Medicare Coverage General Information: ICD-10
Guidance for the International Classification of Disease (ICD)-10 code sets provide flexibility to accommodate future health care needs, facilitating timely electronic processing of claims by reducing requests for additional information to providers.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 30, 2020
The International Classification of Disease (ICD)-10 code sets provide flexibility to accommodate future health care needs, facilitating timely electronic processing of claims by reducing requests for additional information to providers. ICD-10 also includes significant improvements over ICD-9 in coding primary care encounters, external causes of injury, mental disorders, and preventive health. The ICD-10 code sets' breadth and granularity reflect advances in medicine and medical technology, as well as capture added detail on socioeconomics, ambulatory care conditions, problems related to lifestyle, and the results of screening tests.
As a result, medical terminology and disease classifications are being updated to be consistent with current clinical practice per regulations at 45 CFR Part 162. All Centers for Medicare & Medicaid Services (CMS) ICD-10 system changes have been phased-in and are scheduled for completion by October 1, 2014, giving a full year for additional testing, fine-tuning, and preparation prior to full implementation of ICD-10 CM/PCS for all Health Insurance Portability and Accountability Act (HIPAA)-covered entities. ICD-10-CM/PCS will replace ICD-9-CM/PCS diagnosis and procedure codes in all health care settings for dates of service, or dates of discharge for inpatients, that occur on or after the implementation date of ICD-10.
The Coverage and Analysis Group at CMS is the Federal entity that oversees National Coverage Determination (NCD) and Local Coverage Determination (LCD) policies. NCDs and LCDs constitute Medicare coverage decisions made by CMS and applied both nationally and locally across all health insurance payers. In light of HIPAA as it relates to ICD-10, CMS is responsible for converting the ICD-9 codes to ICD-10 codes in NCDs and LCDs as the Agency finds appropriate. There are approximately 330 NCDs spanning a range of time and not all NCDs are appropriate for translation. CMS has determined which NCDs/LCDs should be translated and is in the process of completing the associated systems changes. CMS change request (CR) transmittals and Medicare Learning Network Articles (MLN Matters®) are the vehicles used to communicate information regarding NCD/LCD translations.
The table below contains the various CRs and associated documents that CMS/CAG has issued to date as part of its ICD-10 conversion activities related to NCDs. It will be updated periodically. For more in depth information related to the contents of the table, please contact: Pat Brocato-Simons, patricia.brocatosimons@cms.hhs.gov, 410-786-0261.
The information below is for translations of NCDs. If you have questions about translations of LCDs, please contact your Medicare Administrative Contractor. The contact information can be found here.
| Transmittal | Issue Date | Subject | CR# | NCD# |
|---|---|---|---|---|
| 2024-11-06 | Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (MDS) National Coverage Determination (NCD) 110.23 [Rescinds and replaces Transmittal 12868 issued October 07, 2024, Transmittal 12813 issued August 28, 2024, Transmittal 12781 issued August 21, 2024, and Transmittal 12627 issued May 09, 2024] | 13604 | 110.23 | |
| R12904OTN | 2024-10-24 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)— April 2025 (CR 2 of 2) | 13828 | 190.11, 200.3, 210.3, 220.6.17, 230.18, 260.9, 270.3 |
| R12903OTN | 2024-10-24 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)—April 2025 (CR 1 of 2) | 13818 | 30.3.3, 80.2, 80.2.1, 80.3, 80.3.1, 110.4, 110.18, 110.21, 110.23, 110.24, 190.3 |
| R12883CP | 2024-10-11 | Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 18 Section 170.1 and Chapter 32 Section 340.2 for Coding Revisions to the National Coverage Determinations (NCDs) - January 2025 Change Request (CR) 13706 | 13804 | 100-04 (Ch. 18- Sec. 340.2) |
