Q4129, Q4130, Q4131, Q4132, Q4133, Q4134, Q4135, Q4136, Q4137, Q84138, Q8139, Q4140, Q4141, Q4143, Q4145, Q4146, Q4147, Q4148, Q4149, Q4150, Q4151, Q4152, Q4153, Q4154, Q4155, Q4156, Q4157, Q4158, Q4159, Q4160
Autonomic Function Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35174
 

L35124
ICD-9 Version Retired 09/30/15
Local
95921, 95922, 95923, 95924, 95943
Billing and Coding Guidance
Co-morbidities associated with morbid obesity
ICD-9  ¦  ICD-10
NA ICD-9 Version Retired 09/30/15
National
43644, 43645, 43770, 43775, 43845, 43846, 43847
Bisphosphonate Drug Therapy
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30139
 

L34648
ICD-9 Version Retired 09/30/15
Local
J1436, J1740, J2430, J3489
Blepharoplasty, Blepharoptosis and Brow Lift
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L29973
 

L34528
ICD-9 Version Retired 09/30/15
Local
15820, 15821, 15822, 15823, 67900, 67901, 67902, 67903, 67904, 67906, 67908
Bone Mass Measurement
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31620
 

L34639
ICD-9 Version Retired 09/30/15
Local
76977, 77078, 77080, 77081, 77085, 78350, 78351, G0130
Botulinum Toxin Type A & Type B
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28555
 

L34635
ICD-9 Version Retired 09/30/15
Local
31513, 31570, 31571, 43201, 43236, 46505, 52287, 64611, 64612, 64615, 64616, 64617, 64642, 64643, 64644, 64645, 64646, 64647, 64650, 64653, 67345, 92265, 95873, 95874, J0585, J0586, J0587, J0588
Capsule Endoscopy
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30141
 

L34613
ICD-9 Version Retired 09/30/15
Local
91110, 91111, 91299
Cardiac Catheterization and Coronary Angiography
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30719
 

L34530
ICD-9 Version Retired 09/30/15
Local
33967, 35201, 35206, 35226, 35261, 35266, 35286, 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461, 93462, 93463, 93503, 93505, 93530, 93531, 93532, 93533, 93563, 93564, 93565, 93566, 93567, 93568
Cardiovascular Stress Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28563
 

L34598
ICD-9 Version Retired 09/30/15
Local
93015, 93016, 93017, 93018, 93799
Category III Codes
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35488
 

L35490
ICD-9 Version Retired 09/30/15
Local
0075T, 0076T, 0099T, 0171T, 0172T, 0182T, 0184T, 0191T, 0275T, 0295T, 0296T, 0297T ,0298T, 0308T
Chemotherapy Drugs and their Adjuncts
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28576
 

L35053
ICD-9 Version Retired 09/30/15
Local
A9606, A9699, C9025, C9027, C9399, C9442, C9449, J0640, J0641, J0894, J2353, J3490, J3590, J7315, J9000, J9015, J9017, J9019, J9020, J9025, J9031, J9033, J9035, J9040, J9041, J9042, J9043, J9045, J9047, J9050, J9055, J9060, J9065, J9070, J9098, J9100, J9120, J9130, J9150, J9151, J9160, J9165, J9171, J9178, J9179, J9181, J9185, J9190, J9200, J9201, J9206, J9207, J9208, J9209, J9211, J9214, J9215, J9228, J9230, J9245, J9250, J9260, J9261, J9262, J9263, J9264, J9266, J9267, J9268, J9270, J9280, J9293, J9300, J9301, J9302, J9303, J9305, J9306, J9307, J9310, J9315, J9320, J9330, J9340, J9351, J9354, J9355, J9357, J9360, J9370, J9371, J9390, J9395, J9400, J9600, J9999, Q2043, Q2048, Q2049, Q2050
Chiropractic Services
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30328
 

L34585
ICD-9 Version Retired 09/30/15
Local
98940, 98941, 98942
Circulating Tumor Cell Marker Assays
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L32218
 

L34531
ICD-9 Version Retired 09/30/15
Local
86152, 86153
Clinical Social Worker Services
ICD-9  ¦  ICD-10
NA ICD-9 Version Retired 09/30/15
National
Not Applicable
Colonoscopy and Sigmoidoscopy-Diagnostic
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30304
 

L34614
ICD-9 Version Retired 09/30/15
Local
44388, 44389, 44390, 44391, 44392, 44394, 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45340, 45341, 45342, 45378, 45379, 45380, 45381, 45382, 45384, 45385, 45386, 45391, 45392, G6019, G6020, G6022, G6023, G6024, G6025
Coronary Computed Tomography Angiography (CCTA)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35169
 

