Medicare local coverage
Medicare coverage for Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (LCD)
7 Medicare Administrative Contractors publish a local coverage determination (LCD) for Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound. The snapshot lists 8 LCD records: 7 active, 1 retired.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L39575 | Active | Oct 16, 2023 |
First Coast Service Options, Inc.MAC - Part A, MAC - Part B | L39877 | Active | Oct 11, 2024 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L39118 | Retired Oct 23, 2025 | Oct 23, 2025 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L39116 | Active | Oct 14, 2025 |
Novitas Solutions, Inc.MAC - Part A, MAC - Part B | L39879 | Active | Oct 11, 2024 |
Palmetto GBAMAC - Part A, MAC - Part B | L39128 | Active | Jul 10, 2026 |
Wellpoint FederalMAC - Part A, MAC - Part B | L39139 | Active | Jul 14, 2026 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L39624 | Active | Sep 15, 2025 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A58865Noridian Healthcare Solutions, LLCUpdated Sep 22, 2026
- A58867Noridian Healthcare Solutions, LLCUpdated Oct 23, 2025
- A58883Palmetto GBAUpdated Aug 31, 2026
- A58893Wellpoint FederalUpdated Sep 22, 2026
- A59374CGS Administrators, LLCUpdated Oct 12, 2026
- A59434WPS Insurance CorporationUpdated Sep 17, 2026
- A59764First Coast Service Options, Inc.Updated Oct 16, 2026
- A59766Novitas Solutions, Inc.Updated Oct 16, 2026
CMS also lists 7 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A59277, A59541, A59542, A59564, A59578, A59893, A59894.
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Platelet Rich Plasma Injections for Non-Wound Injections
- Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin
- Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin
- Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds
- Botulinum Toxin Injections
- Cardiology Non-emergent Outpatient Stress Testing
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.