| R12868CP R12868NCD | 2024-10-07 | Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (MDS) National Coverage Determination (NCD) 110.23 [Rescinds and replaces Transmittal 12813 issued August 28, 2024, Transmittal 12781 issued August 21, 2024, and Transmittal 12627 issued May 09, 2024] | 13604 | 110.23 |
| R12822CP | 2024-09-05 | Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 18 Section 170.1 and Chapter 32 Section 190.2 for Coding Revisions to the National Coverage Determinations (NCDs)--April 2024 Change Request (CR) 13390 | 13738 | 100-04 (Ch. 18- Sec.170.1, Ch. 32- Sec.190.2) |
| R12817CP | 2024-08-29 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2025 | 13785 | 190.12 - 190.34 |
| 2024-08-28 | Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (MDS) National Coverage Determination (NCD) 110.23 [Rescinds and replaces Transmittal 12781 issued August 21, 2024, and Transmittal 12627 issued May 09, 2024] | 13604 | 110.23 | |
| R12757OTN | 2024-08-02 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) and Update to the Appropriate Use Criteria (AUC) Program-January 2025 | 13706 | 20.33, 210.10 |
| R12691CP | 2024-06-20 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2024 | 13672 | 190.12 - 190.34 |
| R12683CP | 2024-06-13 | Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 32, Section 150.3 for Coding Revisions to the National Coverage Determinations (NCDs)--October 2024 Change Request (CR)13596 | 13622 | 100.1 |
| R12649CP | 2024-05-23 | National Coverage Determination (NCD) 200.3 - Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease (AD) | 13598 | 200.3 |
| R12627NCD R12627CP | 2024-05-09 | Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (MDS) National Coverage Determination (NCD) | 13604 | 110.23 |
| R12626OTN | 2024-05-09 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--October 2024 | 13596 | 90.2, 110.18, 100.1 |
| R12600BP R12600CP | 2024-05-02 | Expand Diabetes Screening and Diabetes Definitions Policy Update in the Calendar Year 2024 Physician Fee Schedule Final Rule | 13487 | BPM: 15/300/300.1 CPM: 4/300, 18/1/1.2, 18/90/90.1-90.6 |
| R12590NCD | 2024-04-25 | Technical Revision Only to the National Coverage Determination (NCD) Manual, Publication (Pub) 100-03, Chapter 1, Part 4, section 310.1 | 13597 | Chapter 1, Part 4, section 310.1 |
| R12571CP R12571NCD | 2024-04-11 | National Coverage Determination (NCD) 20.7 Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting | 13512 | 20.7 |
| R12540CP | 2024-03-14 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2024 | 13554 | 190.12 - 190.34 |
| R12533CP | 2024-03-07 | Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 32, Section 90 for Coding Revisions to the National Coverage Determinations (NCDs)--July 2024 Change Request (CR) 13507 | 13545 | Section 90 - 110.23 |
| R12493OTN | 2024-02-01 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--July 2024 Update | 13507 | 110.18, 110.23 (formerly NCD 110.8.1), 150.3, 160.18, 220.6.17, 230.1 |
| R12440OTN | 2024-01-03 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--April 2024 Update--CR 2 of 2 [Rescinds and replaces Transmittal 12350 issued November 03, 2023, and Transmittal 12319 issued October 19, 2023] | 13391 | 90.2, 150.3, 160.18, 160.24, 190.3, 210.3, 220.4, 220.6.17, 250.3, 260.1, 260.5, 260.9 |
| R12441OTN | 2024-01-03 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--April 2024 Update--CR 1 of 2 [Rescinds and replaces Transmittal 12318 issued October 19, 2023] | 13390 | 20.4, 20.9.1, 20.16, 20.20, 20.30, 20.31, 20.31.1, 20.31.2, 20.31.3, 110.4, 110.18, 210.10 |
| R12435CP | 2023-12-28 | Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 18, Sections 20.2, 60.3 and Chapter 32, Sections 50.4.1, 200.2 for Coding Revisions to the National Coverage Determinations (NCDs)--April 2024 Change Request (CR) 13391 | 13461 | Chapter 18, Sections 20.2, 60.3 Chapter 32, Sections 50.4.1, 200.2 |
| R12364CP R12364NCD | 2023-11-16 | NCD 220.6.20 - Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease | 13429 | 220.6.20 |