L35121
ICD-9 Version Retired 09/30/15
Local
75571, 75572, 75573, 75574
Cosmetic and Reconstructive Surgery
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30733
 

L34698
ICD-9 Version Retired 09/30/15
Local
11920, 11921, 11922, 11950, 11951, 11952, 11954, 15775, 15776, 15781, 15782, 15783, 15788, 15789, 15792, 15793, 15819, 15824, 15825, 15826, 15828, 15829, 15830, 15832, 15833, 15834, 15835, 15836, 15837, 15838, 15839, 15876, 15877, 15878, 15879, 17340, 17360, 17380, 19300, 19316, 19318, 19324, 19325, 19328, 19330, 19340, 19342, 19350, 19355, 19357, 19361, 19364, 19366, 19367, 19368, 19369, 19370, 19371, 19380, 19396, 30400, 30410, 30420, 30430, 30435, 30450, 69300, C9800, G0429, Q2026, Q2028
Cranial Stereotactic Radiosurgery (SRS) and Cranial Stereotactic Radiotherapy (SRT)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30318
 


L34656
ICD-9 Version Retired 09/30/15
Local
61796, 61797, 61798, 61799, 61800, 63620, 63621, 77371, 77372, 77373, 77432, 77435, G0339, G0340
CT Colonography (Virtual Colonoscopy [VC])
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30300
 

L34697
ICD-9 Version Retired 09/30/15
Local
74261, 74262, 74263
Cytogenetic Studies
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30487
 

L34655
ICD-9 Version Retired 09/30/15
Local
88230, 88233, 88235, 88237, 88239, 88240, 88241, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88267, 88269, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, 88291, 88299
Drug Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L32450
 

L34645
ICD-9 Version Retired 09/30/15
Local
80300, 80301, 80302, 80303, 80304, G0430, G0431, G0434, G6058
Drugs and Biologics (Non-chemotherapy)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L32013
 

L34741
ICD-9 Version Retired 09/30/15
Local
96401, C9257, C9399, J0129, J0178, J0180, J0256, J0257, J0364, J1300, J1642, J1745, J1931, J2001, J2323, J2357, J2503, J2562, J2778, J2796, J3396, J3490, J3590, J9999
Dysphagia
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L33065
 

L34438
ICD-9 Version Retired 09/30/15
Local
74230, 76000, 76001, 92526, 92610, 92611, 92612, 92613, 92614, 92615, 92616, 92617, 92700, 97150
Electrocardiographic (EKG or ECG) Monitoring (Holter or Real-Time Monitoring)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L29584
 


L34636
ICD-9 Version Retired 09/30/15
Local
0295T, 0296T, 0297T, 0298T, 93224, 93225, 93226, 93227, 93228, 93229, 93268, 93270, 93271, 93272, 93224, 93225, 93226, 93227, 93228, 93229, 93268, 93270, 93271, 93272
Electroconvulsive Therapy (ECT)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30493
 

L34595
ICD-9 Version Retired 09/30/15
Local
00104, 90870
Endoscopic Treatment of GERD
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30473
 

L34659
ICD-9 Version Retired 09/30/15
Local
43257, 43499, 43999, 49999
Epidural and Transforaminal Epidural Injections
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30481
 

L34622
ICD-9 Version Retired 09/30/15
Local
01996, 62281, 62282, 62310, 62311, 62318, 62319, 64479, 64480, 64483, 64484, 77003, 77012, 72275
Erythropoiesis Stimulating Agents - Epoetin alfa, Darbepoetin alfa, Peginesatide
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31074
 


L34633
ICD-9 Version Retired 09/30/15
Local
99211, A4657, J0881, J0882, J0885, J0886, J0887, J0888, J0890, Q4081
Erythropoiesis Stimulating Agents (ESAs) in Cancer and Related Neoplastic Conditions
ICD-9  ¦  ICD-10
NA ICD-9 Version Retired 09/30/15
National
J0881, J0885
Facet Joint Injections, Medial Branch Blocks, and Facet Joint Radiofrequency Neurotomy
Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35996 ICD-9 Version Retired 09/30/15
Local
64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636
Flow Cytometry
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30161
 

L34651
ICD-9 Version Retired 09/30/15
Local
88182, 88184, 88185, 88187, 88188, 88189
Health and Behavior Assessment/Intervention
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30514
 

