March 01, 2018

CMS Issues ICD-10 and Other Coding Revisions to NCDs

On February 16, 2018, the Centers for Medicare and Medicaid Services (CMS) issued Change Request (CR) 10473 containing coding revisions to various National Coverage Determinations (NCD).

Modifications to radiology-relevant NCDs include the following:

  • NCD 150.3 Bone Mineral Density Studies. Medicare administrative contractors (MACs) are instructed to add ICD-10 code Z79.811, Long term (current) use of aromatase inhibitors, effective October 1, 2015
  • NCD 220.4 Mammograms. The CR instructs the MACs to accept add-on Healthcare Common Procedure Coding System (HCPCS) code G0279, Diagnostic digital breast tomosynthesis, unilateral or bilateral, when billed with CPT codes 77065, Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral, and 77066, Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral, effective January 1, 2018
  • NCD 220.6.17 PET for Solid Tumors. CMS instructs MACs to delete ICD-10 codes C44.91, Basal cell carcinoma of skin, unspecified, C44.92, Squamous cell carcinoma of skin, unspecified, and C57.9, Malignant neoplasm of female genital organ, unspecified, effective October 1, 2015 

See MLN Matters article MM10473 for further details including a full list of affected NCDs.