| R12355OTN | 2023-11-09 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--January 2024 Update [Rescinds and replaces Transmittal 12184 issued August 03, 2023] | 13278 | 50.3, 90.2, 210.1 |
| R12350OTN | 2023-11-03 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--April 2024 Update--CR 2 of 2 [Rescinds and replaces Transmittal 12319 issued October 19, 2023] | 13391 | 90.2, 150.3, 160.18, 160.24, 190.3, 210.3, 220.4, 220.6.17, 250.3, 260.1, 260.5, 260.9 |
| R12207OTN | 2023-08-11 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--October 2023 Update [Rescinds and replaces Transmittal 12017 issued May 04, 2023] | 13166 | 20.20, 90.2, 210.1 |
| R12183NCD | 2023-08-03 | National Coverage Determination (NCD) 280.16 Power Seat Elevation Equipment on Power Wheelchairs | 13277 | 280.16 |
| R12185CP | 2023-08-03 | National Coverage Determination (NCD) 30.3.3 Acupuncture for Chronic Low Back Pain Revised Frequency Edits | 13288 | 30.3.3 |
| R12017OTN | 2023-05-04 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--October 2023 Update | 13166 | 20.20, 90.2, 210.1 |
| R11952OTN | 2023-04-12 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--July 2023 Update [Rescinds and replaces Transmittal 11884 issued March 01, 2023, and Transmittal 11832 issued February 02, 2023] | 13070 | 20.4, 20.7, 20.20, 150.3, 150.10, 210.1, 220.13 |
| R11929CP R11929NCD | 2023-03-27 | National Coverage Determination (NCD) 50.3 - Cochlear Implantation Manual Update [Rescinds and replaces Transmittal 11875 issued February 23, 2023] | 13073 | 50.3 |
| R11892NCD | 2023-03-09 | Technical Revisions Only to the National Coverage Determination (NCD) Manual | 13105 | Multiple NCDs |
| R11884OTN | 2023-03-01 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--July 2023 Update [Rescinds and replaces Transmittal 11832 issued February 02, 2023] | 13070 | 20.4, 20.7, 20.20, 150.3, 150.10, 210.1, 220.13 |
| 2023-02-23 | National Coverage Determination (NCD) 50.3 - Cochlear Implantation Manual Update | 13073 | 50.3 | |
| 2023-02-16 | An Omnibus CR to Implement Policy Updates in the CY 2023 PFS Final Rule, Including (1) Removal of Selected NCDs (NCD 160.22 Ambulatory EEG Monitoring), and, (2) Expanding Coverage of Colorectal Cancer Screening - Full Agile Pilot CR [Rescinds and replaces Transmittal 11824 issued January 27, 2023] | 13017 | 160.22, 210.3 | |
| R11774CP | 2022-12-30 | National Coverage Determination (NCD 110.24): Chimeric Antigen Receptor (CAR) Tcell Therapy [Rescinds and replaces Transmittal 11721 issued November 28, 2022] | 12928 | 110.24 |
2022-12-08 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2023 | 13026 | 190.18, 190.22, 190.23 | |
2022-11-10 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2023 [Rescinds and replaces Transmittal 11583, dated September 1, 2022] | 12888 | 190.12-190.34 | |
2022-11-09 | National Coverage Determination (NCD) 200.3 - Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease (AD) | 12950 | 200.3 | |
2022-11-09 | International Classification of Disease (ICD-10) Code Update for Coverage of Intravenous Immune Globulin (IVIG) Treatment of Primary Immune Deficiency Diseases in the Home | 12973 | Chapter 15, Section 50.6 of the BPM, Pub 100-02 | |
2022-11-03 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--April 2023 Update | 12960 | 20.4, 210.10 | |
2022-10-05 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)--January 2023 Update--2 of 2 [Rescinds and replaces Transmittal 11546, dated August 4, 2022] | 12842 | 20.32, 110.18, 110.23, 160.18, 190.3, 210.6, 220.6.17, 220.6.20, 260.1, 260.5, 260.9 | |
2022-09-08 | Revision to National Coverage Determination (NCD) 240.2 (Home Use of Oxygen) to Align to 1834(a)(5)(E) of the Social Security Act | 12877 | 240.2, 240.2.2 | |
2022-08-31 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--January 2023 Update [Rescinds and replaces Transmittal 11545 dated August 5, 2022] | 12822 | 20.9.1, 20.20, 20.30, 20.31, 20.31.1, 20.31.2, 20.31.3, 30.3.3, 110.24, 180.1 | |
2022-06-23 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2022 | 12803 | 190.12- 190.34 | |
2022-06-21 | National Coverage Determination (NCD) 90.2, Next Generation Sequencing (NGS) [Rescinds and replaced Transmittal 11055, dated October 21, 2021 | 12483 | 90.2 | |
