Headline numbers
- Titles compared
- 144
- of 168 multi-contractor titles
- Median share in dispute
- 7%
- covered codes not on every version's list
- Titles with most codes in dispute
- 40
- over half of the covered codes
- Titles with identical lists
- 57
- Most divergent title
- Magnetic Resonance Angiography (MRA)
- 1,630 codes differ across 3 versions
- Contractors compared
- 7
Titles ranked by divergence
Divergent codes are covered by at least one contractor version of the title and not by all of them. Smallest and largest name the versions with the shortest and longest covered lists; each title links its comparison page with the code-by-contractor matrix.
The widest gap is Magnetic Resonance Angiography (MRA): 2,066 codes are covered by at least one of its 3 versions, 436 by all of them. In the five most divergent titles, the ICD-10-CM categories with the most disputed codes are T82 Complications of cardiac and vascular prosthetic devices, implants and grafts (138 codes, Magnetic Resonance Angiography (MRA)); S14 Injury of nerves and spinal cord at neck level (126 codes, Nerve Conduction Studies and Electromyography); S06 Intracranial injury (563 codes, Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)); S72 Fracture of femur (760 codes, Total Joint Arthroplasty); M05 Rheumatoid arthritis with rheumatoid factor (123 codes, Erythropoiesis Stimulating Agents). The 119 other titles are in the CSV below.
Titles that reach the most states
A title published across most of the country is where a multi-state group meets the most versions of the same rule; the share column shows how much of the covered list is in dispute.
| Policy title | States | Versions | Share in dispute |
|---|---|---|---|
| Nerve Conduction Studies and Electromyography | 56 | 7 | 68% |
| Micro-Invasive Glaucoma Surgery (MIGS) | 56 | 7 | 90% |
| Cervical Fusion | 56 | 7 | 14% |
| Intravenous Immune Globulin | 56 | 2 | 76% |
| Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea | 56 | 6 | 65% |
| Facet Joint Interventions for Pain Management | 56 | 7 | 31% |
| Trigger Point Injections (TPI) | 56 | 7 | 80% |
| Implantable Continuous Glucose Monitors (I-CGM) | 56 | 7 | 1% |
| Epidural Steroid Injections for Pain Management | 56 | 7 | 2% |
| Frequency of Hemodialysis | 56 | 7 | 2% |
| Colon Capsule Endoscopy (CCE) | 56 | 7 | 0% |
| Transcranial Magnetic Stimulation (TMS) | 56 | 6 | 0% |
| Mohs Micrographic Surgery (MMS) | 54 | 6 | 56% |
| Transurethral Waterjet Ablation of the Prostate | 54 | 5 | 0% |
| Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | 53 | 6 | 72% |
The largest single-contractor outliers
Only here counts codes on this version's covered list that no other version covers; missing counts codes every other version covers that this one does not. A high missing count is where a diagnosis accepted elsewhere is most likely to deny.
| Policy title | LCD | Contractor | Only here | Missing |
|---|---|---|---|---|
| Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) | L34380 | Wellpoint Federal | 1,126 | 16 |
| Non-Invasive Vascular Studies | L34045 | CGS Administrators, LLC | 231 | 901 |
| Total Joint Arthroplasty | L33456 | Palmetto GBA | 432 | 700 |
| MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer | L39017 | CGS Administrators, LLC | 0 | 1,077 |
| Erythropoiesis Stimulating Agents | L34633 | Wisconsin Physicians Service Insurance Corporation | 86 | 912 |
| Controlled Substance Monitoring and Drugs of Abuse Testing | L36393 | First Coast Service Options, Inc. | 28 | 959 |
| Psychiatry and Psychology Services | L34616 | Wisconsin Physicians Service Insurance Corporation | 101 | 754 |
| Speech-Language Pathology | L35070 | Novitas Solutions, Inc. | 833 | 16 |
| Transthoracic Echocardiography (TTE) | L34338 | CGS Administrators, LLC | 294 | 555 |
| Routine Foot Care | L33941 | First Coast Service Options, Inc. | 488 | 339 |
| Magnetic Resonance Angiography (MRA) | L34424 | Palmetto GBA | 564 | 254 |
| Off-label Use of Rituximab and Rituximab Biosimilars | L39297 | Wellpoint Federal | 791 | 4 |
| RAST Type Tests | L34063 | CGS Administrators, LLC | 26 | 664 |
| Intraoperative Neurophysiological Testing | L35003 | Novitas Solutions, Inc. | 413 | 204 |
| Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography) | L34399 | CGS Administrators, LLC | 381 | 163 |
Strictest and most permissive lists, by contractor
For each contractor, the titles it publishes with a coded article where the versions' list sizes differ, how often (and in what share of those titles) its list is the smallest or the largest, how often it is below or above the median of the other versions, and the median of its list size divided by that median.
