ICD-10 Updates to National Coverage Determinations issue
November 16, 20162017 ICD-10 CM diagnosis codes are required on claims for services performed on or after 10/1/2016. However, changes to the claims processing systems to implement the ICD-10 updates for several CMS National Coverage Determinations (NCDs), including the Lab NCDs, will be implemented beginning in early January, 2017 and will occur in phases over the first quarter of 2017. Claims for dates of service on or after 10/1/2016 with ICD-10 diagnoses associated with NCD edits may be subject to medical necessity denials. National Government Services (NGS) is collaborating with CMS on a resolution to this issue. No provider action is necessary at this time. Providers should monitor their medical necessity denials carefully.