CMS revises the October NCD coding update and moves stem-cell changes to April 2027
Oct 4, 2026 edition · GC-2026-0133 · Published 2026-10-04 · Version 2 · Final
CMS’s revised October NCD coding instructions remove the stem-cell changes for a later April 2027 request. October 5 implementation remains scheduled for the retained coding updates, including some earlier effective dates. CMS distinguishes these maintenance changes from new coverage policy.
What happened
CMS issued Transmittal 13968 on September 24, replacing its August 14 transmittal for Change Request 14464. The revision removes the NCD 110.23 stem-cell business requirements from the October package and says they will be included in an April 2027 change request. The rest of the quarterly NCD coding maintenance remains, with an overall October 1 effective date and October 5 implementation date unless a requirement specifies otherwise. CMS explicitly states that this request changes coding and system edits, not the underlying national coverage policy.
The retained instructions address PET cardiac perfusion edits, diagnostic bone-density codes, implantable cardioverter-defibrillator procedures, antiemetic drug coding, CAR-T therapy and a next-generation sequencing test. Several requirements carry earlier code-specific effective dates, so treating every change as applying only to October services would miss part of the package. The bone-density additions are for diagnostic indications, not monitoring. CMS directs contractors to adjust claims brought to their attention without conducting a general search for claims. The implementation task is therefore to use the revised package and its individual dates, while excluding the deferred stem-cell requirements.
Scope and timing
- Authority status
- Final
- Applicability
- Directly applicable
- Audience
- Health systems, Provider networks
- Jurisdiction
- Federal
- Affected functions
- Revenue Cycle, Coding, IT, Compliance
- Responsible owner
- Revenue Cycle
- Recorded date
- 2026-10-05
- Date type
- implementation
Why it matters
Claims edits and coding tables need the revised scope so organizations do not implement withdrawn stem-cell changes with the October release.
Recommended action
Confirm the revised file set, remove NCD 110.23 changes from the October deployment, test affected claims, and verify production implementation.
Implementation playbook
- Confirm the revised CR 14464 file set and scope. Coding · Due 2026-09-29
- Remove NCD 110.23 stem-cell changes from the October deployment. IT · Due 2026-09-30
- Test affected claims and verify production implementation. Revenue Cycle · Due 2026-10-05
Sources
- Transmittal 13968, Change Request 14464Official · Centers for Medicare and Medicaid Services · 2026-09-24 · Source review 2026-09-27
Complete edition and supplemental material
This finding in the complete approved report →Regulatory horizons, CIA trends and implementation trackers remain in the full report.
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