CMS WatchSeptember 23, 2026·6 min read

January 2027 lab NCD edit software: ICD-10 list updates for 23 lab NCDs (CR 14614)

CMS issued Transmittal 13952 / Change Request 14614 on September 16, 2026, updating the clinical diagnostic laboratory NCD edit module (Pub 100-04 Ch 16 §120.2) for January 2027. The January-2027.zip spreadsheet lists ICD-10-CM adds and one delete across laboratory NCDs 190.14-190.34, with most list changes effective October 1, 2026, module effective January 1, 2027, and implementation January 4, 2027.

laboratory NCDICD-10-CMCR 14614January 2027CMS Watch

By the HCC Buddy Coding Team

Published September 23, 2026

Printed laboratory NCD coverage checklist and ICD-10 worksheet on a hospital lab billing desk — CMS Transmittal 13952 / CR 14614 updates the January 2027 laboratory NCD edit module; most ICD-10-CM list changes are effective October 1, 2026. — Illustration: HCC Buddy

Key Takeaways

→On September 16, 2026, CMS issued Transmittal 13952 / Change Request 14614 to update the January 2027 quarterly release of the clinical diagnostic laboratory NCD edit module (Medicare Claims Processing Manual, Pub 100-04, chapter 16, section 120.2).
→The module covers the 23 laboratory NCDs in Pub 100-03 sections 190.12 through 190.34. CMS points contractors to https://www.cms.gov/files/zip/January-2027.zip for the ICD-10-CM add/delete spreadsheet.
→Packet count from the official spreadsheet: 171 ICD-10-CM add tasks and 1 delete task across 21 NCD tabs (examples include HIV Testing 190.14, Blood Counts 190.15, PT/PTT, glucose/A1c, lipids, tumor markers, GGT, hepatitis panel, and fecal occult blood).
→Most list adds are effective October 1, 2026. The edit module itself is effective January 1, 2027, with implementation January 4, 2027. Blood Counts (190.15) also deletes Z87890 from the not-medically-necessary list effective September 30, 2026.
→This is not the same as the live January 2027 non-lab NCD ICD-10 revisions piece (CR 14537 / 14570) or the October 2026 NCD coding revisions (CR 14464), and it is not the October 2026 CLFS quarterly file (CR 14569) or the preliminary CY 2027 CLFS PAMA rates.

On September 16, 2026, the Centers for Medicare & Medicaid Services issued Transmittal 13952 / Change Request 14614, *Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2027*. The PDF is a recurring update notification under Pub 100-04, chapter 16, section 120.2.

If your desk maps diagnosis codes to lab CPT rows for Medicare coverage edits (HIV testing, blood counts, PT/PTT, iron studies, glucose, A1c, thyroid, lipids, tumor markers, GGT, hepatitis panel, fecal occult blood, and the rest of the negotiated lab NCDs), this is the January 2027 module load to put next to the October 1, 2026 ICD-10-CM code-set cutover.

What CR 14614 updates

CMS says nationally uniform software processes claims subject to one of the 23 laboratory NCDs in Pub 100-03 sections 190.12 through 190.34. The edit module is updated quarterly for ministerial coding updates and substantive NCD code-list changes. CR 14614 tells Shared System Maintainers and contractors that the January 2027 release will pick up the ICD-10-CM list changes in the attached spreadsheet.

Field	CMS value
Transmittal / CR	13952 / 14614
Issue date	September 16, 2026
Module effective date	January 1, 2027 (unless noted differently in requirements)
Implementation date	January 4, 2027
Spreadsheet	January-2027.zip

Spreadsheet scope (21 NCD tabs)

The official workbook `spreadsheet_for_January_2027_CR 20260715.xlsx` includes tabs for NCDs 190.14, 190.15, 190.16, 190.17, 190.18, 190.20A, 190.20B, 190.21A, 190.21B, 190.22, 190.23A, 190.23B, 190.24, 190.25, 190.27, 190.28, 190.29, 190.31, 190.32, 190.33, and 190.34. Across those tabs, this packet counted 171 "shall add" ICD-10-CM tasks and 1 "shall delete" task. Codes below are cited exactly as printed in the CMS spreadsheet (undotted alphanumeric as published in the file).

Business requirements in the CR map the same NCDs: covered-list adds for HIV Testing (Diagnosis) (190.14), PTT (190.16), PT (190.17), Serum Iron Studies (190.18), Blood Glucose (190.20A/B), Glycated Hemoglobin/Glycated Protein (190.21A/B), Thyroid Testing (190.22), Lipids (190.23A/B), Digoxin (190.24), Alpha-fetoprotein (190.25), hCG (190.27), CA 125 (190.28), CA 15-3/CA 27.29 (190.29), PSA (190.31), GGT (190.32), Hepatitis Panel (190.33), and Fecal Occult Blood (190.34). Blood Counts (190.15) is different: adds and one delete hit the not medically necessary ICD-10-CM list.

