Changes to Laboratory NCD Edit Software Due in July

The Centers for Medicare & Medicaid Services (CMS) recently informed Medicare payers in Change Request (CR 6964) of changes that will be included in the July 2010 release of Medicare’s edit module for clinical diagnostic laboratory National Coverage Determinations (NCDs).

The following changes affect physicians, providers and suppliers submitting claims to Medicare for clinical diagnostic laboratory services:

  • ICD-9-CM codes V17.4 Family history of other cardiovascular diseases and V18.1 Family history of other endocrine and metabolic diseases have been deleted from the list of non-covered ICD-9-CM codes for all 23 NCDs; and
  • ICD-9-CM codes V17.41 Family history of sudden cardiac death (SCD), V17.49 Family history of other cardiovascular diseases, V18.11 Family history of multiple endocrine neoplasia [MEN] syndrome, and V18.19 Family history of other endocrine and metabolic diseases have been added to the list of non-covered ICD-9-CM codes for all 23 NCDs.

These changes to the laboratory edit module are effective for service dates on or after July 1.

Provider education article MLN Matters MM6964 is also available on the CMS website.

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