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A/B MAC Jurisdiction 6

NGS

Autonomic Function Tests

Botulinum Toxins

   Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography

B-Type Natriuretic Peptide (BNP) Testing

 Cardiac Computed Tomography (CCT) & Coronary Computed Tomography Angiography (CCTA)

Cardiovascular Nuclear Medicine

Cataract Surgery

Chiropractic Services

Computed Tomographic (CT) Colonography for Diagnostic Uses

Corneal Pachymetry

Debridement Services

Drugs & Biologicals, Coverage of, for Label & Off-Label Uses

EEG – 24 Hour Monitoring

Facet Joint Injections, Medial Branch Blocks, & Facet Joint Radiofrequency Neurotomy

Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases

Genomic Sequence Analysis Panels in the Treatment of Non-Small Cell Lung Cancer

Heavy Metal Testing

Implantable Miniature Telescope (IMT)

Incision & Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures

Lumbar

Epidural Injections

Magnetic Resonance Angiography(MRA)

Magnetic Resonance Image Guided High Intensity Focused Ultrasound (MRgFUS) for Essential Tremor

Micro-Invasive Glaucoma Surgery (MIGS)

Minimally-invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint

Molecular Pathology Procedures

Nerve Conduction Studies (NCS) & Electromyography (EMG)

 Non-Invasive Vascular Studies

Non-Vascular Extremity Ultrasound

Ophthalmic Biometry for Intraocular Lens Power Calculation

Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy

& Fundus Photography)

Osteopathic Manipulative Treatment

Outpatient Physical & Occupational Therapy Services

Pain Management

Panretinal (Scatter) Laser Photocoagulation

Percutaneous Coronary Intervention

Peripheral

Nerve

Blocks

Posterior Tibial Nerve Stimulation for Voiding Dysfunction

Prostate Rectal Spacers

Proton

Beam Radiotherapy

Psychiatric Inpatient Hospitalization

Psychiatic Partial Hospitalization Programs

Psychiatry

& Psychology Services

RAST Type Tests

Reduction Mammaplasty

Routine Foot Care & Debridement of Nails

Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

Select Minimally Invasive GERD Procedures

Speech Language Pathology (SLP) Services: Communication Disorders

Stereotactic Radiation Therapy: Stereotactic Radiosurgery (SRS) & Stereotactic Body Radiation Therapy (SBRT)

Total Joint Arthroplasty

Transcranial Magnetic Stimulation

Transesophageal Echocardiography (TEE)

Transrectal Ultrasound

Transthoracic Echocardiography (TTE)

Urine Drug Testing

Urodynamics

Varicose Veins of the Lower Extremity, Treatment of

Venous Angioplasty with or without Stent Placement for the Treatment of Chronic Cerebrospinal Venous Insufficiency

 Vertebroplasty, Vertebral Augmentation; Percutaneous

Visual Electrophysiology Testing

Visual Fields

Testing

Vitamin D Assay Testing