Medicare Non-covered ICD-9-CM Codes
Medicare will not cover the below listed ICD 9 codes at any circumstances when reported with the Laboratory procedures. If a code from this section is given as the reason for the test, the test may be billed to the Medicare beneficiary without billing Medicare first because the service is not covered by statute, in most instances because it is performed for screening purposes and is not within an exception. The beneficiary, however, does have a right to have the claim submitted to Medicare, upon request.
Non-covered ICD-9-CM Codes for All NCD Edits
798.0 – 798.9 Sudden death, cause unknown
V15.85 Personal history of contact with and (suspected) exposure to potentially hazardous body fluids
V16.1 Family history of malignant neoplasm, trachea, bronchus, and lung
V16.2 Family history of malignant neoplasm, other respiratory and intrathoracic organs
V16.40 Family history of malignant neoplasm, genital organs
V16.50 Family history of malignant neoplasm, urinary organs
V16.51 Family history of malignant neoplasm, kidney
V16.52 Family history of malignant neoplasm, bladder
V16.59 Family history of malignant neoplasm, other
V16.6 Family history of malignant neoplasm, leukemia
V16.7 Family history of malignant neoplasm, other lymphatic and hematopoietic neoplasms
V16.8 Family history of malignant neoplasm, other specified malignant neoplasm
V16.9 Family history of malignant neoplasm, unspecified malignant neoplasm
V17.0-V17.3 Family history of certain chronic disabling diseases
V17.41 Family history of sudden cardiac death (SCD)
V17.49 Family history of other cardiovascular diseases
V17.5 – V17.89 Family history of asthma; other chronic respiratory conditions arthritis; other musculoskeletal diseases
V18.0 Family history of diabetes mellitus
V18.11 Family history of multiple endocrine neoplasia (MEN) syndrome
V18.19 Family history of other endocrine and metabolic diseases
V18.2-V18.4, V18.51,V18.59, V18.61, V18.69, V18.7-V18.9 Family history of anemia; other blood disorders; mental retardation; colonic polyps; other digestive disorders; polycystic kidney; other kidney diseases; other genitourinary diseases; infectious and parasitic diseases; genetic disease carrier
V19.0-V19.8 Family history of other conditions
V20.0 – V20.2 Health supervision of infant or child
V20.31 Health supervision for newborn under 8 days old
V20.32 Health supervision for newborn 8 to 28 days old
V28.0 – V28.9 Encounter for antenatal screening of mother
V50.0 – V50.9 Elective surgery for purposes other than remedying health states
V53.2 Hearing aid
V60.0-V60.6 Lack of housing; inadequate housing; lack of material resources; person living alone; no other household person able to render care; holiday relief care; and person living in residential institution
V60.81 Foster care (status)
V60.89 Other specified housing or economic circumstances
V60.9 Unspecified housing or economic circumstances
V62.0 Unemployment
V62.1 Adverse effects of work environment
V65.0 Healthy persons accompanying sick persons
V65.11 Pediatric pre-birth visit for expectant parent(s)
V65.19 Other person consulting on behalf of another person
V68.0 – V68.9 Encounters for administrative purposes
V70.0 – V70.9 General medical examinations
V73.0-V73.6 Special screening examinations for viral and chlamydia diseases
V73.81 Special screening examinations for Human papillomavirus (HPV)
V73.88-V73.89 Other specified chlamydial and viral diseases
V73.98-V73.99 Unspecified chlamydial and viral disease
V74.0 – V74.9 Special screening examinations for bacterial and spirochetal diseases
V75.0 – V75.9 Special screening examination for other infectious diseases
V76.0 Special screening for malignant neoplasms, respiratory organs
V76.3 Special screening for malignant neoplasms, bladder
V76.42-V76.43, V76.45-V76.47, V76.49, V76.50, V76.52, V76.81, V76.89,V76.9 Special screening for malignant neoplasms,(sites other than breast, cervix, and rectum)
V77.0 Special screening for endocrine, nutrition, metabolic, and immunity disorders
V77.2-V77.99 Special screening for endocrine, nutrition, metabolic, and immunity disorders
V78.0-V78.9 Special screening for disorders of blood and blood-forming organs
V79.0-V79.9 Special screening for mental disorders
V80.01 Special screening for traumatic brain injury
V80.09 Special screening for other neurological conditions
V80.1-V80.3 Special screening for glaucoma and other eye conditions; ear diseases
V81.3-V81.6 Special screening for cardiovascular, respiratory, and genitourinary diseases
V82.0-V82.6, V82.71,V82.79, V82.81, V82.89, V82.9 Special screening for other conditions
