WPS reimbursement alerts

This final LCD from WPS (J5/J8) governs molecular testing for solid organ allograft rejection and is now retired as of its last update, meaning coverage policies under L38680 are no longer active for

This final LCD from WPS (J5/J8) establishes coverage criteria for genetic testing related to hereditary thrombophilia, effective October 12, 2026, across six Midwestern states. Providers should review

This final LCD from WPS (J5/J8) establishes coverage criteria for Total Joint Arthroplasty across six Midwestern states, effective August 27, 2026. It governs both Part A and Part B billing, meaning i

This final LCD from WPS (J5/J8) governs coverage criteria for cosmetic versus reconstructive surgery across Iowa, Missouri, Kansas, Nebraska, Indiana, and Michigan, effective August 27, 2026. It estab

This final LCD from WPS (J5/J8) establishes coverage criteria for Micro-Invasive Glaucoma Surgery (MIGS) across six Midwestern states, effective August 27, 2026. It will govern which MIGS procedures a

This active final LCD from WPS (J5/J8) governs coverage criteria for diagnostic colonoscopy and sigmoidoscopy procedures across six Midwestern states, effective August 27, 2026. Providers must ensure

This final LCD from WPS (J5/J8) establishes coverage criteria for non-next generation sequencing targeted molecular panel tests used to guide targeted therapy decisions in cancer patients, effective O

This final LCD from WPS (J5/J8) establishes coverage criteria for allergy diagnostic testing across six Midwestern states, effective September 27, 2026. Providers performing allergy testing must ensur

This final LCD from WPS (Jurisdictions 5 and 8) establishes coverage criteria for cataract surgery across six Midwestern states, effective July 30, 2026. It governs both Part A and Part B billing, mea

This active Final LCD from WPS (J5/J8) establishes coverage criteria for Percutaneous Vertebral Augmentation (PVA) procedures—including vertebroplasty and kyphoplasty—for vertebral compression fractur

This final LCD from WPS (J5, J8) establishes coverage criteria for endoscopic treatment of GERD, effective July 30, 2026, across six Midwestern states under both Part A and Part B. Providers must ensu

This final LCD from WPS (J5/J8) establishes coverage criteria for molecular testing used to detect solid organ allograft rejection, effective August 30, 2026. It applies to Medicare Part A and Part B

The LCD L39044 focuses on coverage for molecular syndromic panels for infectious disease pathogen identification. As a final LCD, it is currently active and will be effective starting June 25, 2026, i

The finalized LCD L39711 pertains to the use of molecular biomarkers for risk stratification of indeterminate pulmonary nodules following bronchoscopy. This LCD is active and will be effective startin

LCD L40272 establishes coverage criteria for MolDX biomarker testing in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH), ef

The proposed LCD could significantly impact billing practices for non-next generation sequencing tests used in diagnosing BCR-ABL negative myeloproliferative neoplasms. It may lead to a more stringent

The proposed LCD for Superficial Radiation Therapy (SRT) will likely supports compliance with updated rates options for providers treating Nonmelanoma Skin Cancers (NMSC). This inclusion may lead to increased utilizat

The proposed LCD for Transurethral Waterjet Ablation of the Prostate could potentially impact billing for urologic procedures by establishing coverage criteria and reimbursement rates. It may streamli

The proposed Local Coverage Determination (LCD) for Allergen Immunotherapy with Subcutaneous Immunotherapy requires billing team review, particularly in allergy-focused practices

The proposed LCD on molecular testing for solid organ allograft rejection could significantly affect billing practices by defining specific guidelines for necessary tests and circumstances under which

The proposed LCD could significantly impact billing for biomarker testing in patients with Ductal Carcinoma In Situ (DCIS). Practices may need to adjust their coding and documentation to align with ne

The proposed LCD for biomarker testing in metabolic liver disease may affect reimbursement practices by clarifying coverage policies which could lead to increased utilization of these tests. Providers

The proposed LCD on genetic testing for hereditary thrombophilia could lead to enhanced coverage for specific tests, impacting the way providers bill for related services. This may increase the number

The proposed Local Coverage Determination (LCD) could significantly affect billing practices for non-next generation sequencing targeted molecular panel tests used in cancer predictive testing. It is

