Laboratory NCD Edit Module Changes

The July 2009 quarterly update of the edit module for clinical diagnostic laboratory services will include several changes in laboratory national coverage determination (NCD) code lists, according to a transmittal the Centers for Medicare & Medicaid Services (CMS) issued May 15.

Please note the following additions to code lists appearing in the update to the laboratory edit module:

For Prothrombin Time (PT) (NCD 190.17), add ICD-9-CM codes 200.30-200.38, 200.40-200.48, 200.50-200.58, 200.60-200.68, 200.70-200.78, 202.70-202.78, and 404.4.

For Serum Iron Studies (NCD 190.18), add ICD-9-CM codes 200.30-200.38, 200.40-200.48, 200.50-200.58, 200.60-200.68, 200.70-200.78, and 202.70-202.78.

For Lipid Testing (NCD 190.23), add ICD-9-CM code 440.4.

For Gamma Glutamyl Transferase (190.32), add ICD-9-CM codes 200.30-200.38, 200.40-200.48, 200.50-200.58, 200.60-200.68, 200.70-200.78, and 202.70-202.78.

These ICD-9-CM codes will be covered by Medicare for clinical diagnostic laboratory services furnished on or after July 1.

This guidance is based on CMS transmittal 1735, Change Request 1481. Provider education article MM6481 is also available.

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