L34603
ICD-9 Version Retired 09/30/15
Local
90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 90816, 90817, 90818, 90819, 90821, 90822, 90823, 90824, 90826, 90827, 90828, 90829, 90845, 90846, 90847, 90849, 90853, 90857, 90862, 90865, 90867, 90868, 90870, 90875, 90876, 90880, 90882, 90885, 90887, 90889, 90899, 96150, 96151, 96152, 96153, 96154, 99401, 99402, 99403, 99404, 99411, 99412 G0375, G0376
Hemophilia Clotting Factors
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31078
 

L34439
ICD-9 Version Retired 09/30/15
Local
J7182, J7183, J7185, J7186, J7187, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7198, J7199, J7200, J7201, Q9975
Home and Domiciliary Services
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31613
 

L34643
ICD-9 Version Retired 09/30/15
Local
99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
Human Granulocyte/Macrophage Colony Stimulating Factors
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30306
 


L34699
ICD-9 Version Retired 09/30/15
Local
J1442, J1446, J2505, J2820
Immune Globulins
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30147
 

L34771
ICD-9 Version Retired 09/30/15
Local
90371, 90375, 90376, 90393, 90396, 96365, 96366, 96372, J0840, J0850, J1459, J1460, J1556, J1557, J1560, J1561, J1566, J1568, J1569, J1571, J1572, J1573, J1599, J1670
Immunizations
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31084
 

L34596
ICD-9 Version Retired 09/30/15
Local
90296, 90476, 90477, 90581, 90585, 90586, 90620, 90621, 90632, 90633, 90634, 90636, 90644, 90645, 90646, 90647, 90648, 90649, 90650, 90675, 90676, 90679, 90680, 90681, 90690, 90691, 90692, 90693, 90696, 90698, 90700, 90702, 90703, 90704, 90705, 90706, 90707, 90708, 90710, 90712, 90713, 90714, 90715, 90716, 90717, 90719, 90720, 90721, 90723, 90725, 90727, 90732, 90733, 90734, 90735, 90736, 90738, 90749
Independent Diagnostic Testing Facilities (IDTF)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31626
 

