View NCDs

CMS develops NCDs to describe circumstances for Medicare coverage nationwide for an item or service. NCDs generally outline the conditions for which an item or service is covered (or not covered) under §1862(a)(1) of the Social Security Act or other applicable provisions of the Act. A NCD can be initiated by CMS if they find an inconsistent local coverage policy, services represent a significant medical advance and no similar service is currently covered by Medicare, service is subject of substantial controversy, or a potential rapid diffusion or overuse exists.

Step 1: Perform a policy search

Use the Medicare Coverage Database (MCD) to search for an NCD. Review our MCD quick reference guide for additional information.

NCDs by Chapter/Section

In the top menu bar click on reports, next click on NCD reports. On the right side of the screen click on sort by chapter/section.

Components of an NCD

Information that may be contained in an NCD includes description information, benefit category, item/service description, indications, and limitations of coverage and/or medical necessity, claims processing instructions, national coverage analyses, transmittal information, revision history, additional information, procedure codes, covered and/or non-covered diagnosis codes.

Note: CPT/HCPCS, ICD-10 codes are not listed within the NCD.

Helpful hints for NCDs

ICD-10 Diagnosis codes

Finding ICD-10 diagnosis codes within NCDs for laboratory services are in links at the bottom of the LCD under the heading titled "Other".

For all other services, locate the NCD transmittal within the ICD-10 CMS web page. Within the transmittal there will be a link to the NCD spreadsheet.

Note: Not all diagnosis codes listed in the NCD spreadsheet are covered. A message will appear at the top of the diagnosis listing to indicate denial or coverage if one of the following diagnosis codes are present on the claim.

NCD revisions

Review alerts on the Medicare Coverage Database Notice Board and the latest site updates located under the search feature. To request a revision to an NCD, refer to the August 7, 2013 Federal Register notice. If you need further assistance regarding NCD requests, please email NCDRequest@cms.hhs.gov. To request an NCD, refer to How to request an NCD.

Note: If you do not find what you are looking for, a procedure may have other policies or guidelines listed on the CMS website.

Continue to Locate guidelines on the CMS website.

Back to the main FastTrack Medicare coverage policies.