2022-06-17 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--October 2022 Update [Rescinds Transmittal 11400, dated May 4, 2022] | 12705 | 20.31, 20.31.1, 20.31.2, 20.31.3, 90.2, 160.18, 180.1, 270.3 | |
2022-06-10 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--July 2021 [Rescinds and replaces Transmittal 10832, dated June 2, 2021, and Transmittal 10804, dated May 17, 2021] | 20.9, 20.20, 20.33, 90.2, 110.23, 210.14, 220.6.19 | ||
2022-05-23 | Revisions to National Coverage Determination (NCD) 240.2 (Home Use of Oxygen) and 240.2.2 (Home Oxygen Use for Cluster Headache) [Rescinds and replaces Transmittal 11263, dated February 10, 2022] | 12607 | 240.2 | |
2022-05-20 |
| 12613 | 180.1, 180.2, 220.6 | |
| R11391OTN | 2022-04-29 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) -- July 2022 [Rescinds and replaces Transmittal 11264, dated February 10, 2022, and Transmittal 11342, dated April 6, 2022] | 12606 | 20.4, 30.3.3, 110.24, 150.3, 160.18, 190.1 |
2022-04-29 |
| 12691 | 210.14 | |
2022-04-27 | Common Working File CWF Editing-National Coverage Determination (NCD) 270.3 Blood-Derived Products for Chronic, Non-Healing Wounds [Rescinds and replaces Transmittal 11262, dated February 10, 2022] | 12611 | 270.3 | |
2022-01-20 | National Coverage Determination (NCD) 270.3 Blood-Derived Products for Chronic, Non-Healing Wounds [Rescinds and replaces Transmittal 11171, dated January 12, 2022] | 12403 | 270.3 | |
2022-01-12 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) -- April 2022 (CR 1 of 2) [Rescinded Transmittal 11068, dated October 21, 2021] | 12480 | 20.4, 20.9.1, 20.31, 20.31.1, 20.31.2, 20.31.3, 30.3.3, 110.18, 110.23, 110.24 | |
2021-12-22 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2022 | 12575 | 190.12-190.34 | |
2021-12-16 | Transvenous (Catheter) Pulmonary Embolectomy National Coverage Determination (NCD) 240.6 | 12537 | 240.6 | |
2021-12-16 | National Coverage Determination (NCD) 220.6.19, Positron Emission Tomography NaF-18 (NaF-18 PET) to Identify Bone Metastasis of Cancer- Manual Update Only | 12526 | 220.6.19 | |
2021-10-29 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) -- April 2022 (CR 2 of 2 for April 2022) | 12482 | 160.27, 190.1, 190.3, 190.5, 210.2, 220.4, 220.6.17, 220.13, 260.9 | |
2021-10-01 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2022 | 12468 | 190.12- 190.34 | |
2021-09-28 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--January 2022 [Rescinds and replaces Transmittal 10963, dated August 19, 2021] | 12399 | 20.4, 110.23, 110.24, 150.13, 160.18, 210.14 | |
2021-09-08 | Claims Processing Instructions for National Coverage Determination 20.33 - Transcatheter Edge-to-Edge Repair [TEER] for Mitral Valve Regurgitation | 12361 | 20.33 | |
2021-08-02 | National Coverage Determination (NCD) Removal [Rescinds and replaces Transmittal 10888, dated July 19, 2021 and Transmittal 10838, dated June 8, 2021] | 12254 | 20.5, 30.4, 100.9, 110.19, 220.2.1, 220.6.16, 220.6 | |
2021-07-20 2021-07-19 | National Coverage Determination (NCD 110.24): Chimeric Antigen Receptor (CAR) T-cell Therapy [Rescinds and replaces Transmittal 10796, dated May 20, 2021] | 12177 | 110.24 | |
2021-07-15 | Changes to the Laboratory National Coverage Determination [NCD] Edit Software for October 2021 | 12384 | 190.12- 190.34 | |
2021-06-15 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2021 [Rescinds and replaces Transmittal 10658, dated March 23, 2021] | 12171 | 190.12- 190.34 | |
2021-06-11 | National Coverage Determination (NCD) 20.9.1 Ventricular Assist Devices (VADs) | 12290 | 20.9.1 | |
2021-05-21 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--October 2021 | 12279 | 20.33, 30.3.3 | |
2021-05-20 | National Coverage Determination (NCD) 210.3 - Screening for Colorectal Cancer (CRC)-Blood-Based Biomarker Tests | 12280 | 210.3 | |
2021-03-23 | Claims Processing Instructions for National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs) | 12104 | 20.4 | |
