Medicare local coverage
Medicare coverage for Transurethral Waterjet Ablation of the Prostate (LCD)
5 Medicare Administrative Contractors publish a local coverage determination (LCD) for Transurethral Waterjet Ablation of the Prostate. The snapshot lists 6 LCD records: 5 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 |
|---|---|---|---|
First Coast Service Options, Inc.MAC - Part A, MAC - Part B | L38726 | Active | Mar 14, 2025 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38707 | Retired Mar 5, 2026 | Mar 5, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L38705 | Active | Feb 23, 2026 |
Novitas Solutions, Inc.MAC - Part A, MAC - Part B | L38712 | Active | Mar 14, 2025 |
Palmetto GBAMAC - Part A, MAC - Part B | L38549 | Active | Oct 24, 2025 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38682 | Active | Oct 21, 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.
- A58008Palmetto GBAUpdated Jan 27, 2026
- A58209WPS Insurance CorporationUpdated Jan 22, 2026
- A58227Noridian Healthcare Solutions, LLCUpdated Feb 23, 2026
- A58229Noridian Healthcare Solutions, LLCUpdated Mar 5, 2026
- A58243Novitas Solutions, Inc.Updated Jan 23, 2026
- A58264First Coast Service Options, Inc.Updated Jan 23, 2026
CMS also lists 11 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A58451, A58522, A58523, A59280, A59596, A59597, A59931, A59932, A60343, A60347, A60348.
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
- Laser Ablation of the Prostate
- Intraosseous Basivertebral Nerve Ablation
- MolDX: Gene Expression Profile Tests for Decision-Making in Castration Resistant and Metastatic Prostate Cancers
- MolDX: Molecular Biomarkers to Risk-Stratify Patients at Increased Risk for Prostate Cancer
- MolDX: Prostate Cancer Genomic Classifier Assay for Men with Localized Disease
- Prostate Cancer Detection with IsoPSA®
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.