CMS October 2026 NCD CR 14464 adds PET tracers, 0554T-0558T, and 0648U
Change Request 14464 / Transmittal 13910 is the October 2026 quarterly ICD-10 and other coding update to NCD edits. CMS rescinds Transmittal 13752 to remove BR 14464.5 (NCD 250.4). No policy is being changed. Effective October 1, 2026. Implementation October 5, 2026.
By the HCC Buddy Coding Team
Published August 31, 2026
Key Takeaways
- →CR 14464 / Transmittal 13910 (August 14, 2026, Pub 100-20) is the October 2026 quarterly ICD-10 and other coding update to NCD edits. CMS says no policy is being changed.
- →Transmittal 13910 rescinds Transmittal 13752 (May 26, 2026) to remove BR 14464.5, NCD 250.4 Treatment of Actinic Keratosis.
- →Effective date is October 1, 2026 (date of service unless otherwise specified). Implementation date is October 5, 2026. Several BRs use earlier specified dates.
- →MM14464 lists NCDs 20.4, 90.2, 110.18, 110.23, 110.24, 150.3, and 220.6.1. MACs will not search for claims. They will adjust claims brought to their attention.
- →This is not a CMS-HCC or V28 map, not Friday's ColoSense NCD 210.3 add, and not the January 2027 NCD ICD-10 pair.
CMS issued Change Request 14464 on August 14, 2026, as Transmittal 13910 (Pub 100-20 One-Time Notification). Transmittal 13752 issued May 26, 2026, is rescinded and replaced to remove business requirement 14464.5, NCD 250.4 Treatment of Actinic Keratosis.
EFFECTIVE DATE: October 1, 2026 (date of service unless otherwise specified). IMPLEMENTATION DATE: October 5, 2026. CMS says no policy is being changed as a result of these updates.
This is one quarterly NCD maintenance CR. It is not Friday's ColoSense CPT 0421U add under NCD 210.3, and it is not the live January 2027 NCD ICD-10 coding revisions.
What CR 14464 updates
The transmittal says the purpose of this CR is to provide a quarterly maintenance update of ICD-10 coding conversions and other coding updates specific to NCDs. Those coding changes come from newly available codes, coding revisions to NCDs released separately, or coding feedback received.
CMS also prints this clarification: coding (as well as payment) is a separate and distinct area of the Medicare Program from coverage policy/criteria. Revisions to codes within an NCD are not intended to change the original intent of the NCD. Any policy-related changes to NCDs continue to be implemented via the current, long-standing NCD process.
MM14464 (revised August 14, 2026) lists these NCDs: 20.4, 90.2, 110.18, 110.23, 110.24, 150.3, and 220.6.1. The MLN What's Changed box says CMS made no substantive changes to the article other than to remove NCD 250.4 and update the CR release date, transmittal numbers, and transmittal links.
Business requirements (CR 14464 list)
The table below is the CR's own numbered list. It is not a 44-code gallery. Where the transmittal did not print a long descriptor, this page does not invent one. Look up official titles in the encoder or the code book.
| BR | NCD (as printed) | What Transmittal 13910 tells MACs to do |
|---|---|---|
| 14464.1 | 220.6.1 PET for Perfusion of the Heart | Make existing edits overridable, effective April 1, 2025. Create a PARM for tracer codes and read the PARM instead of the tracer listing in Reason Code 32438 (and a matching PARM for Reason Code 32440). Load A9598 effective 1/1/2018 and A9611 effective 04/01/2025. Add CPT 78430-78434 into edit logic for reason code 32438. |
| 14464.2 | 150.3 Bone (Mineral) Density Studies | Add CPT 0554T, 0555T, 0556T, 0557T, and 0558T as payable, effective January 1, 2024. Waive co-insurance and deductible for 0554T-0558T. Update frequency edits. These codes are not being added for monitoring, but only for diagnostic indications. |
| 14464.3 | 20.4 Implantable Cardioverter Defibrillation | Add ICD-10-PCS 02HM3KZ, X2HM3GB, and X2HV3GB as a covered procedure, effective April 1, 2026. |
| 14464.4 | 110.23 Stem Cell Transplant | Allow Type of Bill (TOB) 13X to allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (MDS). Line-level deny HSCT services when not submitted on 13X TOB. |
| 14464.5 | (deleted) | This requirement has been deleted. Transmittal 13910 removes NCD 250.4 Treatment of Actinic Keratosis from the CR. |
| 14464.6 | 110.18 Aprepitant for Chemotherapy-Induced Emesis | Add HCPCS J9278 to the list of chemotherapeutic drugs covered, effective April 1, 2026. |
| 14464.7 | 110.18 Aprepitant for Chemotherapy-Induced Emesis | Terminate HCPCS C9308, effective March 31, 2026. |
| 14464.8 | 110.24 CAR-T | Add ICD-10-CM C88.40: Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission as covered under HCPCS Q2054 (Breyanzi), effective FDA approval date of December 4, 2025. |
| 14464.9 | 90.2 NGS | Add CPT 0648U effective July 1, 2026, for Oncomine Dx Express Test. |
| 14464.10 | (all attached NCDs) | Contractors shall not search for any claims, but shall adjust claims brought to their attention. |
See the attached spreadsheet for 14464.3, 14464.6, 14464.7, 14464.8, and 14464.9. The zip is Medicare-Coverage-DeterminationProcess-CR14464.zip.
