Radiology’s Fight Against Prior Authorization Delays
ACR is leading national efforts to make prior authorization more efficient and clinically appropriate while reducing the administrative burden and supporting national legislation.
Read moreMain Content
CMS Updates ICD-10 Codes for Radiology NCDs
Sept. 4, 2025
CMS recently released Change Request 14194, which contains coding revisions to various National Coverage Determinations (NCD) relevant to radiology.
Modifications include the following NCDs:
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.
Related ACR News
ACR Supports Medicaid Coverage of Lung Cancer Screening
ACR-backed bill would mandate Medicaid lung cancer screening, expand cessation coverage, ban prior auth—aiming to save lives and reduce disparities.
Read morePatient-Centered Imaging Care Led by Radiologists
ACR helps its state chapters fight scope of practice expansion, such as helping to oppose bills in state legislatures that would allow non-physicians to practice independently.
Read more