Key facts for NCD 110.14
- Benefit category
- Incident to a physician's professional Service, Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services
- Effective date
- 07/30/1992
- Transmittal
- Transmittal 59
- Versions published
- 1
- Manual chapter
- 110
- NCD Manual (Pub. 100-03)
TL;DR
NCD 110.14 sets Medicare's national policy for apheresis (therapeutic pheresis) under the benefit category "Incident to a physician's professional Service, Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services", effective 07/30/1992. • Plasmapheresis in the treatment of primary macroglobulinemia (Waldenstrom); It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
A. General
Apheresis (also known as pheresis or therapeutic pheresis) is a medical procedure utilizing specialized equipment to remove selected blood constituents (plasma, leukocytes, plataelets, or cells) from whole blood. The remainder is retransfused into the person from whom the blood was taken.
For purposes of Medicare coverage, apheresis is defined as an autologous procedure, i.e., blood is taken from the patient, processed, and returned to the patient as part of a continuous procedure (as distinguished from the procedure in which a patient donates blood preoperatively and is transfused with the donated blood at a later date).
Indications and limitations of coverage
B. Indications
Apheresis is covered for the following indications:
• Plasma exchange for acquired myasthenia gravis;
• Leukapheresis in the treatment of leukemia;
• Plasmapheresis in the treatment of primary macroglobulinemia (Waldenstrom);
• Treatment of hyperglobulinemias, including (but not limited to) multiple myelomas, cryoglobulinemia and hyperviscosity syndromes;
• Plasmapheresis or plasma exchange as a last resort treatment of thromobotic thrombocytopenic purpura (TTP);
• Plasmapheresis or plasma exchange in the last resort treatment of life threatening rheumatoid vasculitis;
• Plasma perfusion of charcoal filters for treatment of pruritis of cholestatic liver disease;
• Plasma exchange in the treatment of Goodpasture's Syndrome;
• Plasma exchange in the treatment of glomerulonephritis associated with antiglomerular basement membrane antibodies and advancing renal failure or pulmonary hemorrhage;
• Treatment of chronic relapsing polyneuropathy for patients with severe or life threatening symptoms who have failed to respond to conventional therapy;
• Treatment of life threatening scleroderma and polymyositis when the patient is unresponsive to conventional therapy;
• Treatment of Guillain-Barre Syndrome; and
• Treatment of last resort for life threatening systemic lupus erythematosus (SLE) when conventional therapy has failed to prevent clinical deterioration.
C. Settings
Apheresis is covered only when performed in a hospital setting (either inpatient or outpatient) or in a nonhospital setting, e.g., a physician directed clinic when the following conditions are met:
• A physician (or a number of physicians) is present to perform medical services and to respond to medical emergencies at all times during patient care hours;
• Each patient is under the care of a physician; and
• All nonphysician services are furnished under the direct, personal supervision of a physician.
Text reproduced from the CMS Medicare Coverage Database record for NCD 110.14 version 1. View the original on cms.gov.
Revision history
07/1992 - Provided coverage of apheresis when performed either in an inpatient or outpatient hospital setting or in a nonhospital setting if patient is under the care of a physician and a physician is present to direct and supervise the nonphysician services. Effective date 07/30/1992. (TN 59)
02/1986 - Provided coverage of apheresis for treatment of Guillain-Barre Syndrome and for treatment of life-threatening Systemic Lupus Erythematosus. Effective date 02/14/1986. (TN 4)
How this NCD shows up on remittances
A service denied under a National Coverage Determination returns CARC 50 (not deemed medically necessary) with remark N386 (decision based on an NCD); a denial citing a local policy instead carries N115. Because NCDs bind nationally, the appeal path is documentation that the patient meets the indications above, not a contractor-policy argument.
How QuickIntell applies NCD 110.14
QuickAuth checks the ordered service and diagnosis against NCD and LCD criteria before the encounter, QuickCode validates the diagnosis pairing on the claim, and QuickRCM routes CARC 50 denials with the policy text and the covered-code list attached so the appeal starts with evidence.
Frequently asked questions — NCD 110.14
What does NCD 110.14 cover?
Apheresis is covered for the following indications: The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 110.14 take effect?
The current version (1) is effective 07/30/1992, published in transmittal 59. This is the only published version.
Does a Local Coverage Determination override NCD 110.14?
No. A National Coverage Determination binds all Medicare Administrative Contractors; an LCD can only address services or circumstances the NCD leaves open. Claims denied under this NCD typically return CARC 50 with remark N386 (NCD) rather than N115 (LCD).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.
- Medicare Coverage Database NCDs via the CMS Coverage APIVersion API snapshot 2026-09-27 · effective 2026-09-20 · file national-coverage-ncd.jsonSHA-256 a90fadfd264b9ef4…
Disclaimer
This page reproduces the CMS National Coverage Determination text and, for laboratory NCDs, the CMS ICD-10 edit lists, as an operational reference. Coverage decisions depend on the full policy, the claim and the contractor; nothing here is legal, clinical or billing advice. CPT codes are shown as numbers only; CPT descriptors are copyright AMA.