L34763
ICD-9 Version Retired 09/30/15
Local
70010, 70015, 70030, 70100, 70110, 70120, 70130, 70134, 70140, 70150, 70160, 70170, 70190, 70200, 70210, 70220, 70240, 70250, 70260, 70300, 70310, 70320, 70328, 70330, 70332, 70336, 70350 70355, 70360, 70370, 70371, 70373, 70380, 70390, 70450, 70460, 70470, 70480, 70481, 70482, 70486, 70487, 70488, 70490, 70491, 70492, 70496, 70498, 70540, 70542, 70543, 70544, 70545, 70546, 70547, 70548, 70549, 70551, 70552, 70553, 70554, 70555, 70557, 70558, 70559, 71010, 71015, 71020, 71021, 71022, 71023, 71030, 71034, 71035, 71040, 71060, 71100, 71101, 71110, 71111, 72010, 72020, 72040, 72050, 72052, 72069, 72070, 72072, 72074, 72080, 72090, 72100, 72114, 72120, 72125, 72126, 72127, 72128, 72129, 72130, 72131, 72132, 72133, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72170, 72190, 72191, 72192, 72193, 72194, 72195, 72196, 72197, 72198, 72200, 72202, 72220, 72240, 72255, 72265, 72270, 72275, 72285, 72295, 73000, 73010, 73020, 73030, 73040, 73050, 73060, 73070, 73080, 73085, 73090, 73092, 73100, 73110, 73115, 73120, 73130, 73144 ,73200, 73201, 73202, 73206, 73218, 73219, 73220, 73221, 73222, 73223, 73500, 73510, 73520, 73525, 73530, 73540, 73550, 73560, 73562, 73564, 73565, 73580, 73590, 73592, 73600, 73610, 73615, 73620, 73630, 73650, 73660, 73700, 73701, 73702, 73706, 73718, 73719, 73720 ,73721, 73722, 73723, 73725, 74000, 74010, 74020, 74022, 74150, 74160, 74170, 74174, 74175, 74176, 74177, 74178, 74181, 74182, 74183, 74185, 74190, 74210, 74220, 74230, 74240, 74241, 74245, 74246, 74247, 74249, 74250 ,74251, 74260, 74261, 74262, 74263, 74280, 74283, 74290, 74300, 74301, 74305, 74320 ,74327, 74328, 74329, 74330, 74400, 74415, 74420 ,74425, 74430, 74440, 74445, 74450, 74455, 74470, 74710, 74740, 74742, 74775, 75557, 75559, 75561, 75563, 75565, 75571, 75572, 75573, 75574, 75600, 75605, 75625, 75630, 75635, 75650, 75658, 75660, 75662, 75665, 75671, 75676, 75680, 75685, 75705, 75710, 75716, 75726, 75731, 75733, 75736, 75741, 75743, 75743, 75756, 75774, 75791, 75801, 75803, 75805, 75807, 75809, 75810, 75820, 75822, 75825, 75827, 75831, 75833, 75840, 75842, 75860, 75870, 75872, 75880, 75885, 75887, 75889, 75891, 75893, 75898, 75900, 75945, 75946, 75982, 76000, 76001, 76010, 76080, 76098, 76100, 76101, 76102, 76120, 76125, 76376, 76377, 76380, 76506, 76510, 76511, 76512, 76513, 76514, 76516, 76519, 76529, 76536, 76604, 76641, 76642, 76700, 76705, 76770, 76775, 76776, 76800, 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76818, 76819, 76820, 76821, 76825, 76826, 76827, 76828, 76830, 76831, 76856, 76857, 76870, 76872, 76873, 76881, 76882, 76885, 76886, 76930, 76932, 76937, 76940, 76945, 76946, 76970, 76975, 76977, 77002, 77003, 77011, 77012, 77021, 77051, 77052, 77053, 77054, 77055, 77056, 77057, 77058, 77059, 77061, 77062, 77063, 77071, 77072, 77073, 77074, 77075, 77076, 77077, 77078, 77080, 77081, 77084, 77085, 77086, 78012, 78013, 78014, 78015, 78016, 78018, 78020, 78070, 78071, 78072, 78075, 78102, 78103, 78104, 78110, 78111, 78120, 78121, 78122, 78130, 78135, 78140, 78185, 78190, 78191, 78195, 78201, 78202, 78205, 78206, 78215, 78216, 78226, 78227, 78230, 78231, 78232, 78258, 78261, 78262, 78264, 78270 ,78271, 78272, 78278, 78282, 78290, 78291, 78300, 78305, 78306, 78315, 78320, 78414, 78428, 78445, 78451, 78452, 78453, 78454, 78456, 78457, 78458, 78459, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, 78579, 78580, 78582, 78597, 78598, 78600, 78601, 78605, 78606, 78607, 78608, 78609, 78610, 78630, 78635, 78645, 78647, 78650, 78660, 78700, 78701, 78707, 78708, 78709, 78710, 78725, 78730, 78740, 78761, 78800, 78801, 78802, 78803, 78804, 78805, 78806, 78807, 78811, 78812, 78813, 78814, 78815, 78816, 78891, 91010, 91013, 91020, 91022, 91030, 91034, 91035, 91037, 91038, 91040, 91065, 91110, 91112, 91117, 91120, 91122, 91132, 91133, 91200, 92081, 92082, 92083, 92100, 92132, 92133, 92134, 92136, 92140, 92225, 92226, 92227, 92228, 92230, 92235, 92240, 92250, 92260, 92265, 92270, 92275, 92283, 92284, 92285, 92286, 92287, 92541, 92542, 92543, 92544, 92545, 92546, 92547, 92548, 92550, 92552, 92553, 92555, 92556, 92557, 92558, 92561, 92562, 92563, 92564, 92565, 92567, 92568, 92570, 92571, 92572, 92575, 92576, 92577, 92579, 92582, 92583, 92584, 92585, 92586, 92587, 92588, 92596, 93000, 93005, 93010, 93015, 93016, 93017, 93018, 90324, 90325, 93040, 93041, 93042, 93224, 93225, 93226, 93227, 93228, 93229, 93260, 93261, 93268, 93270, 93271, 93272, 93278, 93279, 93280, 93281, 93282, 93283, 93284, 93285, 93288, 93289, 93290, 93291, 93292, 93293, 93294, 93295, 93296, 93297, 93298, 93299, 93303, 93304, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, 93350, 93351, 93352, 93600, 93602, 93603, 93609, 93610, 96312, 96613, 93615, 93616, 93618, 93619, 93620, 93621, 93622, 93623, 93624, 93631, 93640, 93641, 93642, 93644, 93660, 93662, 93701, 93724, 93740, 93745, 93750, 93770, 93784, 93786, 93788, 93790, 93880, 93882, 93886, 93888, 93890, 93892, 93893, 93895, 93922, 93923, 93924, 93925, 93926, 93930, 93931, 93965, 93970, 93971, 93975, 93976, 93978, 93979, 93980, 93981, 93990, 94010, 94014, 94015, 94016, 94060, 94070, 94150, 94200, 94250, 94375, 94400, 94450, 94452, 94453, 94620, 94621, 94680, 94681, 94690, 94726, 94727, 94728, 94729, 94750, 94760, 94761, 94762, 94770, 94772, 95004, 95017, 95018, 95024, 95027, 95028, 95044, 95052, 95056, 95060, 95065, 95070, 95071, 95075, 95078, 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, 95812, 95813, 95816, 95819, 95822, 95824, 95827, 95830, 95860, 95861, 95863, 95864, 95867, 95868, 95868, 95869, 95870, 95872, 95875, 95885, 95886, 95887, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95921, 95922, 95923, 95924, 95925, 95926, 95927, 95928, 95929, 95930, 95933, 95937, 95938, 95939, 95943, 95950, 95951, 95953, 59554, 95956, 95957, 95958, 96000, 96001, 96002, 96003, 96004, G0389, G0398, G0399, G0400
Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30153
 