2021-01-14 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--April 2021 [Rescinded Transmittal 10515, dated December 10, 2020 and Transmittal 10432, dated October 30, 2020] | 12027 | 20.5, 20.33, 110.10, 110.21, 110.23, 160.18, 180.1, 190.3, 210.6, 220.4, 220.6.17, 220.13, 260.1 | |
2020-09-11 | National Coverage Determination (NCD 90.2): Next Generation Sequencing (NGS) for Medicare Beneficiaries with Germline (Inherited) Cancer | 11837 | 90.2 | |
2020-08-27 | National Coverage Determination (NCD30.3.3): Acupuncture for Chronic Low Back Pain (cLBP) [Rescinded Transmittal 10128, dated May 8, 2020] | 11755 | 30.3.3 | |
2020-08-14 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2020 [Rescinded Transmittal 10215, dated July 10, 2020] | 11889 | 190.12- 190.34 | |
2020-07-31 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--January 2021 Update | 11905 | 50.3, 90.2, 220.6.17 | |
2020-06-23 | National Coverage Determination (NCD) 160.18 Vagus Verve Stimulation (VNS) [Rescinded Transmittal 10145, dated May 22, 2020] | 11461 | 160.18 | |
2020-06-19 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--July 2020 Update [Rescinded Transmittal 2439, dated February 21, 2020] | 11655 | 90.2, 150.3, 190.3, 220.6.1, 220.6.8, 220.6.19, 230.18, 270.1 | |
2020-06-10 | NCD (20.32) Transcatheter Aortic Valve Replacement (TAVR) [Rescinded Transmittals 217 and 4546 dated March 13, 2020] | 11660 | 20.32 | |
2020-05-01 | National Coverage Determination (NCD) 20.19 Ambulatory Blood Pressure Monitoring (ABPM) | 11650 | 20.19 | |
2020-02-04 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--April 2020 Update [Rescinded Transmittal 2382, dated November 1, 2019] | 11491 | 20.9, 20.9.1, 20.34, 110.4, 110.23, 190.3, 190.11, 210.3, 260.9 | |
2019-12-13 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2020 | 11593 | 190.12- 190.34 | |
2019-10-29 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2020 [Rescinded Transmittal 4400, dated September 27, 2019] | 11485 | 190.12- 190.34 | |
2019-09-19 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--January 2020 Update [Rescinded Transmittal 2348, dated August 9, 2019] | 11392 | 20.7, 110.18, 110.23, 150.3, 220.4, 220.13, 270.3 | |
2019-07-05 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2019 | 11344 | 190.12- 190.34 | |
2019-05-03 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) | 11229 | 20.31, 20.31.1, 20.31.2, 20.31.3, 110.18, 150.3, 220.13 | |
2019-04-10 | National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) [Rescinded Transmittal 210, dated November 30, 2018 and Transmittal 214, dated March 6, 2019] | 10878 | 90.2 | |
2019-03-22 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2019 | 11224 | 190.12- 190.34 | |
2019-02-14 | National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs) [Rescinded Transmittal 211 dated December 13, 2018] | 10865 | 20.4 | |
2019-02-01 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) | 11134 | 20.29, 110.18, 110.21, 110.23, 150.3, 160.18, 160.24 | |
2019-02-01 | Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)—Clarification of Payment Rules and Expansion of International Classification of Diseases Tenth Edition (ICD-10) Diagnosis Codes | 11022 | 20.35 | |
2019-02-01 | Update to Mammography Editing | 11132 | 220.4 | |
2018-11-09 | International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) | 11005 | 20.7, 110.21, 210.2, 220.4, 230.18, 80.11 | |
2018-11-08 | International Classification of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) [Rescinded Transmittal 2138, dated September 18, 2018, and Transmittal 2122, dated August 10, 2018] | 10859 | 110.18, 110.21, 190.3, 190.11, 220.6.17, 260.1, 270.1, 270.3, 80.11 | |
2018-10-19 | Magnetic Resonance Imaging (MRI) | 10877 | 220.2 | |
2018-09-28 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2019 | 10941 | 190.12- 190.34 | |
2018-07-20 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2018 | 10873 | 190.12- 190.34 | |
2018-05-11 | Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) [Rescinded Transmittals 205, 3992, 206 and 4016] | 10295 | 20.35 | |
2018-05-04 | International Code of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) | 10622 | 110.18, 150.3, 190.11, 220.13, 220.6.16, 220.6.17 | |
