Key facts for NCD 140.5
- Benefit category
- Physicians' Services
- Effective date
- 05/01/1997
- Transmittal
- Transmittal 99
- Versions published
- 1
- Manual chapter
- 140
- NCD Manual (Pub. 100-03)
TL;DR
NCD 140.5 sets Medicare's national policy for laser procedures under the benefit category "Physicians' Services", effective 05/01/1997. Medicare recognizes the use of lasers for many medical indications. Procedures performed with lasers are sometimes used in place of more conventional techniques. In the absence of a specific noncoverage instruction, and where a laser has been approved for… It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Indications and limitations of coverage
Medicare recognizes the use of lasers for many medical indications. Procedures performed with lasers are sometimes used in place of more conventional techniques. In the absence of a specific noncoverage instruction, and where a laser has been approved for marketing by the Food and Drug Administration, Medicare Administrative Contractor discretion may be used to determine whether a procedure performed with a laser is reasonable and necessary and, therefore, covered.
The determination of coverage for a procedure performed using a laser is made on the basis that the use of lasers to alter, revise, or destroy tissue is a surgical procedure. Therefore, coverage of laser procedures is restricted to practitioners with training in the surgical management of the disease or condition being treated.
Text reproduced from the CMS Medicare Coverage Database record for NCD 140.5 version 1. View the original on cms.gov.
Revision history
05/1997 - Restricted coverage to practitioner's with training in surgical management of disease or condition being treated. Effective date NA. (TN 99)
04/1986 - Consolidated all other laser guideline-related sections into one section called Laser Procedures. Effective date NA. (TN 6)
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 140.5
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 140.5
What does NCD 140.5 cover?
Medicare recognizes the use of lasers for many medical indications. Procedures performed with lasers are sometimes used in place of more conventional techniques. In the absence of a specific noncoverage instruction, and where a laser has been approved for marketing by the Food and Drug Administration, Medicare Administrative Contractor discretion may be used to determine whether a procedure performed with a laser… The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 140.5 take effect?
The current version (1) is effective 05/01/1997, published in transmittal 99. This is the only published version.
Does a Local Coverage Determination override NCD 140.5?
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.