Coding Analysis for Labs (CAL) Tracking Sheet

Blood Counts (Addition of ICD-9-CM Codes V77.1, V81.0, V81.1, and V81.2 to the list of Codes that Do Not Support Medical Necessity)



The current national coverage determination (NCD) for blood counts is constructed so that any ICD-9-CM code not on the list of Codes That Do Not Support Medical Necessity or List of Codes Not Covered by Medicare are covered. Prior to January 1, 2005, ICD-9-CM codes V77.1, V81.0, V81.1, and V81.2 were on the List of Codes Not Covered by Medicare, as these codes are screening. However, effective January 1, 2005, the Medicare law was changed to add diabetes and cardiovascular screening as a Medicare covered benefit. In order to implement this statutory change, these codes were removed from the List of Codes Not Covered by Medicare. Without adding them to the list of codes that are not medically necessary for blood counts, the framework of the NCD resulted in these codes being covered. We will be reviewing these codes more carefully with the benefit of public comment to make a determination if the codes should be added to the List of Codes that Do Not Support Medical Necessity for blood counts.

National Coverage Determinations

Benefit Category

Diagnostic Laboratory Tests

Requestor Information

Requestor Name Requestor Letter
Internally Generated N/A

Important Dates

Formal Request Accepted and Review Initiated
Expected CAL Completion Date
Public Comment Period
01/31/2005 - 03/02/2005
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released


Lead Analysts
Jackie Sheridan-Moore
Lead Medical Officers
James Rollins, MD

Medicare Benefit Category Determination Date

Actions Taken

January 31, 2005

Posted notice of CAL to Internet for public comments

March 15, 2005

Posted decision memorandum to the Internet.