Every version by contractor
Open a version for its full policy text, contracts, codes and related NCDs. Covered codes are the count of ICD-10-CM codes in the version's billing and coding article; a dash means the export attaches no coded article.
| LCD | Contractor | States | Revised | Covered codes | Policy words |
|---|---|---|---|---|---|
| L38916 | Novitas Solutions, Inc. | AR CO DC DE LA MD MS NJ NM OK PA TX | 2021-07-11 | 193 | 373 |
| L38918 | First Coast Service Options, Inc. | FL PR VI | 2021-07-11 | 193 | 373 |
| L39027 | Wellpoint Federal | CT DN IL MA ME MN NH QN RI UN VT WI | 2026-04-01 | 192 | 368 |
How to use the comparison
Start from the state where the service is furnished and open that contractor's version; its billing and coding article carries the diagnosis codes the claims system will test. For a group that bills in several jurisdictions, the version with the smallest covered list is the safe common denominator for pre-service review, and the version with the largest list shows what documentation can support an appeal elsewhere. The L38916 version is the one most searched for this title; the LCD lookup guide explains how jurisdictions are assigned, and the LCD hub lists every topic that more than one contractor has written.
Frequently asked questions
Why are there 3 LCDs called "Respiratory Pathogen Panel Testing"?
Each Medicare Administrative Contractor writes its own Local Coverage Determination for its jurisdiction. 3 contractors publish a policy with this title covering 27 states; they often start from one contractor's text and then revise separately, so dates, criteria and diagnosis lists differ by jurisdiction.
Which "Respiratory Pathogen Panel Testing" LCD applies to my claim?
The one written by the contractor that processes the claim: the A/B MAC for the state where the service is furnished, or the DME MAC region for equipment. The table lists each policy's states; open the policy for that jurisdiction and its billing and coding article.
How different are the diagnosis lists?
Among the 3 versions with a billing and coding article, the covered ICD-10-CM list ranges from 192 to 193 codes. A diagnosis accepted under one contractor can deny under another, which is the most common cause of coverage denials for multi-state groups.
When were these policies last revised?
Revision effective dates run from 2021-07-11 to 2026-04-01. A claim is judged against the version in force on the date of service.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-09-24 · effective 2026-09-20 · file lcd.csvSHA-256 2fcc4251b6ddd1eb…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-09-24 · effective 2026-09-20 · file article.csvSHA-256 f31932f1df3b4035…
Disclaimer
Policy metadata and code counts are reproduced from the CMS Medicare Coverage Database export as an operational reference. Verify against the current LCD and article on cms.gov before billing. Not legal, clinical or billing advice.