Noridian A57079 R7 (tendon, ligament and ganglion cyst injections) now in effect
Published November 8, 2026 · Coverage November 1–7, 2026, Pacific · Medium priority
The R7 revision took effect on November 1, 2026. The CMS Medicare Coverage Database now shows A57079 at revision effective date 11/01/2026, with R7 the latest entry in the revision history; R6 (conformity with Local Coverage Determination (LCD) L40265) also carries a revision effective date of 11/01/2026. The R7 notice's summary of changes carries the instruction to use M72.0 for CPT codes 20527 and 26341; the earlier revision's text was not compared.
Background
Billing and coding article A57079 gives billing and coding guidance to be used with its associated local coverage determination, and applies under Noridian's Part A contract covering all of California as well as its Part B contracts. The R6 revision, effective the same day as R7, made conforming changes reflecting the policy in LCD L40265, Peripheral Nerve Injections and Procedures for Chronic Pain.
Who this affects
Jurisdiction E (California) Part A/B billers of CPT 20527 and 26341.
Why it matters
What 'in effect' means: from its November 1, 2026 effective date, the current article (R7, which also contains the R6 conformity changes) is the version to code against; the article as revised carries the diagnosis-pairing instruction. Inference: a claim edit built on an earlier revision should be checked against R7. The notice does not decide any claim's medical necessity. Inference: claims for these codes with November dates of service that lack the paired diagnosis are exposed to denial.
Recommended action
- Affected Jurisdiction E billing and clinical teams can compare the revised notice with the current article and their applicable documentation and medical-necessity rules before changing claim edits (published article).
- Inference: confirm that claim edits for CPT 20527 and 26341 with dates of service on or after 2026-11-01 reflect R7, and spot-check early November claims.
Scope and timing
- Authority status
- Effective
- Responsible owner
- Coding and Revenue Cycle (Jurisdiction E billing); affected: clinical documentation
- Publication date
- 2026-10-29
- Effective date
- 2026-11-01
Not established
LCD L40265 itself not reviewed.
Earlier article: November 4, 2026 edition →
Sources
Complete edition and supplemental material
This article in the complete report →
Executive triage, source-coverage limitations, context and forward horizons remain in the complete report.
Read the entire Medicare & Medicaid Sweep report →