CMS pulls NCD 110.23 stem-cell coding from October 2026 CR 14464 (R13968OTN); deferred to April 2027

On September 24, 2026, the Centers for Medicare & Medicaid Services issued Transmittal 13968 / Change Request 14464 (Pub 100-20 One-Time Notification), titled *International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)- October 2026*. The PDF rescinds and replaces Transmittal 13910 (August 14, 2026).

If your desk was staging the October 5, 2026 systems load from R13910, the Monday-morning change is narrow but real: NCD 110.23 Stem Cell coding instructions that were in CR 14464 are pulled from this CR and parked for an April 2027 change request. The rest of the October 2026 NCD coding package stays.

What Transmittal 13968 changes

CMS prints this replacement reason at the top of the transmittal:

> Transmittal 13910 issued August 14, 2026, is being rescinded and replaced by Transmittal 13968, dated September 24, 2026, to remove NCD 110.23 Stem Cell, by removing business requirements 14464.4 through 14464.4.1.1, as it will be added to an April 2027 CR. All other information remains the same.

In the business requirements table of Transmittal 13968:

CMS does not reprint the prior stem-cell instruction text inside R13968. For what Transmittal 13910 previously directed under BR 14464.4, see the live October 2026 NCD CR 14464 overview: allow Type of Bill (TOB) 13X for allogeneic hematopoietic stem cell transplantation (HSCT) for myelodysplastic syndromes (MDS), and line-level deny HSCT services when not submitted on TOB 13X. Those instructions are not carried forward in Transmittal 13968's active BR list.

What still runs on the October 2026 CR schedule

Transmittal 13968 keeps the same CR subject and the same overall dates for the remaining requirements:

Active BRs that remain in R13968 include NCD 220.6.1 (PET for Perfusion of the Heart), NCD 150.3 (Bone Mineral Density Studies / CPT 0554T-0558T), NCD 20.4 (Implantable Cardioverter Defibrillation ICD-10-PCS adds), NCD 110.18 (Aprepitant / J9278 and C9308), NCD 110.24 (CAR-T / C88.40 under Q2054), NCD 90.2 (NGS / CPT 0648U), plus BR 14464.10 (adjust claims brought to attention; do not search). Spreadsheet pointer remains Medicare-Coverage-DeterminationProcess-CR14464.zip.

Desk impact for stem-cell / HSCT billers

• Do not treat the October 2026 CR 14464 package as the vehicle that installs the NCD 110.23 TOB 13X / allogeneic HSCT-for-MDS edit language that R13910 had carried under BRs 14464.4-14464.4.1.1.
• Calendar an April 2027 CR watch for the stem-cell BRs CMS says will be added later. R13968 does not publish the April 2027 CR number yet.
• Keep current NCD 110.23 coverage policy separate from this coding-maintenance CR. CMS repeats that these quarterly NCD coding updates do not change NCD policy criteria.
• For the other October 1 / October 5 NCD coding lines that remain in CR 14464, continue to use the live overview and the official spreadsheet; this page is only the stem-cell pull delta.

What this is not

• Not a rewrite of the live October 2026 NCD ICD-10 coding revisions (CR 14464 / R13910 overview). That page covers the broader October package; this page covers the September 24 R13968 replacement that removes NCD 110.23 from that package.
• Not the live January 2027 laboratory NCD edit software (CR 14614) story.
• Not the live January 2027 non-lab NCD ICD-10 revisions pair.
• Not an NCCI PTP or MUE file. NCCI quarterly items remain on a separate desk track (HOLD).
• Not a change to NCD 110.23 coverage criteria themselves. CMS says no policy is being changed as a result of these coding updates.

Look up related procedure and diagnosis descriptors in the encoder after you confirm the active CR text. Browse companion CMS Watch items on /news.