CMS Issues Revisions to NCDs Relevant to Radiology

The Centers for Medicare and Medicaid Services (CMS) recently released Change Request (CR) 13070, which contains coding revisions to various National Coverage Determinations (NCD) pertinent to radiology.

Modifications include the following radiology-related NCDs:

• NCD 20.7 Percutaneous Transluminal Angioplasty (PTA) — Medicare administrative contractors (MACs) were made aware of the descriptor change for Current Procedural Terminology® code 37799, Unlisted procedure, vascular surgery, retroactive to January 1.
• NCD 150.3 Bone Density Studies — CMS instructs MACs to remove the bone strength and fracture risk using finite element analysis of functional data, and bone-mineral density, utilizing data from a computed tomography scan codes 0554T, 0555T, 0556T, 0557T, 0558T retroactive to July 1, 2019, and add the bone strength and fracture risk codes 0743T, 0749T, 0750T, effective Jan. 1, 2023. In addition, MACs are to update messaging to remove ALERT RARC M38 and add M76 retroactive to May 1, 2016.
• NCD 220.13 Percutaneous Image-Guided Breast Biopsy — CMS instructs MACs to add the percutaneous breast biopsies using stereotactic guidance and magnetic resonance guidance codes C7501, C7502 for multiple lesions (ambulatory surgery center setting only), retroactive to January 1.

Further details, including a full list of affected NCDs, can be accessed through CMS’ Medicare Learning Network.

For more information, contact Maria Tran, American College of Radiology® Director of Economic Policy.