December 10, 2018

CMS Updates ICD-10 Code Lists to Percutaneous Transluminal Angioplasty and Mammography NCDs

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.