Who Got to Comment on Your Morton's Neuroma Coverage?
Noridian revised its tendon, ligament and ganglion cyst LCD on September 29 with one sentence of explanation and no list of what changed. Four CPT codes and nine diagnoses come off on November 1, worth $2,021,923 of CY2024 allowed in its own 15 states. 64632 lands on an explicit non-covered list where one diagnostic injection is permitted, and 68 percent of its dollars sit above the first. The comment window that decided all of it closed on November 8, 2025, on a document with a different name and a different number.
Noridian's entire stated reason for changing a nine-year-old injection policy, verbatim and complete:
"Administrative task to make conforming changes reflecting the policy in Peripheral Nerve Injections and Procedures for Chronic Pain (L40265), which was established through the notice and comment LCD process."
That is the whole explanation. It names no codes.
The policy is L34218, "Injections - Tendon, Ligament, and Ganglion Cyst," in force since October 2015 across 15 states plus American Samoa, Guam and the Northern Mariana Islands. Revision R7 takes effect November 1. Noridian updated the record on September 29 and posted its own notice on October 8, which repeats the sentence above, lists the affected contract numbers, and stops there.
The LCD's Synopsis of Changes reads N/A. Fields changed: none. The notice period dates printed on the document still say April 6 to May 21, 2017.
Run the diff and the article underneath loses four CPT codes and nine diagnosis codes. Those four codes drew $2,021,923 of Medicare allowed inside Noridian's own footprint in CY2024.
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