Coding Analyses for Labs

CMS has determined that ICD-9-CM diagnosis code V76.44, Prostate cancer screening, is not appropriately included on the list of ICD-9-CM codes that are not covered by Medicare. CMS intends to modify the list of “ICD-9-CM Codes Denied” in the Laboratory NCD Coding Manual. This change affects the entire 23 negotiated clinical diagnostic laboratory NCDs. Since removal of V76.44 from the codes denied list would automatically result in inappropriate inclusion on the list of covered diagnoses for blood counts, CMS has also added V76.44 to the list of codes that do not support medical necessity for blood counts.

Source: https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=167