ABN’s Lab ICD-10 Search Tool
What is the A-List?
A-LIST is designed as a search tool to aid in the selection of medically acceptable diagnostic codes for test groups included in the National Coverage Determination (NCD) and Local Coverage Determination (LCD) documents. The documents are in PDF format and easily searched. The responsibility for properly and correctly navigating the A-LIST for Medicare coding remains with the physicians and their staff. The A-LIST is simply a search tool offered for the convenience of physicians and not a substitute for the professional judgment required of the physicians. The use of this search tool constitutes a waiver of all claims against MMC, its affiliates and employees, arising from the use of the search tool and coding taken therefrom.
How do I find the diagnostic information I need?
The home page contains the following information:
- Complete National Coverage Determination (NCD) document.
- National Coverage Determination (NCD) test groups.
- Local Coverage Determination (LCD) test groups.
Within each test group, there are 3 main documents:
- Complete NCD/LCD specific to test group
- Acceptable ICD-10 codes associated with MMC test
- Details such as Description, Indications, and Limitations (Time-specific information and coding suggestions may be found in Details).
Additional Coding Guidelines for CMS tests referred to in this section are found in the front section of the complete NCD document.) To search for specific information, simply click on the desired category of the test group. A document will open in a PDF format.
Additional information, including shortcuts, can be found in this document.
National Coverage Determination (NCD)
The Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (ICD-10-CM) from the U.S. Department of Health & Human Services Centers for Medicare & Medicaid Services provides complete NCD documentation.
Local Coverage Determination (LCD)
PLEASE READ CAREFULLY
Local Coverage Determination (LCD) are written differently than the NCD documents. Some test groups have specific coverage determinations for each test, and some test groups have special conditions.
| Test Group Coverage Determination | CPT | MMC Tests | Code Lookup Document | Details | Date Published |
|---|---|---|---|---|---|
Acute Hepatitis Panel / Hepatitis Panel | 80074 | Hepatitis Panel W/Rfx, Acute | Code Lookup 190.33 | NCD July 2022 | |
Alpha-fetoprotein | 82105 | AFP Tumor Marker, Serum Integrated Screen Part 2 Maternal Quad Screen Maternal Serum AFP Maternal Serum Screen 5 | Code Lookup 190.25 | NCD July 2022 | |
Allergy Testing | 82785 | Gammaglobulin (immunoglobulin); IgE | Code Lookup A56558 | LCD 07/11/21 | |
| 86003 | Allergen specific IgE, each allergen | ||||
| Assays for Vitamins and Metabolic Function | 82180 | Assay of ascorbic acid | Code Lookup A56416 | LCD 10/01/21 | |
| 82306 | Vitamin D 25 hydroxy | ||||
| 82379 | Assay of carnitine | ||||
| 82607 | Vitamin B12 | ||||
| 82652 | Vitamin D,1,25-Dihydroxy | ||||
| 82746 | Assay of folic acid serum | ||||
| 83090 | Assay of homocystine | ||||
| 83698 | Assay of lipoprotein pla2 | ||||
| 84207 | Assay of vitamin B6 | ||||
