ICD-10
The International Classification of Disease (ICD)-10 code sets provide flexibility to accommodate future health care needs, facilitating timely electronic processing of claims by reducing requests for additional information to providers. ICD-10 also includes significant improvements over ICD-9 in coding primary care encounters, external causes of injury, mental disorders, and preventive health. The ICD-10 code sets' breadth and granularity reflect advances in medicine and medical technology, as well as capture added detail on socioeconomics, ambulatory care conditions, problems related to lifestyle, and the results of screening tests.
As a result, medical terminology and disease classifications are being updated to be consistent with current clinical practice per regulations at 45 CFR Part 162. All Centers for Medicare & Medicaid Services (CMS) ICD-10 system changes have been phased-in and are scheduled for completion by October 1, 2014, giving a full year for additional testing, fine-tuning, and preparation prior to full implementation of ICD-10 CM/PCS for all Health Insurance Portability and Accountability Act (HIPAA)-covered entities. ICD-10-CM/PCS will replace ICD-9-CM/PCS diagnosis and procedure codes in all health care settings for dates of service, or dates of discharge for inpatients, that occur on or after the implementation date of ICD-10.
The Coverage and Analysis Group at CMS is the Federal entity that oversees National Coverage Determination (NCD) and Local Coverage Determination (LCD) policies. NCDs and LCDs constitute Medicare coverage decisions made by CMS and applied both nationally and locally across all health insurance payers. In light of HIPAA as it relates to ICD-10, CMS is responsible for converting the ICD-9 codes to ICD-10 codes in NCDs and LCDs as the Agency finds appropriate. There are approximately 330 NCDs spanning a range of time and not all NCDs are appropriate for translation. CMS has determined which NCDs/LCDs should be translated and is in the process of completing the associated systems changes. CMS change request (CR) transmittals and Medicare Learning Network Articles (MLN Matters®) are the vehicles used to communicate information regarding NCD/LCD translations.
The table below contains the various CRs and associated documents that CMS/CAG has issued to date as part of its ICD-10 conversion activities related to NCDs. It will be updated periodically. For more in depth information related to the contents of the table, please contact: Pat Brocato-Simons, patricia.brocatosimons@cms.hhs.gov, 410-786-0261.
The information below is for translations of NCDs. If you have questions about translations of LCDs, please contact your Medicare Administrative Contractor. The contact information can be found here.
| Transmittal | Issue Date | Subject | CR# | NCD# |
|---|---|---|---|---|
| 2017-06-29 | Screening for Hepatitis B Virus (HBV) Infection | 9859 | 210.6 | |
|
2017-06-16 |
Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2017 |
10156 |
190.23, 190.21, 190.27 |
|
| R1854OTN | 2017-05-26 | ICD-10 Coding Revisions to National Coverage Determinations (NCDs) for October 2017 | 10086 | 20.29, 20.31, 20.31.1, 20.31.2, 20.31.3, 40.7, 80.2, 80.2.1, 80.3, 80.3.1, 80.11, 100.1, 110.4, 110.23, 190.3, 190.11, 210.13, 220.4, 220.6.17, 270.1 |
