Superseded Local Coverage Article

Allergen immunotherapy – new Part B LCD


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Contractor Information

Article Information

General Information

Article ID
Article Title
Allergen immunotherapy – new Part B LCD
Article Type
Original Effective Date
Revision Effective Date
Revision Ending Date
Retirement Date
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Article Guidance

Article Text

LCD ID number: L37800 (Florida/Puerto Rico/U.S. Virgin Islands)

The local coverage determination (LCD) for allergen immunotherapy was developed to address coverage criteria, coding requirements, documentation requirements, and utilization parameters for allergen immunotherapy. The LCD also addresses providers eligible to perform this service. Furthermore, in creating this new LCD, the current LCD for allergen immunotherapy (L33804) will be retired when this new LCD becomes effective.

Effective date

This new LCD is effective for services rendered on or after October 18, 2018. LCDs are available through the CMS Medicare coverage database at

A coding article for an LCD (when present) may be found by selecting “Related Local Coverage Documents” in the “Section Navigation” drop-down menu at the top of the LCD page.

Note: To review active, future and retired LCDs click here.

Coding Information

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.


Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.




ICD-10-CM Codes that are Covered


ICD-10-CM Codes that are Not Covered


Revision History Information

Revision History DateRevision History NumberRevision History Explanation
10/18/2018 R1

Corrected typographical error.

Associated Documents

Related National Coverage Documents
Statutory Requirements URLs
Rules and Regulations URLs
CMS Manual Explanations URLs
Other URLs
Public Versions
Updated On Effective Dates Status
09/10/2021 10/18/2018 - 09/10/2021 Retired View
08/24/2018 10/18/2018 - N/A Superseded You are here
08/24/2018 10/18/2018 - N/A Superseded View