2018-02-02 | Editing Update for Mammography Services | 10435 | 220.4 | |
2018-02-28 | ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs) [Rescinded Transmittal 2033 dated February 16, 2018] | 10473 | 20.5, 110.18, 110.21, 150.3, 190.1, 190.11, 210.3, 210.4.1, 210.6, 220.4, 220.6.17, 250.4 | |
2018-01-18 | ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs) [Rescinded Transmittal 1975 dated November 9, 2017] | 10318 | 20.9, 20.9.1, 20.16, 20.29, 20.30, 20.33, 40.1, 80.11, 80.2 80.2.1 80.3 80.3.1, 110.18, 110.21, 110.23, 160.27, 190.3, 190.11, 220.4, 220.6.17, 220.13, 260.1, 270.1, 270.3 | |
2017-12-22 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2018 | 10424 | 190.12- 190.34 | |
2017-11-21 | Replacement of Mammography HCPCS Codes, Waiver of Coinsurance and Deductible for Preventive and Other Services, and Addition of Anesthesia and Prolonged Preventive Services | 10181 | 220.4, 210.3 and other preventive services | |
2017-11-17 | Hyperbaric Oxygen (HBO) Therapy (Section C, Topical Application of Oxygen) | 10220 | 20.29 | |
2017-11-09 | New Positron Emission Tomography (PET) Radiopharmaceutical/Tracer Unclassified Codes | 10319 | 220.6 | |
2017-11-03 | Update to Pub 100-04, Chapter 18 Preventive and Screening Services - Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) | 10338 | 210.14 | |
2017-10-06 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2018 | 10309 | 190.12- 190.34 | |
2017-08-16 2016-02-05 | Screening for the Human Immunodeficiency Virus (HIV) Infection [Rescinded Transmittal 3778 dated May 24, 2017] | 9980 9403 | 210.7 | |
2017-08-04 2017-06-29 | Screening for Hepatitis B Virus (HBV) Infection [Rescinded Transmittal 3804 dated June 29, 2017; Transmittal 197, Pub. 100-03, and Transmittal 3793, Pub. 100-04 dated June 9, 2017] | 9859 | 210.6 | |
2017-07-28 | National Coverage Determination (NCD20.8.4): Leadless Pacemakers | 10117 | 20.8.4 | |
2017-07-27 | ICD-10 Coding Revisions to National Coverage Determinations (NCDs) | 10184 | 160.18, 210.4.1, 220.6.17, 220.6.20 | |
2017-07-27 2017-05-26 2015-01-30 2014-05-16 | Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS)[Rescinded Transmittals 199, Pub. 100-03 and 3805, Pub. 100-04, dated July 11, 2017] Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS) Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS)-Blinded Clinical Trial – Follow-Up CR to Implement a Second Claims Processing Procedure Code Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS) | 10089 8954 8757 | 150.13 | |
2017-06-16 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2017 | 10156 | 190.23, 190.21, 190.27 | |
2017-05-26 | ICD-10 Coding Revisions to National Coverage Determinations (NCDs) for October 2017 | 10086 | 20.29, 20.31, 20.31.1, 20.31.2, 20.31.3, 40.7, 80.2, 80.2.1, 80.3, 80.3.1, 80.11, 100.1, 110.4, 110.23, 190.3, 190.11, 210.13, 220.4, 220.6.17, 270.1 | |
2017-03-17 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2017 | 10036 | 190.21, 190.33 | |
2017-02-17 | ICD-10 Coding Revisions to National Coverage Determinations (NCDs) for July 2017 | 9982 | 20.31, 20.31.1, 20.31.2, 20.31.3, 20.34, 190.3, 220.4, 260.3.1, 270.1 | |
2017-02-03 | ICD-10 Coding Revisions to National Coverage Determination (NCDs) for April 2017 [Rescinded Transmittal 1755, dated November 18, 2016] | 9861 | 40.1, 40.7, 80.2 80.2.1 80.3 80.3.1, 80.11, 100.1, 110.4, 110.18, 110.23, 180.1, 190.1, 210.3, 220.4, 220.6.17, 260.5, 260.3.1, 270.6 | |
2017-01-13 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2017 | 9934 | 190.12-190.34 | |
2016-11-17 | Coding Revisions to National Coverage Determination (NCDs) for January 2017 [Rescinded Transmittal 1708, dated August 19, 2016] | 9751 | 20.7, 20.19, 20.33, 40.1, 160.18, 180.1, 190.3, 220.6.17, 220.6.20, 230.18, 260.1 | |
2016-11-16 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2017 [Rescinded Transmittal 3628, dated October 21, 2016] | 9806 | 190.12-190.34 | |