|
2017-05-26 2015-01-30 2014-05-16 |
Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS) Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS)-Blinded Clinical Trial – Follow-Up CR to Implement a Second Claims Processing Procedure Code Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS) |
10089 8954 8757 |
150.13 | |
|
2017-05-24 2016-02-05 |
Screening for the Human Immunodeficiency Virus (HIV) Infection |
9980 9403 |
210.7 | |
| R3738CP | 2017-03-17 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2017 | 10036 | 190.21, 190.33 |
| R1798OTN | 2017-02-17 | ICD-10 Coding Revisions to National Coverage Determinations (NCDs) for July 2017 | 9982 | 20.31, 20.31.1, 20.31.2, 20.31.3, 20.34, 190.3, 220.4, 260.3.1, 270.1 |
| R1792OTN | 2017-02-03 | ICD-10 Coding Revisions to National Coverage Determination (NCDs) for April 2017 [Rescinded Transmittal 1755, dated November 18, 2016] | 9861 | 40.1, 40.7, 80.2 80.2.1 80.3 80.3.1, 80.11, 100.1, 110.4, 110.18, 110.23, 180.1, 190.1, 210.3, 220.4, 220.6.17, 260.5, 260.3.1, 270.6 |
| R3691CP | 2017-01-13 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2017 | 9934 | 190.12-190.34 |
| R1753OTN | 2016-11-17 | Coding Revisions to National Coverage Determination (NCDs) for January 2017 [Rescinded Transmittal 1708, dated August 19, 2016] | 9751 | 20.7, 20.19, 20.33, 40.1, 160.18, 180.1, 190.3, 220.6.17, 220.6.20, 230.18, 260.1 |
| R3656CP | 2016-11-16 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2017 [Rescinded Transmittal 3628, dated October 21, 2016] | 9806 | 190.12-190.34 |
| 2016-07-01 |
Stem Cell Transplantation for Multiple Myeloma, Myelofibrosis, Sickle Cell Disease, and Myelodysplastic Syndromes [Rescinded Transmittal 3509 dated April 29, 2016] Stem Cell Transplantation for Multiple Myeloma, Myelofibrosis, Sickle Cell Disease, and Myelodysplastic Syndromes [Rescinded by Transmittal 191 dated April 29, 2016] |
9620 | 110.23 | |
| R1672OTN | 2016-06-03 | Coding Revisions to National Coverage Determinations (NCDs) for October 2016 [Rescinded Transmittal 1665, dated May 13, 2016] | 9631 | 20.29, 20.4, 20.7, 20.9, 50.3, 110.18, 210.3, 210.4, 210.4.1, 220.4, 230.9, 260.9 |
| R3515CP | 2016-05-06 | Percutaneous Left Atrial Appendage Closure (LAAC) | 9638 | 20.34 |
| R1658OTN | 2016-04-29 | Coding Revisions to National Coverage Determinations for July 2016 | 9540 | 20.29, 20.33, 90.1, 110.18, 110.4, 150.3, 160.18, 160.24, 210.14, 210.3, 220.13, 220.4, 230.18, 260.1 |
| R3485CP | 2016-03-25 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2016 | 9584 | 190.12-190.34 |
| 2016-02-05 | Screening for Cervical Cancer With Human Papillomavirus (HPV) Testing—National Coverage Determination (NCD) | 9434 | 210.2.1 | |
|
2015-12-30 2015-08-28 |
National Coverage Determination (NCD) for Screening for Colorectal Cancer Using Cologuard - A Multitarget Stool DNA Test | 9115 | 210.3 | |
| R3429CP | 2015-12-22 | New Influenza Virus Vaccine Code | 9357 | n/a |
|
2015-12-10 2015-02-20 |
National Coverage Determination (NCD) for Single Chamber and Dual Chamber Permanent Cardiac Pacemakers | 9078 | 20.8.3 | |