L34589
ICD-9 Version Retired 09/30/15
Local
20526, 20527, 20550, 20551, 20612, 26341, 28899, 64450, 64455, 64632, 64640, J0775
Intra-articular Injections of Hyaluronan
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30149
 

L34525
ICD-9 Version Retired 09/30/15
Local
20610, 20611, J7321, J7323, J7324, J7325, J7326, J7327
Intraoperative Neurophysiological Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30721
 

L34623
ICD-9 Version Retired 09/30/15
Local
95940, 95941, G0453
Low Vision Services
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L32007
 

L34532
ICD-9 Version Retired 09/30/15
Local
92081, 92082, 92083, 92250, 97003, 97004, 97110, 97112, 97530, 97532, 97533, 97535, 97537, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99354
Luteinizing Hormone-Releasing Hormone (LHRH) Analogs
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30479
 


L34590
ICD-9 Version Retired 09/30/15
Local
11981, 11982, 11983, 96402, J1675, J1950, J3315, J9202, J9217, J9218, J9219, J9225, J9226
Mohs Micrographic Surgery
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35492
 

L35494
ICD-9 Version Retired 09/30/15
Local
17311, 17312, 17313, 17314, 17315, 88300, 88302, 88304, 88304, 88307, 88309, 88331, 88332, 88342
Molecular Diagnostic Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L33219
 

L34762
ICD-9 Version Retired 09/30/15
Local
81200, 81201, 81202, 81203, 81205, 81206, 81207, 81208, 81209, 81210, 81211, 81212, 81213, 81214, 81215, 81216, 81217, 81220, 81221, 81223, 81224, 81226, 81227, 81228, 81229, 81235, 81242, 81243, 81244, 81250, 81251, 81252, 81253, 81254, 81255, 81257, 81260, 81270, 81275, 81280, 81281, 81282, 81290, 81292, 81293, 81294, 81295, 81296, 81297, 81298, 81299, 81300, 81301, 81302, 81303, 81304, 81317, 81318, 81319, 81324, 81325, 81326, 81355, 81381, 81330, 81331, 81403, 81405, 81406, 88341, 88342, 88363, G9143
Myocardial Perfusion Imaging and Cardiac Blood Pool Studies
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31072
 


L34625
ICD-9 Version Retired 09/30/15
Local
78451, 78452, 78453, 78454, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78494, 78496, 93015, 93016, 93017, 93018, A4641, A9500, A9502, A9505, A9512, A9539, A9560, C9898, J0152, J1250, J2785
Nerve Blocks for Peripheral Neuropathy
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L34673
 

L35222
ICD-9 Version Retired 09/30/15
Local
64450, 76881, 76882, 76942, 76999, 97032, 97139, G0282, G0283
Nerve Conduction Studies and Electromyography
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31346
 

L34594
ICD-9 Version Retired 09/30/15
Local
51785, 92265, 95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95873, 95874, 95885, 95886, 95887, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95933, 95937, 95999, G0255
Non-Coronary Vascular Stents
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30798
 

