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US · guidance

CMS Pub. 100-04, ch. 13, § 30.1.1

Payment Criteria

activein force · 2026-08-25 – presentas-observed

A/B MACs (B) make separate payments for LOCM (HCPCS codes Q9945-Q9951) in the case of all

medically necessary intrathecal radiologic procedures furnished to nonhospital patients. Effective

January 1, 2005 in the case of intraarterial and intravenous radiologic procedures, the five restrictive

criteria (a history of previous adverse reaction to contrast material, with the exception of a sensation of

heat, flushing, or a single episode of nausea or vomiting; a history of asthma or allergy; significant

cardiac dysfunction including recent or imminent cardiac decompensation, severe arrhythmia, unstable

angina pectoris, recent myocardial infarction, and pulmonary hypertension; generalized severe

debilitation; or sickle cell disease) for the payment of LOCM are eliminated.

History

(Rev. 627, Issued: 07-29-05, Effective: 01-01-05, Implementation: 10-31-05)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
3b0481f2cb733382f79e5e6ed6eea5c4c1d41756e1841f2ac8b3f67525d2d18e
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