| R1580OTN | 2015-12-03 | ICD-10 Conversion/Coding Infrastructure Revisions to National Coverage Determinations (NCDs)--3rd Maintenance CR for January/April 2016 | 9252 | 20.5, 20.7, 20.9.1, 20.9, 20.16, 20.20, 20.29, 80.2, 80.2.1, 80.3, 80.3.1, 80.11, 100.1, 110.4, 110.10, 110.21, 150.3, 160.18, 160.24, 180.1, 190.11, 210.2, 210.3, 220.6.16, 220.13, 250.3, 250.5, 260.1, 270.6 |
|
2015-11-05 2015-06-19 2015-03-11 2014-11-19 |
Reporting of Type of Bill (TOB) 014x for Billing Screening of Hepatitis C Virus (HCV) in Adults Screening for Hepatitis C Virus (HCV) in Adults – Implementation of Additional Common Working File (CWF) and Shared System Maintainer (SSMs) Edits Screening for Hepatitis C Virus (HCV) in Adults |
9360 9200
8871 |
210.13 | |
| R3396CP | 2015-11-05 | Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2016 | 9352 | 190.12-190.34 |
| R3374CP | 2015-10-15 | Medicare Coverage of Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) | 9246 | 210.14 |
| 2015-05-22 | NCD20.30 Microvolt T-wave Alternans (MTWA) | 9162 | 20.30 | |
| R3241CP | 2015-04-24 | Transcatheter Mitral Valve Repair (TMVR)-National Coverage Determination (NCD) | 9002 | 20.33 |
| R3228CP | 2015-04-03 | Changes to the Laboratory National Coverage Determination (NCD) Software for July 2015 | 9124 | 190.12-190.34 |
| R3232CP | 2015-04-03 | Preventive and Screening Services — Update - Intensive Behavioral Therapy for Obesity, Screening Digital Tomosynthesis Mammography, and Anesthesia Associated with Screening Colonoscopy | 8874 | 210.12, 220.4, 210.3 |
| R1478OTN | 2015-03-06 | ICD-10 Conversion/Coding Infrastructure Revisions/ICD-9 Updates to National Coverage Determinations (NCDs)--2nd Maintenance CR for July 2015 | 9087 | 20.29, 20.9.1, 50.3, 80.2, 80.2.1, 80.3, 80.3.1, 110.10, 150.3, 160.18, 180.1, 210.2, 250.3 |
|
2015-01-08 2014-05-28 |
Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors (This CR rescinds and fully replaces CR8468/TR2873 dated February 6, 2014) Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors (This CR rescinds and fully replaces CR8468/R162NCD dated 4/18/14) |
8739 | 220.6.17 | |
| R172NCD R3054CP |
2014-08-29 | Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy | 8803 | 20.9.1 |
|
2014-08-22 2012-09-24 2012-05-18 |
Extracorporeal Photopheresis Extracorporeal Photopheresis (ICD-10)—replaces R2543 dated 7/9/12, R2506 dated 8/3/12, R2494 dated 7/10/12, R2473 dated 5/18/12 Extracorporeal Photopheresis (ICD-10) |
8808 7806 |
110.4 |
|
| R2976CP | 2014-06-13 | Changes to the Laboratory NCD Software for October 2014 | 8797 | 190.12-190.34 |
| R1388OTN | 2014-05-23 | ICD-10 Conversion/Coding Infrastructure Revisions/ICD-9 Updates to NCDs - Maintenance CR (29 NCDs) for October 2014 | 8691 | 20.5, 20.7, 20.20, 20.29, 50.3, 70.2.1, 80.2, 80.2.1, 80.3, 80.3.1, 100.1, 110.4, 110.8.1, 110.10, 150.3, 160.18, 160.24, 160.27, 180.1, 190.1, 190.8, 190.11, 210.1, 210.2, 210.3, 210.10, 250.3, 250.4, 250.5 |
| 2014-04-15 | Aprepitant for Chemotherapy-Induced Emesis—Replaces R2883CP, R180BP, R163NCD dated 2/21/14 | 8418 | 110.18 | |
| 2014-03-27 | Beta Amyloid Positron Emission Tomography (PET) in Dementia and Neurodegenerative Disease—replaces R2871CP and R160NCD dated 2/6/14 | 8526 | 220.6.20 | |