The proposed LCD on Peripheral Nerve Blocks and Procedures for Chronic Pain may enhance access to necessary pain management techniques, impacting reimbursement for such procedures. The clarity provide

The proposed LCD for Allergy Diagnostic Testing could impact billing practices by clarifying coverage expectations and potentially enhancing reimbursement rates for providers. As the guidelines are es

The proposed Local Coverage Determination (LCD) for Computed Tomography Cerebral Perfusion Analysis (CTP) requires billing team review. This could increase

The proposed LCD for Botulinum Toxin Injections could streamline billing practices, potentially increasing reimbursement rates for providers. It may also clarify guidelines for coverage, leading to re

The new LCD on SCODI by WPS introduces specific guidelines that could impact the billing processes for ophthalmic diagnostic imaging services. Practices may need to adjust their coding and ensure comp

The implementation of the LCD for molecular testing in hereditary transthyretin amyloidosis requires billing team review. Providers should be aware of the guide

The new LCD for genetic testing related to heritable thoracic aortic disease may significantly impact billing practices for related tests. Providers should prepare for changes in coding and coverage t

With the new LCD regarding non-next generation sequencing tests for diagnosing BCR-ABL negative myeloproliferative neoplasms effective from August 17, 2025, providers must ensure adjustments are made

The implementation of this new LCD on genetic testing for hypercoagulability may create billing complexities for providers. It emphasizes the need for proper documentation and ICD-10 coding to ensure

The upcoming implementation of the NRAS Genetic Testing LCD by WPS will significantly influence billing procedures for oncology-related services. Providers should anticipate changes in claims submissi

The implementation of the MolDX LCD for phenotypic biomarker detection from circulating tumor cells will create significant changes in how tests are reimbursed under Medicare. Providers will need to p

The implementation of the MolDX guidelines for molecular biomarker testing in rheumatoid arthritis could significantly affect billing processes related to targeted therapy. Providers will need to ensu

The new LCD for genetic testing related to BCR-ABL negative myeloproliferative disease will clarify billing procedures and permissible tests. It is crucial for claims to align with the specified crite

The updated LCD for Urine Drug Testing by WPS may impact reimbursement rates and billing practices for providers. It requires careful review to ensure compliance with new guidelines and proper coding

The new Local Coverage Determination (LCD) for Visual Electrophysiology Testing issued by WPS is expected to impact billing practices significantly starting from August 28, 2025. This may lead to clai

The LCD on Vitamin D Assay Testing by WPS may impact billing by clarifying coverage criteria which may lead to more denials for tests not meeting the outlined requirements. This could require provider

The introduction of this LCD for EKG Monitoring requires billing team review-time monitoring services. Providers will need to ensure compliance

The new LCD for the treatment of varicose veins will impact billing by providing clear guidelines and criteria for reimbursement. Providers should prepare for potential changes in claim approvals star

The new LCD for Somatosensory Testing establishes specific guidelines that may affect reimbursement rates for this service. Providers will need to ensure they meet the outlined criteria to secure prop

The implementation of Allergen Immunotherapy with SCIT may affect billing practices for allergists and related specialists. Providers will need to adjust their coding and documentation to align with n

The new LCD for Amniotic and Placental Derived Product Injections will impact billing practices for musculoskeletal treatments starting September 25, 2025. Providers should prepare for potential chang

The new LCD on Pelvic Floor Dysfunction could significantly affect billing practices for anorectal manometry and EMG procedures. Ensuring compliance with the latest guidelines from WPS will be crucial

The implementation of the MGMT Promoter Methylation Analysis LCD requires billing team review. Additionally, this L

The implementation of the new LCD for Implantable Continuous Glucose Monitors (I-CGM) by WPS may affect billing processes for diabetes management services. Providers will need to familiarize themselve

The new LCD for Pharmacogenomics Testing by WPS may lead to supports compliance with updated rates practices for these tests. Providers will need to ensure that they meet the updated criteria to avoid claim de

The introduction of the LCD for Transurethral Waterjet Ablation of the Prostate may lead to increased compliance updates for practices adopting this technology. As coverage becomes effective in Dec