In accordance with section 4554 of the Balanced Budget Act of 1997, CMS entered into negotiated rulemaking proceedings to develop national coverage determinations (NCDs) for clinical diagnostic laboratory services.  Under the negotiations, we developed 23 laboratory NCDs.  These NCDs are different than most other Medicare NCDs in that they include lists of ICD-9-CM codes.  All codes are included on one of three lists--covered codes, not covered codes, and codes that do not support medical necessity.  The NCDs were published under the Administrative Procedures Act in the Federal Register of November 23, 2001.

CMS announced a mechanism for keeping the NCD code list current.  CMS updates the NCD code list quarterly as necessary to incorporate new codes, correct ministerial errors, incorporate the results of Coding Analysis published else where on this site, and incorporate reconsideration of the NCDs that alter covered indications.  The quarterly updates are published in the NCD Coding Policy Manual.  You can download the current and previous coding manuals from this site. Alternatively, you can access individual NCDs from the lab index list below.

Downloads
Lab Code List [ZIP, 505KB] NCD Coding Policy Manual and Change Report: January 2009 [ZIP, 865KB] January 2009 [PDF, 1.66MB] October 2008 [ZIP, 1MB] October 2008 [PDF, 1.56MB] July 2008 [ZIP, 1MB] July 2008 [PDF,1.54MB] April 2007 [ZIP, 465KB] April 2007 [PDF, 1.5MB] January 2007 [ZIP, 477KB] January 2007 [PDF, 1.6MB] Negotiated Rulemaking: Coverage and Administrative Policies for Clinical Diagnostic Laboratory Services: 66 FR 58788-58836 [PDF, 301KB] 66 FR 58837-58886 [PDF, 239KB] 66 FR 58887-58890 [PDF, 45KB] Procedures for Maintaining Code Lists in the Negotiated National Coverage Determinations for Clinical Diagnostic Laboratory Services [CMS–3119–FN] [PDF, 63KB]
Related Links Inside CMS
Index of Lab NCDs Clinical Lab Center Coverage Center Medicare Coverage Database
Related Links Outside CMS
There are no Related Links Outside CMS

Page Last Modified: 12/19/2008 9:00:38 AM
Help with File Formats and Plug-Ins