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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.