| 84252 | Assay of vitamin B2 | ||||
| 84425 | Assay of vitamin B1 | ||||
| 84446 | Assay of vitamin E | ||||
| 84590 | Assay of vitamin A | ||||
| 84597 | Assay of vitamin K | ||||
| 85385 | Fibrinogen antigen | ||||
| 86352 | Cell function assay w/ stim | ||||
| Biomarkers Overview | 81162 | BRCA 1&2 seq & full dup/del | Code Lookup | LCD 12/21/2021 |
|
| 81227 | Cyp2c9 gene | ||||
| 81240 | F2 gene - Prothrombin gene | ||||
| 81241 | F5 gene - Factor V Leiden | ||||
| 81291 | Mthfr gene | ||||
| 81376 81382 | |||||
| HLA typing for celiac disease | |||||
| 81381 | HLA-B 5701 | ||||
| 81355 | Vkorc1 gene | ||||
| Biomarkers for Oncology | 81206/81207 | BCR/ABL gene | Code Lookup | LCD 12/13/2020 |
|
| 81270 | JAK2 | ||||
| 81402 | MPL | ||||
| Blood Counts (This test group provides codes that DO NOT support medical necessity) | 85007 | CBC w/ Manual Diff | Code Lookup 190.15 | NCD July 2022 | |
| 85008 | Peripheral Smear | ||||
| 85013 | Hematocrit (Spun), Body Fluid | ||||
| 85014 | Hematocrit (Spun), Body Fluid | ||||
| 85018 | Hemoglobin | ||||
| 85025 | CBC With Auto Diff | ||||
| 85027 | Complete Blood Count CBC Without Diff | ||||
| 85048 | White Blood Count Total Eosinophil WBC Autodiff Eosinophil Absolute | ||||
| 85049 | Platelet Count | ||||
CA 15-3/CA 27.29Tumor Antigen by Immunoassay | 86300 | Cancer AG 15-3 (CA15-3) CA 15-3, CSF Cancer Ag 27.29, Serum | Code Lookup 190.29 | NCD July 2022 | |
| CA 19-9 Tumor Antigen by immunoassay | 86301 | Carbohydrate AG 19-9(CA19-9) CA 19-9, CSF | Code Lookup | NCD July 2022 | |
| CA 125 Tumor Antigen by immunoassay | 86301 | Cancer AG 125 CA 125 CSF CA 125 Peritoneal Fluid CA 125 Pleural Fluid | Code Lookup 190.28 | NCD July 2022 | |
| Carcinoembryonic Antigen (CEA) | 86301 | CEA CEA, CSF Fluid CEA, Pericardial Fluid CEA, Peritoneal Fluid CEA, Pleural Fluid | Code Lookup 190.26 | NCD July 2022 | |
| Collagen Crosslinks, Any Method | 82523 | Collegen Cross Linked, 24hr Ur Collagen Cross Linked,Random Collagen 1c-Telopep (CTX) | Code Lookup 190.19 | NCD July 2022 | |
C-Reactive Protein (CRP) | 86141 | Cardio CRP CRP, High Sensitivity | Code Lookup (hsCRP) (A56643) | LCD 11/07/19 | |
| Digoxin Therapeutic Drug Assay | 80162 | Digoxin | Code Lookup 190.24 | NCD July 2022 | |
| Drug Testing | G0480/G0481 G0482/G0483 | Each drug classification-confirmation | Code Lookup A56645 | LCD 10/17/19 | |
| 80305/80306 80307 | Drug Scrn Qualitive High Compl Urine Drug Screen-Conf (C.O.C) Alcohol Ethanol Except Breath | ||||
| 83789 | UDS Mult Drug Classes | ||||
| Iodine | |||||
| Fecal Occult Blood Test | 86301 | Stool Occult Blood Occult Blood-Colorectal Screen | Code Lookup | Chart | NCD July 2022 |
| 82272 | Stool Occ Blood Non Screening | Code Lookup 190.34 | |||
| Gamma Glutamyl Transferase (GGT) | 82977 | GGTP | Code Lookup 190.32 | NCD July 2022 | |
| Glucose (Blood) Testing | 82962 | Glucose Meter | Code Lookup 190.20 | NCD July 2022 | |
| 83036 | Glucose 2 Hr P P Glucose | ||||
| Glycated Hemoglobin(A1C)/ Glycated Protein | 82985 | Fructosamine | Code Lookup 190.21 | NCD July 2022 | |
| 83036 | A1C Hemoglobin | ||||
