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National Coverage Determination (NCD) for Abortion (140.1)

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Publication Number

100-3

Manual Section Number

140.1

Manual Section Title

Abortion


Version Number

1

Effective Date of this Version

10/1/1998

Ending Effective Date of this Version

6/19/2006


Implementation Date

4/1/1999


Benefit Category
Physicians' Services
Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Indications and Limitations of Coverage

Abortions are not covered Medicare procedures except:

  1. If the pregnancy is the result of an act of rape or incest; or
  2. In the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed.

This restricted coverage applies to CPT codes 59840, 59841, 59850, 59851, 59852, 59855, 59856, 59857, and 59866.


Transmittal Number

108

Revision History

03/1999 - Restricted coverage to pregnancies resulting from rape or incest, or that endanger the life of the mother. Effective date NA. Restrictions are included in section 508 and 509 of the Omnibus Consolidated and Emergency Supplemental Appropriations Act for fiscal year 1999. (TN 108) (CR 778)


Other Versions
  • Abortion - Version 2, Effective between 6/19/2006 - 1/1/0001
CPT Copyright Statement
CPT only copyright 2002-2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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