L34640
ICD-9 Version Retired 09/30/15
Local
33880, 33881, 33883, 33884, 33886, 33889, 33891, 34800, 34802, 34803, 34804, 34805, 34806, 34808, 34812, 34813, 34820, 34825, 34826, 34830, 34831, 34832, 34833, 34834, 34839, 34841, 34842, 34843, 34844, 34845, 34846, 34847, 34848, 34900, 37236, 37237, 37238, 37239, 37799, 75952, 75953, 75954, 75956, 75957, 75958, 75959
Non-Coronary Vascular Stents
Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35998 ICD-9 Version Retired 09/30/15
Local
37221, 37223, 37226, 37227, 37230, 37231, 37234, 37235, 37236, 37237, 37238, 37239
Non-Invasive Abdominal / Visceral Vascular Studies
Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35755 ICD-9 Version Retired 09/30/15
Local
55899, 76936, 93975, 93976, 93978, 93979, 93980, 93981
Non-Invasive Cerebrovascular Studies
Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35753 ICD-9 Version Retired 09/30/15
Local
93880, 93882, 93886, 93888, 93890, 93892, 93893, 93895
Non-Invasive Peripheral Arterial Vascular Studies
Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35761 ICD-9 Version Retired 09/30/15
Local
93922, 93923, 93924, 93925, 93926, 93930, 93931
Non-Invasive Peripheral Venous Vascular Studies including Hemodialysis Access
Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35751 ICD-9 Version Retired 09/30/15
Local
93965, 93970, 93971, 93990, 90995, G0365
Non-Invasive Vascular Testing (N.I.V.T)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28586 ICD-9 Version Retired 09/30/15
Local
55899, 76936, 90940, 93880, 93882, 93886, 93888, 93890, 93892, 93893, 93922, 93923, 93924, 93925, 93926, 93930, 93931, 93965, 93970, 93971, 93975, 93976, 93978, 93979, 93980, 93981, 93990, G0365
Paravertebral Facet Joint Block and Facet Joint Denervation
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30483
 


L34534
ICD-9 Version Retired 09/30/15
Local
64490, 64491, 64492, 64493, 64494, 64495, 64633, 64634, 64635, 64636
Pelvic Floor Dysfunction: Anorectal Manometry and EMG
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35482
 

L35486
ICD-9 Version Retired 09/30/15
Local
51784, 51785, 91122
Percutaneous Coronary Interventions (PCI)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L34139
 

L34761
ICD-9 Version Retired 09/30/15
Local
92920, 92921, 92924, 92925, 92928, 92929, 92933, 92934, 92937, 92938, 92941, 92943, 92944, 92973, 92974, 92975, 92978, 92979, 93571, 93572, C9600, C9601, C9602, C9603, C9604, C9605, C9606, C9607, C9608
Polysomnography and Other Sleep Studies
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31082
 

L34535
ICD-9 Version Retired 09/30/15
Local
95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, G0398, G0399, G0400
Posterior Tibial Nerve Stimulation PTNS
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28457
 

L34436
ICD-9 Version Retired 09/30/15
Local
64566
Proton Beam Therapy
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31617
 

L34634
ICD-9 Version Retired 09/30/15
Local
77520, 77522, 77523, 77524, 77525
Psychiatric Inpatient Hospitalization
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L34679
 

L35223
ICD-9 Version Retired 09/30/15
Local
Not Applicable
Psychiatric Partial Hospitalization Program (PHP)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30491
 

L34601
ICD-9 Version Retired 09/30/15
Local
90785, 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90846, 90847, 96101, 96102, 96103, 96116, 96118, 96119, 96120, G0129, G0176, G0177, G0410, G0411
Psychiatry and Psychology Services
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30489
 

L34616
ICD-9 Version Retired 09/30/15
Local
90785, 90791, 90792, 90804, 90805, 90806, 90807, 90808, 90909, 90810, 90811, 90812, 90813, 90814, 90815, 90816, 90817, 90818, 90819, 90821, 90822, 90823, 90824, 90826, 90827, 90828, 90829, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90857, 90862, 90863, 90865, 90880, 90885, 90887, 90889, 90899, 96101, 96102, 96103, 96105, 96110, 96111, 96116, 96118, 96119, 96120, 96125, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99221, 99222, 99223, 99224, 99225, 99226, 99231, 99232, 99233, 99234, 99235, 99236, 99238, 99239, 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254, 99255, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99339, 99340, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99354, 99355, 99356, 99357, 99358, 99359, 99360, 99363, 99364, 99366, 99367, 99368, 99374, 99375, 99377
Psychological and Neuropsychological Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31990
 

L34646
ICD-9 Version Retired 09/30/15
Local
96101, 96102, 96103, 96105, 96110, 96111, 96116, 96118, 96119, 96120, 96125
Psychological Services under the "Incident to" Provision
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30715
 

L34591
ICD-9 Version Retired 09/30/15
Local
90785, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90880, 90899
Radiation Oncology Including Intensity Modulated Radiation Therapy (IMRT)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30316
 


