MLN – Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2021

This MLN Matters® Article is for physicians, other providers, and suppliers submitting claims to Medicare Administrative Contractors (MACs) for services they provide to Medicare patients.

In accordance with the Medicare Claims Processing Manual, Chapter 16, Section 120.2, CMS updates the laboratory edit module as necessary to reflect coding updates and substantive changes to the NCDs. The changes are a result of coding analysis decisions developed under the procedures for maintenance of codes in the negotiated NCDs and biannual updates of the ICD-10-CM codes. This allows us to process laboratory claims subject to one of the 23 NCDs (see Medicare National Coverage Determination, Sections 190.12 – 190.34) uniformly throughout the nation.

Source: https://www.cms.gov/files/document/mm12384.pdf