| R2865CP | 2014-01-31 | Changes to the Laboratory NCD Edit Software for ICD-10 Codes | 8494 | 190.12-190.34 |
| R2852CP | 2014-01-10 | Changes to the Laboratory NCD Edit Software for April 2014 (ICD-10) | 8585 | 190.12-190.34 |
|
2013-12-23 2013-01-29 |
Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid Obesity—replaces R2816CP and R157NCD dated 11/15/13 Bariatric Surgery for the Treatment of Morbid Obesity National Coverage Determination, Addition of Laparoscopic Sleeve Gastrectomy (LSG) |
8484 8028 |
100.1 |
|
|
2013-11-29 2013-07-11 2013-01-07 2012-09-24 |
Transcatheter Aortic Valve Replacement (TAVR) Follow-up - Implementation of Permanent CPT Code Transcatheter Aortic Value Replacement (TAVR)-Implementation of Mandatory Reporting of Clinical Trial Number Transcatheter Aortic Valve Replacement (TAVR) Coding Update/Policy Clarification Transcatheter Aortic Valve Replacement (TAVR)—replaces R2512/R145NCD dated 8/3/12 |
8537 8255 8168 7897 |
20.32 |
|
| R154NCD, R2720CP | 2013-06-10 | Autologous Platelet-Rich Plasma (PRP) for Chronic Non- Healing Wounds—replaces R153NCD/R2710CP 5/21/13 and R152NCD/R2666CP dated 3/8/13 | 8213 | 270.3 |
| R1199OTN | 2013-03-15 | ICD-10 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS NCDs(CR 3 of 3)-30 NCDs for July/October 2013 | 8197 | 20.16, 20.30, 20.31, 20.31.1, 20.31.2, 20.4, 20.7, 40.1, 40.7, 50.3, 100.14, 110.4, 110.8.1, 150.10, 180.1, 190.1, 190.11, 190.3, 190.5, 190.8, 210.10,210.2, 210.4, 210.4.1, 210.7, 220.4, 220.6.16, 220.6.19, 260.1, 260.9 |
| R1174OTN | 2013-02-01 | Changes to the Laboratory NCD Software for ICD-10 | 8202 | 190.12-190.34 |
| R1165OTN | 2013-01-18 | ICD-10 Conversion from ICD-9 and Related Code Infrastructure of the Medicare Shared Systems as They Relate to CMS NCDs (CR 2 of 3 )-11 NCDs for April 2013 | 8109 | 20.16, 20.20, 20.29, 20.9, 90.1, 210.1, 210.3, 260.1, 260.3.1, 260.5, 270.1 |
| 2012-11-30 | Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low Back Pain (CLBP)—replaces R144NCD/R2511 dated 8/3/12 | 7836 | 160.27 | |
| R1122OTN | 2012-09-14 | ICD-10 Conversion from ICD-9 of the Medicare Shared Systems as They Relate to CMS NCDs (CR 1 of 3) (ICD-10)19 NCDs for January 2013 | 7818 | 20.19, 20.5, 70.2.1, 80.11, 80.2, 80.2.1, 80.3, 80.3.1, 110.10, 110.21, 110.4, 150.3, 160.18, 160.24, 220.13, 230.9, 250.3, 250.4, 250.5 |
|
2012-05-23 2012-01-26 |
Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs (ICD-10)—replaces R2402 dated 1/26/12 Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs (ICD-10) |
7610 | 210.10 | |
| R2465CP | 2012-05-11 | Assigned Codes for Home Oxygen Use for Cluster Headache (CH) in a Clinical Trial (ICD-10) | 7820 | 240.2.2 |
| 2012-03-07 | Intensive Behavioral Therapy for Obesity—replaces R2409 dated 2/3/12 | 7641 | 210.12 | |
| R852OTN | 2011-01-28 | Expansion of Multi Carrier System (MCS) Procedure Code File to Accommodate ICD-10 Diagnosis Codes | 7297 | n/a |
|
2012-01-25 2012-01-06 |
CWF Editing for Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer (PROVENGE) Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer—replaces R133 dated 7/8/11, R2339 dated 11/2/11 |
7659 7431 |
110.22 |
- Page last Modified: 07/07/2017 9:20 AM
- Help with File Formats and Plug-Ins