Specified dates inside the CR
The CR effective date is October 1, 2026, unless otherwise specified. Several business requirements do specify other dates:
- NCD 220.6.1 overridable edits: April 1, 2025. A9598: January 1, 2018. A9611: April 1, 2025.
- NCD 150.3 CPT 0554T-0558T payable, waived co-insurance and deductible, and frequency-edit updates: January 1, 2024.
- NCD 20.4 ICD-10-PCS adds: April 1, 2026.
- NCD 110.18 J9278 add: April 1, 2026. C9308 terminate: March 31, 2026.
- NCD 110.24 C88.40 under Q2054 (Breyanzi): FDA approval date of December 4, 2025.
- NCD 90.2 CPT 0648U: July 1, 2026.
Systems implementation for this transmittal is October 5, 2026.
MAC search rule
Business requirement 14464.10 says contractors shall not search for any claims, but shall adjust claims brought to their attention. MM14464 repeats that MACs will not search for claims but will adjust claims you bring to their attention.
If a claim needs one of these NCD edit updates, bring that claim to the MAC. Do not wait for a file sweep.
What this is not
It is not a change to NCD coverage criteria. CMS repeats that no policy is being changed as a result of these updates.
It is not a CMS-HCC or V28 mapping change. An NCD edit list is not a RAF map. If the question is risk adjustment, use the model year you are actually coding in ICD-10 to HCC.
It is not Friday's NCD 210.3 ColoSense (0421U) coverage add. That CR rewrites colorectal screening coverage and claims processing. This CR is the October 2026 quarterly NCD code-list maintenance update.
It is not the live January 2027 NCD ICD-10 coding revisions. Those are CR 14537 and CR 14570 (Transmittals 13906 and 13923). Different quarter, different CRs.
It is not Tuesday's October 2026 HCPCS file / G0685. That ZIP is the Level II alpha-numeric file, not this NCD edit CR.
Look up official long descriptors in the encoder or the code book before you release a claim that depends on one of these lines.
What coders should do now
- 1Load CR 14464 / Transmittal 13910 against your NCD edit file. Do not keep BR 14464.5. That requirement is deleted (NCD 250.4 is removed from this CR).
- 2For NCD 220.6.1, expect overridable PET edits, PARM tracer loads for A9598 and A9611, and CPT 78430-78434 in reason code 32438 logic.
- 3For NCD 150.3, treat 0554T-0558T as payable diagnostic (not monitoring) bone density codes, with co-insurance and deductible waived, effective January 1, 2024.
- 4If a claim needs these NCD edits, bring it to the MAC. Contractors shall not search for claims.
- 5Look up official descriptors in the [encoder](/encoder) or the [code book](/code-book). This CR is not a V28 or CMS-HCC map. Use [ICD-10 to HCC](/icd10-to-hcc) only if the question is risk adjustment.
Frequently Asked Questions
When is CR 14464 effective?
Transmittal 13910 prints an effective date of October 1, 2026 (date of service unless otherwise specified) and an implementation date of October 5, 2026. Several business requirements specify earlier dates, including January 1, 2024, for CPT 0554T-0558T under NCD 150.3 and July 1, 2026, for CPT 0648U under NCD 90.2.
Did CMS change NCD coverage policy in this CR?
No. The transmittal says no policy is being changed as a result of these updates. It is a quarterly maintenance update of ICD-10 coding conversions and other coding updates specific to NCDs.
What happened to NCD 250.4 in CR 14464?
Transmittal 13910, dated August 14, 2026, rescinds and replaces Transmittal 13752 (May 26, 2026) to remove business requirement 14464.5, NCD 250.4 Treatment of Actinic Keratosis. BR 14464.5 now reads that the requirement has been deleted. MM14464 says that is the only substantive article change.
Will MACs search their files for claims that need these edits?
No. Business requirement 14464.10 says contractors shall not search for any claims, but shall adjust claims brought to their attention. MM14464 repeats that MACs will not search.
Is this the same article as the January 2027 NCD ICD-10 coding revisions?
No. This page is CR 14464 / Transmittal 13910, the October 2026 quarterly NCD coding CR. The live January 2027 piece is CR 14537 and CR 14570. Different CRs, different quarters.
Sources
- Transmittal 13910 / CR 14464: ICD-10 and Other Coding Revisions to NCDs, October 2026 (Pub 100-20) — CMS, Aug 14, 2026
- MM14464: ICD-10 and Other Coding Revisions to National Coverage Determinations, October 2026 Update — CMS / MLN Matters, Invalid Date
- CMS Transmittal R13910OTN page — CMS, Aug 14, 2026
- NCD spreadsheets for CR 14464 — CMS, Apr 17, 2026
Related Tools
Encoder
Look up official descriptors for the CPT, HCPCS, ICD-10-CM, and ICD-10-PCS codes named in CR 14464. This page does not invent titles the transmittal omitted.
Code Book
Confirm tabular text for C88.40, 0648U, 0554T-0558T, 78430-78434, and the ICD-10-PCS lines before you release the claim.
ICD-10 to HCC
CR 14464 is an NCD edit-list maintenance update, not a CMS-HCC or V28 map. Use the model year you are actually coding if the question is RAF.
HCC Buddy Coding Team
Editorial
Every HCC Buddy news article is checked against the current CMS-HCC model and the active FY ICD-10-CM tabular release before it publishes.
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