L34652
ICD-9 Version Retired 09/30/15
Local
11920, 11921, 11922, 16000, 16010, 16015, 16020, 16025, 16030, 36425, 53670, 53675, 76376, 77014, 77261, 77262, 77263, 77280, 77285, 77290, 77295, 77299, 77300, 77301, 77306, 77307, 77316, 77317, 77318, 77321, 77331, 77332, 77333, 77334, 77336, 77338, 77370, 77371, 77372, 77373, 77385, 77386, 77399, 77401, 77417, 77422, 77423, 77427, 77431, 77435, 77470, 77499, 77520, 77522, 77523, 77525, 99211, 99212, 99213, 99214, 99215, 99238, 99281, 99282, 99283, 99284, 99285, 90780, 90781, 90841, 90843, 90844, 90847, 99050, 99052, 99054, 99058, 99071, 99090, 99150, 99151, 99180, 99182, 99185, 99371, 99372, 99373, G6001, G6002, G6003, G6004, G6005, G6006, G6007, G6008, G6009, G6010, G6011, G6012, G6013, G6014, G6015, G6016, G6017
Radiofrequency Treatment for Urinary Incontinence
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31615
 

L34642
ICD-9 Version Retired 09/30/15
Local
53860
Radiopharmaceutical Agents
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31361
 

L34657
ICD-9 Version Retired 09/30/15
Local
77781, 77782, 77783, 77784, 78012, 78013, 78014, 78015, 78016, 78018, 78020, 78070, 78071, 78072, 78075, 78099, 78102, 78103, 78104, 78110, 78111, 78120, 78121, 78122, 78130, 78135, 78140, 78185, 78190, 78191, 78195, 78199, 78201, 78202, 78205, 78206, 78215, 78216, 78226, 78227, 78230, 78231, 78232, 78258, 78261, 78262, 78264, 78267, 78270, 78271, 78272, 78278, 78282, 78290, 78291, 78299, 78300, 78305, 78306, 78315, 78320, 78350, 78351, 78399, 78414, 78428, 78445, 78451, 78452, 78453, 78454, 78456, 78457, 78458, 78459, 78466, 78468, 78469, 78472, 78473, 78481, 78483, 78491, 78492, 78494, 78496, 78499, 78580, 78584, 78585, 78586, 78587, 78588, 78591, 78593, 78594, 78596, 78599, 78600, 78601, 78605, 78606, 78607, 78608, 78609, 78610, 78603, 78635, 78645, 78647, 78650, 78660, 78699, 78700, 78701, 78707, 78708, 78709, 78710, 78725, 78730, 78740, 78761, 78799, 78800, 78801, 78802, 78803, 78804, 78805, 78806, 78807, 78808, 78811, 78812, 78813, 78814, 78815, 78816, 78999, 79005, 79101, 79200, 79300, 79403, 79440, 79445, 79900, 79999, A4641, A4642, A4643, A4644, A4645, A4646, A4647, A9500, A9501, A9502, A9503, A9504, A9505, A9507, A9508, A9510, A9512, A9516, A9517, A9520, A9521, A9524, A9526, A9527, A9528, A9529, A9530, A9531, A9532, A9536, A9537, A9538, A9539, A9540, A9541, A9542, A9543, A9544, A9545, A9546, A9547, A9548, A9550, A9551, A9552, A9553, A9554, A9555, A9556, A9557, A9558, A9559, A9560, A9561, A9562, A9563, A9564, A9566, A9567, A9568, A9569, A9570, A9571, A9572, A9580, A9582, A9584, A9586, A9599, A9600, A9604, A9699, C9898, J1245
Removal of Benign Skin Lesions
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L35496
 

L35498
ICD-9 Version Retired 09/30/15
Local
11200, 11201, 11300, 11301, 11302, 11303, 11305, 11306, 11307, 11308, 11310, 11311, 11312, 11313, 11400, 11401, 11402, 11403, 11404, 11406, 11420, 11421, 11422, 11423, 11424, 11426, 11440, 11441, 11442, 11443, 11444, 11446, 17106, 17107, 17108, 17110, 17111
Routine Foot Care
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30322
 

L34586
ICD-9 Version Retired 09/30/15
Local
11055, 11056, 11057, 11719, 11720, 11721, G0127
Sacroiliac Joint Injections
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31359
 

L34443
ICD-9 Version Retired 09/30/15
Local
20610, 20611, 27096, 64999, G0260
Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L34143
 


L34760
ICD-9 Version Retired 09/30/15
Local
76512, 92132, 92133, 92134, 92225, 92226, 92235, 92250
Selective Internal Radiation Therapy (SIRT) for Primary and Secondary Hepatic Malignancy (90YMicrosphere Hepatic Brachytherapy)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30137
 