| Histocompatibility Testing | 86812 | HLA-B27 Antigen | Code Lookup | NCD Feb 2017 | |
| Human Chorionic Gonadotropin (HCG) | 84702 | Total HCG Integrated Screen Part 2 Maternal Quad Screen Maternal Serum Screen 5 HCG Total, Non Pregnant | Code Lookup 190.27 | NCD July 2022 | |
| Human Immunodeficiency Virus (HIV) Testing (Diagnosis) | 86689 | HIV AB HIV1 WB W/Rflx TO HIV2 HIV-1 AB, Western Blot, Serum | Code Lookup 190.14 | NCD July 2022 | |
| 86703 | HIV1/HIV2 AB, EIA SCR W/Rflx | ||||
| 87535 | HIV-1 RNA, QL TMA | ||||
| Human Immunodeficiency Virus (HIV) Testing (Prognosis Including Monitoring) | 87536 | HIV1 RNA QN, PCR | Code Lookup 190.13 | NCD July 2022 | |
| 87539 | HIV1 RNA QN, BDNA | ||||
| Iron (Serum) Studies | 82728 | Ferritin | Code Lookup 190.18 | NCD July 2022 | |
| 86301 | Iron Total Iron, 24hr Urine Mayo Iron, Liver Tissue | ||||
| 83550 | Total Iron Binding Cap & Iron Iron & TIBC W/% Saturation | ||||
| 84466 | Transferrin, Serum Carbohydrate Def Transferrin | ||||
| Lipid Testing | 80061 | Lipid Panel | Code Lookup 190.23 | NCD July 2022 | |
| 82465 | Cholesterol Lipoprotein Fractionation Lipid Phenotype Profile | ||||
| 83700 | Lipid Phenotype Profile | ||||
| 83701 | VAP TM Cholesterol Lipoprotein Fractionation | ||||
| 83718 | HDL Cholesterol | ||||
| 84478 | Triglycerides VAP Tm Cholesterol Lipoprotein Fractionation Lipid Phenotype Profile VLDL Cholesterol | ||||
| 83721 | LDL Cholesterol, Direct | ||||
| Pap Smear | P3000 | Pap Smear | Chart | NCD July 2022 | |
| G0123 | Thin Prep Pap Screen Thin Prip Pap W/Rfx HPV | ||||
| G0145 | T Prep Screen Rfx/Hpv (Imaged) Thin Prep Pap-Screen (Imaged) | ||||
| Partial Thromboplastin Time (PTT) | 85730 | DIC Screen (ITXM) ITXM Lup Anti-Coag Pnl (ITXM) Lupus Anticoagulant Evaluation Lupus Coag Screen (ITXM) Mixing/Correction Studies Partial Thromb Time PTT Von Willebrand Panel Von Willebrand Screen (ITXM) | Code Lookup 190.16 | NCD July 2022 | |
| Prostate Specific Antigen | 84153 | Prostatic Specific Antigen PSA, Free & Total PSA, Post-Prostatectomy | Code Lookup 190.31 | NCD July 2022 | |
| G0103 | Prostatic Specific Antigen, Screen | Code Lookup 190.31 | Chart | ||
| Prothrombin Time (PT) | 86301 | INR DIC Screen (ITXM) ITXM Lup Anti-Coag Pnl (ITXM) Lupus Coag Screen (ITXM) Mixing/Correction Studies | Code Lookup 190.17 | NCD July 2022 | |
| Thyroid Testing | 84436 | Thyroxine (T4) | Code Lookup 190.22 | NCD July 2022 | |
| 86301 | Free T4 T4, Free Direct Dialysis | ||||
| 84443 | TSH TSH 3rd Generation (High Sens) TSH With Reflex | ||||
| 84479 | T3 Uptake T-Uptake (TBI) | ||||
| Urine Culture, Bacterial | 87086 | Urine Culture | Code Lookup 190.12 | NCD July 2022 |
Other Resources
Medicare NCDs
Search and download directly from the Medicare Coverage Database site: National Coverage NCD Report Results
Medicare Preventative Services Chart
Use this tool for finding coverage information for preventative lab services including Pap tests, PSA, and occult blood/colorectal screening: Medicare Preventive Services
LCD-Active Test Group Index
Use this index to view and search an alphabetical list of all active LCDs and articles for applicable CPT/HCPCs codes: Medicare Jurisdiction L