Dates that matter for claim DOS

October 1, 2026: Most ICD-10-CM adds in the spreadsheet take effect on this date (BR examples: 14614.1 HIV covered add; 14614.2 Blood Counts not-medically-necessary adds; 14614.3-14614.21 covered adds for PT/PTT through fecal occult blood).
September 30, 2026: BR 14614.2.1 deletes listed codes from the Blood Counts (190.15) not-medically-necessary list. The spreadsheet delete row is Z87890 (Personal history of sex reassignment).
January 1, 2027 / January 4, 2027: Edit module effective and shared-system implementation dates for the January 2027 quarterly release.

Contractors shall adjust claims brought to their attention. They do not need to search files to retract or retroactively pay prior claims (BR 14614.24).

Desk examples from the CMS sheet (not an exhaustive code list)

Pull the zip before you rebuild any local cheat sheet. Illustrative rows only:

NCD	Direction	Example ICD-10-CM (as in CMS sheet)	Descriptor (CMS sheet)
190.14 HIV Testing (Diagnosis)	Add to covered list (eff. 10/1/2026)	J4B	Pulmonary mycetoma
190.15 Blood Counts	Add to not medically necessary list (eff. 10/1/2026)	F64A	Gender identity disorder, in remission
190.15 Blood Counts	Delete from not medically necessary list (eff. 9/30/2026)	Z87890	Personal history of sex reassignment
190.16 PTT	Add to covered list	K740A; K7683; M043	Hepatic fibrosis, moderate fibrosis; Intestinal failure-associated liver disease; VEXAS syndrome
190.20A/B Glucose	Add to covered list	E89830; E89838	Post bariatric hypoglycemia; Other postprocedural hypoglycemia
190.27 hCG	Add to covered list	O00121; O0031 (and related interstitial / cesarean-scar ectopic rows)	Interstitial / cesarean scar ectopic pregnancy codes as listed

Larger tabs in this release include Blood Counts (190.15: 33 adds + 1 delete), PT (190.17: 24 covered adds), and GGT (190.32: 24 covered adds). Do not invent codes beyond the official file.

What this is not

Not the live January 2027 NCD ICD-10 coding revisions story (CR 14537 / 14570; PET, NGS, implants, and related non-lab NCDs).
Not the live October 2026 NCD ICD-10 coding revisions (CR 14464).
Not the October 2026 CLFS/CLIA quarterly update (CR 14569) or the preliminary CY 2027 CLFS PAMA rates.
Not an NCCI PTP/AOC edit file. NCCI quarterly items remain on a separate desk track.

Look up ICD-10 descriptors in the encoder after you load the official spreadsheet. Compare related diagnosis options in Compare when a covered versus not-medically-necessary path is unclear. Browse companion CMS Watch items on /news.

What coders should do now

1Download January-2027.zip from CMS and open spreadsheet_for_January_2027_CR 20260715.xlsx; filter your highest-volume lab NCD tabs (at least 190.15 Blood Counts, 190.17 PT, 190.20/190.21 glucose/A1c, 190.32 GGT).
2Calendar October 1, 2026 for most ICD-10-CM list adds, September 30, 2026 for the Blood Counts Z87890 delete from the not-medically-necessary list, and January 1 / January 4, 2027 for module effective / implementation.
3Update local LCD/NCD cheat sheets and claim-scrubber rules from the CMS sheet only; do not invent dotted code forms or descriptors that are not in the file.
4When a denial lands after October 1, 2026 DOS, check whether the diagnosis sits on the covered list versus the Blood Counts not-medically-necessary list before you appeal.
5Keep this CR separate from CR 14464 / CR 14537-14570 non-lab NCD coding revisions and from CLFS rate/file updates already covered on /news.

Frequently Asked Questions

Is CR 14614 the same as the January 2027 NCD ICD-10 revisions already on /news?

No. The live January 2027 NCD ICD-10 revisions article covers CR 14537 / 14570 (including PET, NGS, and related non-lab NCDs). CR 14614 / Transmittal 13952 updates the clinical diagnostic laboratory NCD edit module for Pub 100-03 sections 190.12 through 190.34.

When do the ICD-10-CM list changes apply versus when the edit module loads?

CMS business requirements date most ICD-10-CM adds as effective October 1, 2026. The January 2027 laboratory NCD edit module is effective January 1, 2027, with implementation January 4, 2027. Blood Counts (190.15) deletes Z87890 from the not-medically-necessary list effective September 30, 2026.

Will MACs automatically reopen old lab claims for these ICD-10 list changes?

No. BR 14614.24 says contractors shall adjust claims brought to their attention and do not need to search their files to retract payment or retroactively pay claims.

Where is the official code list?

CMS links the NCD spreadsheet at https://www.cms.gov/files/zip/January-2027.zip from Transmittal 13952 / CR 14614. Use that file as the source of truth for adds and deletes.