L34524
ICD-9 Version Retired 09/30/15
Local
37241, 37243, 77263, 77290, 77300, 77370, 77470, 75894, 77399, 77778, 77790, C2616
Somatosensory Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L32902
 

L34624
ICD-9 Version Retired 09/30/15
Local
95860, 95861, 95863, 95864, 95865, 95866, 95867, 95868, 95869, 95870, 95872, 95873, 95874, 95875, 95885, 95886, 95887, 95905, 95907, 95908, 95909, 95910, 95911, 95912, 95913, 95921, 95922, 95923, 95924, 95925, 95926, 95927, 95928, 95929, 95930, 95933, 95937, 95938
Stereotactic Body Radiation Therapy
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28366
 

L34647
ICD-9 Version Retired 09/30/15
Local
31626, 32553, 49411, 55876, 77373, 77435, C9728, G0339, G0340
Stereotactic Computer Assisted Volumetric and/or Navigational Procedure
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L29586
 


L34599
ICD-9 Version Retired 09/30/15
Local
20985, 61781, 61782, 61783, 62161, 62162, 62163, 62164, 62165
Surgical Treatment of Obstructive Sleep Apnea (OSA)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30731
 

L34526
ICD-9 Version Retired 09/30/15
Local
21110, 21141, 21145, 21196, 21199, 21685, 30140, 30802, 31600, 31610, 41512, 41530, 42145, 42299,
Thrombopoietic Growth factor - Oprelvekin
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30151
 

L34602
ICD-9 Version Retired 09/30/15
Local
96372, J2355
Transcranial Magnetic Stimulation (TMS)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L32220
 

L34641
ICD-9 Version Retired 09/30/15
Local
90867, 90868, 90869
Transesophageal Echocardiography (Including Intraoperative TEE)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28574
 


L34584
ICD-9 Version Retired 09/30/15
Local
36000, 90760, 90761, 90765, 90766, 90773, 90774, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, 93325, 93799, A9700, C8925, C8926, C8927, G9157, Q9955, Q9956, Q9957
Transthoracic Echocardiography (TTE)
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28565
 

L34637
ICD-9 Version Retired 09/30/15
Local
93014, 93041, 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93350, 93351, 93352, A9700, C8921, C8922, C8923, C8924, C8928, C8929, C8930, Q9955, Q9956, Q9957
Treatment of Varicose Veins of the Lower Extremities
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30143
 

L34536
ICD-9 Version Retired 09/30/15
Local
36468, 36470, 36471, 36475, 36476, 36478, 36479, 37500, 37700, 37718, 37722, 37735, 37760, 37761, 37765, 37766, 37780, 37785, 37799, 93965, 93970, 93971
Trigger Points, Local Injections
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30155
 

L34588
ICD-9 Version Retired 09/30/15
Local
20552, 20553
Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L32452
 



L34523
ICD-9 Version Retired 09/30/15
Local
35460, 35476, 75978
Vertebroplasty (Percutaneous) and Vertebral Augmentation including cavity creation
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30516
 


L34592
ICD-9 Version Retired 09/30/15
Local
20225, 20250, 20251, 22325, 22326, 22327, 22328, 22510, 22511, 22512, 22513, 22514, 22515, 22899, 62292, 63003, 63005, 63011, 63012, 63015, 63016, 63017, 63020, 63030, 63035, 63040, 63042, 63043, 63044, 63045, 63046, 63047, 63048, 630510, 63051, 63055, 63056, 63057, 63064, 63066, 63075, 63076, 63077, 63078, 63081, 63082, 63085, 63086, 63087, 63088, 63090, 63091
Visual Fields
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31348
 

L34615
ICD-9 Version Retired 09/30/15
Local
92081, 92082, 92083
Vitamin B 12 Injections
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L30145
 

L34444
ICD-9 Version Retired 09/30/15
Local
J3420
Vitamin D Assay Testing
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L31076
 

L34658
ICD-9 Version Retired 09/30/15
Local
82306, 82652
Wound Care
ICD-9:   Iowa ¦ Kansas ¦ Missouri ¦ Nebraska

ICD-10: Iowa ¦ Kansas ¦ Missouri ¦ Nebraska
L28572
 

L34587
ICD-9 Version Retired 09/30/15
Local
11042, 11043, 11044, 11045, 11046, 11047, 97026, 97028, 97035, 97597, 97598, 97602, 97605, 97606, 97607, 97608, 97610, G0281, G0329