2016-07-01 | Stem Cell Transplantation for Multiple Myeloma, Myelofibrosis, Sickle Cell Disease, and Myelodysplastic Syndromes [Rescinded Transmittal 3509 dated April 29, 2016] Stem Cell Transplantation for Multiple Myeloma, Myelofibrosis, Sickle Cell Disease, and Myelodysplastic Syndromes [Rescinded Transmittal 191 dated April 29, 2016] | 9620 | 110.23 (formerly NCD 110.8.1) | |
2016-06-03 | Coding Revisions to National Coverage Determinations (NCDs) for October 2016 [Rescinded Transmittal 1665, dated May 13, 2016] | 9631 | 20.29, 20.4, 20.7, 20.9, 50.3, 110.18, 210.3, 210.4, 210.4.1, 220.4, 230.9, 260.9 | |
2016-05-06 | Percutaneous Left Atrial Appendage Closure (LAAC) | 9638 | 20.34 | |
2016-04-29 | Coding Revisions to National Coverage Determinations for July 2016 [Rescinded Transmittal 1630 dated February 26, 2016] | 9540 | 20.29, 20.33, 90.1, 110.18, 110.4, 150.3, 160.18, 160.24, 210.14, 210.3, 220.13, 220.4, 230.18, 260.1 | |
2016-03-25 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2016 | 9584 | 190.12-190.34 | |
2016-02-05 | Screening for Cervical Cancer With Human Papillomavirus (HPV) Testing—National Coverage Determination (NCD) | 9434 | 210.2.1 | |
2015-12-30 2015-08-28 | National Coverage Determination (NCD) for Screening for Colorectal Cancer Using Cologuard - A Multitarget Stool DNA Test [Rescinded Transmittal 3319 dated August 6, 2015] | 9115 | 210.3 | |
2015-12-22 | New Influenza Virus Vaccine Code [Rescinded Transmittal 3403 dated November 9, 2015] | 9357 | n/a | |
2015-12-10 2015-02-20 | National Coverage Determination (NCD) for Single Chamber and Dual Chamber Permanent Cardiac Pacemakers [Rescinded Transmittal 3384, dated October 26, 2015 and Transmittal 186, dated October 26, 2015] | 9078 | 20.8.3 | |
2015-12-03 | ICD-10 Conversion/Coding Infrastructure Revisions to National Coverage Determinations (NCDs)--3rd Maintenance CR for January/April 2016 [Rescinded Transmittal 1547 dated October 5, 2015] | 9252 | 20.5, 20.7, 20.9.1, 20.9, 20.16, 20.20, 20.29, 80.2, 80.2.1, 80.3, 80.3.1, 80.11, 100.1, 110.4, 110.10, 110.21, 150.3, 160.18, 160.24, 180.1, 190.11, 210.2, 210.3, 220.6.16, 220.13, 250.3, 250.5, 260.1, 270.6 | |
2015-11-05 2015-06-19 2015-03-11 2014-11-19 | Reporting of Type of Bill (TOB) 014x for Billing Screening of Hepatitis C Virus (HCV) in Adults Screening for Hepatitis C Virus (HCV) in Adults – Implementation of Additional Common Working File (CWF) and Shared System Maintainer (SSMs) Edits Screening for Hepatitis C Virus (HCV) in Adults [Rescinded Transmittal 3127 dated November 19, 2014 and Transmittal 174 dated September 5, 2014] | 9360 9200 8871 | 210.13 | |
2015-11-05 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2016 [Rescinded Transmittal 3366 dated October 2, 2015] | 9352 | 190.12-190.34 | |
2015-10-15 | Medicare Coverage of Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) | 9246 | 210.14 | |
2015-05-22 | NCD20.30 Microvolt T-wave Alternans (MTWA) | 9162 | 20.30 | |
2015-04-24 | Transcatheter Mitral Valve Repair (TMVR)-National Coverage Determination (NCD) [Rescinded Transmittal 3142 dated December 5, 2014] | 9002 | 20.33 | |
2015-04-03 | Changes to the Laboratory National Coverage Determination (NCD) Software for July 2015 | 9124 | 190.12-190.34 | |
2015-04-03 | Preventive and Screening Services — Update - Intensive Behavioral Therapy for Obesity, Screening Digital Tomosynthesis Mammography, and Anesthesia Associated with Screening Colonoscopy [Rescinded Transmittal 3160 dated January 7, 2015] | 8874 | 210.12, 220.4, 210.3 | |
2015-03-06 | ICD-10 Conversion/Coding Infrastructure Revisions/ICD-9 Updates to National Coverage Determinations (NCDs)--2nd Maintenance CR for July 2015 | 9087 | 20.29, 20.9.1, 50.3, 80.2, 80.2.1, 80.3, 80.3.1, 110.10, 150.3, 160.18, 180.1, 210.2, 250.3 | |
2015-01-08 2014-05-28 | Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors (This CR rescinds and fully replaces CR8468/TR2873 dated February 6, 2014) Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors (This CR rescinds and fully replaces CR8468/R162NCD dated 4/18/14) | 8739 | 220.6.17 | |
2014-08-29 | Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy | 8803 | 20.9.1 | |
2014-08-22 2012-09-24
2012-05-18 | Extracorporeal Photopheresis Extracorporeal Photopheresis (ICD-10)—replaces R2543 dated 9/7/12, R2506 dated 8/3/12, R2494 dated 7/10/12, R2473 dated 5/18/12 Extracorporeal Photopheresis (ICD-10) | 8808 7806 | 110.4 | |