| Contractor | Titles | Smallest | Largest | Below others | Above others | Median size vs others |
|---|---|---|---|---|---|---|
| CGS Administrators, LLC | 66 | 31 (47%) | 21 (32%) | 36 | 25 | 0.99x |
| Palmetto GBA | 50 | 14 (28%) | 12 (24%) | 15 | 18 | 1.00x |
| Wellpoint Federal | 45 | 13 (29%) | 17 (38%) | 14 | 24 | 1.01x |
| Wisconsin Physicians Service Insurance Corporation | 41 | 8 (20%) | 19 (46%) | 12 | 15 | 1.00x |
| Noridian Healthcare Solutions, LLC | 39 | 6 (15%) | 7 (18%) | 10 | 11 | 1.00x |
| Novitas Solutions, Inc. | 28 | 8 (29%) | 6 (21%) | 17 | 10 | 0.96x |
| First Coast Service Options, Inc. | 26 | 8 (31%) | 5 (19%) | 18 | 7 | 0.92x |
Counting only the titles where the contractor versions' covered lists differ in size, and ranking by share so that contractors publishing more such titles are not favoured, CGS Administrators, LLC has the smallest list in the largest share of its titles: 31 (47%) of the 66 it publishes. Wisconsin Physicians Service Insurance Corporation has the largest list in the largest share: 19 (46%) of the 41 it publishes. Contractors with fewer than 10 such titles are not ranked. These counts describe list size only. A contractor with shorter lists may cover the same conditions through broader instructions, and one with longer lists may add frequency or documentation limits in the policy text; read the LCD before drawing conclusions about how a contractor pays.
Method, limits and reuse
Titles are grouped the way the LCD hub groups them: active LCDs whose normalised titles match or extend one another form a topic, and a topic needs two or more active policies. For each policy, the covered set is every ICD-10-CM code in the covered lists of its linked billing and coding articles (codes are compared undotted, so I65.23 and I6523 are the same code). Versions with no coded article are excluded from that title's comparison. The figures come from the MCD release 2026-10-08 and the FY2027 ICD-10-CM code set and are rebuilt with every weekly export; non-covered lists, frequency limits, modifiers and the policy text are not part of the measure.
Download the per-title CSV. Each topic comparison page lists the versions, the categories where they part and a code-by-contractor sample, with the full matrix as a CSV; the LCD code lookup answers the question for one code, one state and one diagnosis. The reference methodology records file versions and hashes. Figures may be reused with attribution to QuickIntell and a link to this page.
Where QuickIntell fits across jurisdictions
Groups that bill in several MAC jurisdictions meet every version of this policy. QuickAuth coordinates requirement checks and documentation per case with human review, and QuickRCM keeps claim readiness and coverage denials in one workflow.
Frequently asked questions
Do Medicare contractors cover the same diagnoses for the same LCD?
Often not. Of the 144 policy titles where at least two contractors publish a coded billing article, 40 have more than half of their covered ICD-10-CM codes on some contractors' lists and not others, and 57 have identical lists. The median title has 7% of its covered codes in dispute (MCD release 2026-10-08).
Which contractor has the strictest diagnosis lists?
Counting only the titles where the contractor versions' covered lists differ in size, and ranking by share so that contractors publishing more such titles are not favoured, CGS Administrators, LLC has the smallest list in the largest share of its titles: 31 (47%) of the 66 it publishes. Wisconsin Physicians Service Insurance Corporation has the largest list in the largest share: 19 (46%) of the 41 it publishes. Contractors with fewer than 10 such titles are not ranked. A smaller list is not the same as a stricter policy: text, frequency limits and documentation rules also decide coverage.
How is divergence measured?
For each policy title, every contractor version's covered set is the union of the ICD-10-CM codes in the coded billing and coding articles linked to that LCD. Divergent codes are the codes in the union of those sets but not in their intersection: covered by at least one version and not by all. Versions with no coded article are left out and named on the topic page.
Can I reuse the data?
Yes. The CSV has one row per policy title with the counts and the smallest, largest and outlier versions; each topic page offers the full code-by-contractor CSV. The underlying CMS data is public domain; cite QuickIntell and link this page.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…
- ICD-10-CM FY2027 code descriptionsVersion FY2027 · effective 2026-10-01 · file icd10cm_codes_2027.txtSHA-256 3c0583a38ee0e848…
Disclaimer
Counts are computed from the CMS Medicare Coverage Database export as an operational reference and compare list sizes, not policies. Verify against the current LCD and article on cms.gov before billing. Not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.