On Nov. 9, 2018, the Centers for Medicare and Medicaid Services (CMS) issued Change Request (CR) 11005 containing coding updates to various National Coverage Determinations (NCD).
Modifications to radiology-relevant NCDs include the following:
NCD20.7 Percutaneous Transluminal Angioplasty (PTA)-Medicare Administrative Contractors (MACs) are instructed to add ICD-10 codes I63.031, I63.032, I63.033, I63.131, I63.132, I63.133, and I63.233 to the list of covered ICD-10 codes effective October 1, 2015.
CMS further instructs MACs to end-date unspecified ICD-10 codes I66.9, I66.09, I66.19, and I66.29 effective April 1, 2019.
NCD220.4 Mammograms- CMS instructs MACs to add ICD-10 codes N63.10 Unspecified lump in the right breast, unspecified quadrant and N63.20 Unspecified lump in the left breast, unspecified quadrant to the list of covered ICD-10 codes effective October 1, 2018.
Note: Dual diagnosis codes depicting specific quadrants can be reported instead of unspecified quadrants if found more appropriate by provider.
See MLN Matters article MM11005 for further details including a full list of affected NCDs.