2014-07-18 | Cardiac Rehabilitation Programs for Chronic Heart Failure | 8758 | 20.10.1 | |
2014-06-13 | Changes to the Laboratory NCD Software for October 2014 | 8797 | 190.12-190.34 | |
2014-05-23 | ICD-10 Conversion/Coding Infrastructure Revisions/ICD-9 Updates to NCDs - Maintenance CR (29 NCDs) for October 2014 | 8691 | 20.5, 20.7, 20.20, 20.29, 50.3, 70.2.1, 80.2, 80.2.1, 80.3, 80.3.1, 100.1, 110.4, 110.8.1, 110.10, 150.3, 160.18, 160.24, 160.27, 180.1, 190.1, 190.8, 190.11, 210.1, 210.2, 210.3, 210.10, 250.3, 250.4, 250.5 | |
2014-04-15 | Aprepitant for Chemotherapy-Induced Emesis—Replaces R2883CP, R180BP, R163NCD dated 2/21/14 | 8418 | 110.18 | |
2014-03-27 | Beta Amyloid Positron Emission Tomography (PET) in Dementia and Neurodegenerative Disease—replaces R2871CP and R160NCD dated 2/6/14 | 8526 | 220.6.20 | |
2014-01-31 | Changes to the Laboratory NCD Edit Software for ICD-10 Codes [Rescinded Transmittal 2806 dated November 1, 2013] | 8494 | 190.12-190.34 | |
2014-01-10 | Changes to the Laboratory NCD Edit Software for April 2014 (ICD-10) | 8585 | 190.12-190.34 | |
| 2013-12-23
2013-01-29 | Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid Obesity—replaces R2816CP and R157NCD dated 11/15/13
Bariatric Surgery for the Treatment of Morbid Obesity National Coverage Determination, Addition of Laparoscopic Sleeve Gastrectomy (LSG) — replaces R148 and R2590 dated 11/9/12 | 8484 8028 | 100.1 |
| 2013-11-29
2013-07-11
2013-01-07 2012-09-24 | Transcatheter Aortic Valve Replacement (TAVR) Follow-up - Implementation of Permanent CPT Code Transcatheter Aortic Value Replacement (TAVR)-Implementation of Mandatory Reporting of Clinical Trial Number(replaces R2689 dated 5/3/13) Transcatheter Aortic Valve Replacement (TAVR) Coding Update/Policy Clarification Transcatheter Aortic Valve Replacement (TAVR)—replaces R2512/R145NCD dated 8/3/12 | 8537
8255
8168 7897 | 20.32 |
2013-06-10 | Autologous Platelet-Rich Plasma (PRP) for Chronic Non- Healing Wounds—replaces R153NCD/R2710CP 5/21/13 and R152NCD/R2666CP dated 3/8/13 | 8213 | 270.3 | |
2013-03-15 | ICD-10 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS NCDs(CR 3 of 3)-30 NCDs for July/October 2013 | 8197 | 20.16, 20.30, 20.31, 20.31.1, 20.31.2, 20.4, 20.7, 40.1, 40.7, 50.3, 100.14, 110.4, 110.8.1, 150.10, 180.1, 190.1, 190.11, 190.3, 190.5, 190.8, 210.10,210.2, 210.4, 210.4.1, 210.7, 220.4, 220.6.16, 220.6.19, 260.1, 260.9 | |
2013-02-01 | Changes to the Laboratory NCD Software for ICD-10 | 8202 | 190.12-190.34 | |
2013-01-18 | ICD-10 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS NCDs (CR 2 of 3 )-11 NCDs for April 2013(replaces R11620 dated 1/4/13) | 8109 | 20.16, 20.20, 20.29, 20.9, 90.1, 210.1, 210.3, 260.1, 260.3.1, 260.5, 270.1 | |
2012-11-30 | Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low Back Pain (CLBP)—replaces R144NCD/R2511 dated 8/3/12 | 7836 | 160.27 | |
2012-09-14 | ICD-10 Conversion from ICD-9 of the Medicare Shared Systems as They Relate to CMS NCDs (CR 1 of 3) (ICD-10)19 NCDs for January 2013 | 7818 | 20.19, 20.5, 70.2.1, 80.11, 80.2, 80.2.1, 80.3, 80.3.1, 110.10, 110.21, 110.4, 150.3, 160.18, 160.24, 220.13, 230.9, 250.3, 250.4, 250.5 | |
| 2012-05-23
2012-01-26 | Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs (ICD-10)—replaces R2402 dated 1/26/12 Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs (ICD-10) | 7610 | 210.10 |
2012-05-11 | Assigned Codes for Home Oxygen Use for Cluster Headache (CH) in a Clinical Trial (ICD-10) | 7820 | 240.2.2 | |
2012-03-07 | Intensive Behavioral Therapy for Obesity—replaces R2409 dated 2/3/12 | 7641 | 210.12 | |
2011-01-28 | Expansion of Multi Carrier System (MCS) Procedure Code File to Accommodate ICD-10 Diagnosis Codes | 7297 | n/a | |
2012-01-25 2012-01-06 | CWF Editing for Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer (PROVENGE) Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer—replaces R136 and R2339 dated 11/2/11, R133 dated 7/8/11. | 7659 7431 | 110.22 |
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.