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Mammograms (NCD 220.4) and Percutaneous Image-Guided Breast Biopsy (NCD 220.13) ICD-10 Update

Provider/Supplier Type(s) Impacted: Not applicable

Reason Codes: Not applicable

Claim Coding Impact: Not applicable

Description of Issue: NCD 220.4 and NCD 220.13 are currently not accepting the new ICD-10 diagnoses codes. The specific codes for both NCD 220.4 and NCD 220.13 are N63.11-N63.14, N63.21-N63.24, N63.31, N63.32, N63.41, N63.42. These new codes replace N63 that was end dated on September 30, 2017.

Noridian Action Required: Noridian is implementing a temporary correction to accept the new ICD-10 codes for these two policies by January 2, 2018. The permanent correction will be implemented April 2, 2018.

Provider/Supplier Action Required: At this time, no provider/supplier action is required.

Proposed Resolution/Solution: For any claims that processed incorrectly from October 1, 2017 - January 2, 2018, a mass adjustment will be completed to process according to the revised NCDs. The adjustment process will not begin until after the April 2, 2018 implementation.

Date Reported: 12/28/17

Date Resolved:

Last Updated Dec 28, 2017