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

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