Local Coverage Determination for Endoscopic and ...

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Local Coverage Determination (LCD) for Endoscopic andPercutaneous lysis of Epidural Adhesions (L29256)Contractor InformationContractor NameFirst Coast Service Options, Number09102Contractor TypeMAC - Part BBack to TopLCD InformationDocument InformationLCD ID NumberL29256LCD TitleEndoscopic and Percutaneous lysis ofEpidural AdhesionsContractor's Determination Number62263AMA CPT/ADA CDT Copyright StatementCPT codes, descriptions and other data onlyare copyright 2011 American MedicalAssociation (or such other date of publicationof CPT). All Rights Reserved. ApplicableFARS/DFARS Clauses Apply. Current DentalTerminology, (CDT) (including procedurecodes, nomenclature, descriptors and otherdata contained therein) is copyright by theAmerican Dental Association. 2002, 2004American Dental Association. All rightsreserved. Applicable FARS/DFARS Geographic JurisdictionFloridaOversight RegionRegion IVOriginal Determination Effective DateFor services performed on or after 02/02/2009Original Determination Ending DateRevision Effective DateFor services performed on or after 10/01/2010Revision Ending DateCMS National Coverage PolicyLanguage quoted from CMS National Coverage Determinations (NCDs) and coverageprovisions in interpretive manuals are italicized throughout the Local Coverage Determination (LCD).

N/A Indications and Limitations of Coverage and/or Medical Necessity Endoscopic epidural lysis of adhesions (also known as endoscopic lysis) and percutaneous

  Coverage, Determination, Local, Endoscopic, Lysis, Local coverage determination for endoscopic