Key facts for NCD 160.22
- Benefit category
- Diagnostic Tests (other)
- Effective date
- 04/10/2023
- Implemented 04/10/2023
- Transmittal
- Transmittal 11892
- Versions published
- 3
- Manual chapter
- 160
- NCD Manual (Pub. 100-03)
TL;DR
NCD 160.22 sets Medicare's national policy for ambulatory eeg monitoring - retired under the benefit category "Diagnostic Tests (other)", effective 04/10/2023 and implemented 04/10/2023. (Rev. 11892; Issued: 03-09-23; Effective: 04-10-23; Implementation: 04-10-23) It has been revised 2 times since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
Ambulatory, or 24-hour electroencephalographic (EEG) monitoring is accomplished by a cassette recorder that continuously records brain wave patterns during 24 hours of a patient's routine daily activities and sleep. The monitoring equipment consists of an electrode set, preamplifiers, and a cassette recorder. The electrodes attach to the scalp, and their leads are connected to a recorder, usually worn on a belt.
Indications and limitations of coverage
160.22 – Ambulatory EEG Monitoring (RETIRED)
(Rev. 11892; Issued: 03-09-23; Effective: 04-10-23; Implementation: 04-10-23)
Effective January 1, 2023, NCD 160.22 is retired.
Text reproduced from the CMS Medicare Coverage Database record for NCD 160.22 version 3. View the original on cms.gov.
Revision history
02/2023 Transmittal 11824 issued January 27, 2023, is being rescinded and replaced by Transmittal 11865, dated, February 16, 2023, to add the Spanish version of MSN Message 18.29 to the IOM for publication 100-04. This correction does not make any revisions to the companion Pubs.100-02 or 100-03; all revisions are associated with Pub. 100-04. All other information remains the same.(Rev.11824; Issued: 01-27-23; Effective: 01-01-23; Implementation: 02-27-23) ( TN 11865 ) (CR13017)
01/2023 160.22 Ambulatory EEG Monitoring (Retired)
(Rev.11824; Issued: 01-27-23; Effective: 01-01-23; Implementation: 02-27-23)
Effective January 1, 2023, the Centers for Medicare & Medicaid Services removed the national coverage determination (NCD) for Ambulatory EEG Monitoring. In the absence of an NCD, coverage determinations will be made by the Medicare Administrative Contractors under section 1862(a)(1)(A) of the Social Security Act. ( TN 11824 ) (CR13017)
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 160.22
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 160.22
What does NCD 160.22 cover?
160.22 – Ambulatory EEG Monitoring (RETIRED) The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 160.22 take effect?
The current version (3) is effective 04/10/2023, implemented 04/10/2023, published in transmittal 11892. CMS lists 3 versions of this NCD.
Does a Local Coverage Determination override NCD 160.22?
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.