CMS Updates ICD-10 Codes for Radiology NCDs

CMS recently released Change Request 14194, which contains coding revisions to various National Coverage Determinations (NCD) relevant to radiology.

Modifications include the following NCDs:

NCD 220.4 Mammograms

Effective Oct. 1, Medicare Administrative Contractors (MACs) are instructed to update coverage criteria by adding the following ICD-10 diagnosis codes:

• C50.A1 – Malignant inflammatory neoplasm of right breast
• C50.A2 – Malignant inflammatory neoplasm of left breast
• Z84.A – Family history of exposure to diethylstilbestrol
• Z91.B – Personal risk factor of exposure to diethylstilbestrol

NCD 220.6.17 Positron Emission Tomography (FDG) for Oncologic Conditions

• CMS instructs MACs to add ICD-10 diagnosis codes C50.A1, C50.A2, Z84.A effective Oct. 1.

NCD 220.13 Percutaneous Image-Guided Breast Biopsy

• CMS instructs MACs to add ICD-10 diagnosis codes C50.A1 and C50.A2 effective Oct. 1.

See Change Request 14194 and MLN Matters article MM14194 for further details, including a full list of affected NCDs.

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