CMS ICD-10 Updates Affect Mammography, PET, BMD NCDs

CMS issued Change Requests (CRs) 14537 and 14570, containing International Classification of Diseases, Tenth Revision (ICD-10) coding updates to various National Coverage Determinations (NCDs). The CRs become effective Jan. 1, 2027; however, the new ICD-10 codes associated with these updates become effective Oct. 1, 2026.

Modifications to radiology-relevant NCDs include:

• NCD 150.3 Bone Density - Medicare administrative contractors (MACs) are instructed to add ICD-10 code: 
  
  • Q87.A Loeys-Dietz syndrome. 
• NCD 220.4 Mammograms - CMS instructs MACs to add the following ICD-10 codes: 
  
  • N99.860 Intraoperative and postprocedural nipple ischemia
  • N99.861 Intraoperative and postprocedural nipple necrosis. 
• NCD 220.6.17 PET (FDG) for Oncologic Conditions - CMS instructs MACs to add ICD-10 codes: 
  
  • C78.31 Secondary malignant neoplasm of larynx
  • C78.32 Secondary malignant neoplasm of pharynx
  • C79.83 Secondary malignant neoplasm of oral cavity

See CRs 14537 and 14570 for more details, including a full list of affected NCDs. ACR® encourages practices to review the updates and revisions and make any necessary system changes.

If you have questions about the NCD process or coding revisions, contact Alicia Blakey, ACR Manager of Economic Policy, or Maria Tran, ACR Director of Economic Policy.