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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.

 

Links related to ICD-10 NCDs (as of 5/23/2018)
Transmittal Issue Date Subject CR# NCD#

R207NCD

R4049CP

2018-05-11

Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)

[Rescinded Transmittals 205, 3992, 206 and 4016]

10295

20.35

R2076OTN

2018-05-04

International Code of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)

10622

110.18, 150.3, 190.11, 220.13, 220.6.16, 220.6.17

R3961CP

2018-02-02

Editing Update for Mammography Services

10435

220.4

R2039OTN

2018-02-28

ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs)

[Rescinded Transmittal 2033, dated February 16, 2018]

10473

20.5, 110.18, 110.21, 150.3, 190.1, 190.11, 210.3, 210.4.1, 210.6, 220.4, 220.6.17, 250.4

R2005OTN

2018-01-18

ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs)

[Rescinded Transmittal 1975 dated November 9, 2017]

10318

20.9, 20.9.1, 20.16, 20.29, 20.30, 20.33, 40.1, 80.11, 80.2 80.2.1 80.3 80.3.1, 110.18, 110.21, 110.23, 160.27, 190.3, 190.11, 220.4, 220.6.17, 220.13, 260.1, 270.1, 270.3

R3937CP

2017-12-22

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2018

10424

190.12- 190.34

R3844CP

2017-11-21

Replacement of Mammography HCPCS Codes, Waiver of Coinsurance and Deductible for Preventive and Other Services, and Addition of Anesthesia and Prolonged Preventive Services

10181

220.4, 210.3 and other preventive services

R203NCD

R3921CP

2017-11-17

Hyperbaric Oxygen (HBO) Therapy (Section C, Topical Application of Oxygen)

10220

20.29

R3911CP

2017-11-09

New Positron Emission Tomography (PET) Radiopharmaceutical/Tracer Unclassified Codes

10319

220.6

R3872CP

2017-10-06

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2018

10309

190.12- 190.34

R3835CP

R190NCD
R3461CP

2017-08-16

2016-02-05

Screening for the Human Immunodeficiency Virus (HIV) Infection

[Rescinded Transmittal 3778, dated May 24, 2017]

9980

9403

210.7

R3831CP

R198NCD

2017-08-04

2017-06-29

Screening for Hepatitis B Virus (HBV) Infection

[Rescinded Transmittal 3804, dated June 29, 2017; Transmittal 197, Pub. 100-03, and Transmittal 3793, Pub. 100-04 dated June 9, 2017]

9859

210.6

R201NCD

R3815CP

2017-07-28

National Coverage Determination (NCD20.8.4): Leadless Pacemakers

10117

20.8.4

R1875OTN

2017-07-27

ICD-10 Coding Revisions to National Coverage Determinations (NCDs)

10184

160.18, 210.4.1, 220.6.17, 220.6.20

R3811CP

R200NCD

R3175CP

R2959CP
R167NCD

2017-07-27

2015-01-30

2014-05-16

Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS)

[Rescinded Transmittals 199, Pub. 100-03 and 3805, Pub. 100-04, dated July 11, 2017]

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

R3797CP

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

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

R3556CP

R193NCD

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 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

[Rescinded Transmittal 1630, dated February 26, 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

R189NCD

R3460CP

2016-02-05

Screening for Cervical Cancer With Human Papillomavirus (HPV) Testing—National Coverage Determination (NCD)

9434

210.2.1

R188NCD

R183NCD

2015-12-30

2015-08-28

National Coverage Determination (NCD) for Screening for Colorectal Cancer Using Cologuard - A Multitarget Stool DNA Test

[Rescinded Transmittal 3319, dated August 6, 2015]

9115

210.3

R3429CP

2015-12-22

New Influenza Virus Vaccine Code

[Rescinded Transmittal 3403, dated November 9, 2015]

9357

n/a

R3421CP

R187NCD

R3204CP

R179NCD

2015-12-10

2015-02-20

National Coverage Determination (NCD) for Single Chamber and Dual Chamber Permanent Cardiac Pacemakers

[Rescinded Transmittal 3384, dated October 26, 2015 and Transmittal 186, dated October 26, 2015]

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

[Rescinded Transmittal 1547, dated October 5, 2015]

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

R3393CP

R3285CP

R3215CP

R177NCD

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

[Rescinded Transmittal 3127, dated November 19, 2014 and Transmittal 174 dated September 5, 2014]

9360

9200

8871

210.13

R3396CP

2015-11-05

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2016

[Rescinded Transmittal 3366, dated October 2, 2015]

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

R182NCD

R3265CP

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)

[Rescinded Transmittal 3142, dated December 5, 2014]

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

[Rescinded Transmittal 3160, dated January 7, 2015]

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

R3162CP

R168NCD

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

R3050CP

R2551CP

R143NCD

2014-08-22

2012-09-24

2012-05-18

Extracorporeal Photopheresis

Extracorporeal Photopheresis (ICD-10)—replaces R2543 dated 9/7/12, 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

R2931CP
R185BP
R165NCD

2014-04-15

Aprepitant for Chemotherapy-Induced Emesis—Replaces R2883CP, R180BP, R163NCD dated 2/21/14

8418

110.18

R2915CP
R164NCD

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

[Rescinded Transmittal 2806, dated November 1, 2013]

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

R2841CP
R158NCD

R150NCD
R2641CP

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) — replaces R148 and R2590 dated 11/9/12

8484

8028

100.1

R2827CP

R2737CP

R2628CP

R147NCD
R2552CP

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(replaces R2689 dated 5/3/13)

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(replaces R11620 dated 1/4/13)

8109

20.16, 20.20, 20.29, 20.9, 90.1, 210.1, 210.3, 260.1, 260.3.1, 260.5, 270.1

R149NCD

R2605CP

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

R2476CP

R141NCD

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

R142NCD
R2421CP

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

R2394CP

R140NCD

R2380CP

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 R136 and R2339 dated 11/2/11, R133 dated 7/8/11.

7659

7431

 110.22

.