Key facts for NCD 180.2
- Benefit category
- Prosthetic Devices
- Effective date
- 04/10/2023
- Implemented 04/10/2023
- Transmittal
- Transmittal 11892
- Versions published
- 3
- Manual chapter
- 180
- NCD Manual (Pub. 100-03)
TL;DR
NCD 180.2 sets Medicare's national policy for enteral and parenteral nutritional therapy - retired under the benefit category "Prosthetic Devices", 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
Effective January 1, 2022, the Centers for Medicare & Medicaid Services determined that no national coverage determination (NCD) is appropriate at this time for Enteral and Parenteral Nutritional Therapy. In the absence of an NCD, coverage determinations will be made by the Medicare Administrative Contractors under 1862(a)(1)(A) of the Social Security Act.
Indications and limitations of coverage
180.2 - Enteral and Parenteral Nutritional Therapy (RETIRED)
(Rev. 11892; Issued: 03-09-23; Effective: 04-10-23; Implementation: 04-10-23)
Effective January 1, 2022, the Centers for Medicare & Medicaid Services determined that no national coverage determination (NCD) is appropriate at this time for Enteral and Parenteral Nutritional Therapy. In the absence of an NCD, coverage determinations will be made by the Medicare Administrative Contractors under 1862(a)(1)(A) of the Social Security Act.
Text reproduced from the CMS Medicare Coverage Database record for NCD 180.2 version 3. View the original on cms.gov.
Revision history
05/2022 - Transmittal 11272, dated February 18, 2022, is being rescinded and replaced by Transmittal 11426, dated, May 20, 2022 to revise chapter 32 of the IOM for Pub. 100-04. This correction does not make any revisions to the companion Pub. 100-02 or Pub. 100-03; all revisions are associated with Pub. 100-04. All other information remains the same. ( TN 11426 ) (CR12613)
02/2022 - The purpose of this Omnibus change request is to make Medicare contractors aware of the updates to remove two National Determination NCDs, updates to the Medical Nutritional Therapy (MNT) policy and updates to the Pulmonary Rehabilitation (PR), Cardiac Rehabilitation (CR), and Intensive Cardiac Rehabilitation (ICR) resulting from changes specified in the calendar year 2022 Physician Fee Schedule (PFS) final rule published on November 19, 2021. ( TN 11272 ) (CR12613)
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 180.2
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 180.2
What does NCD 180.2 cover?
180.2 - Enteral and Parenteral Nutritional Therapy (RETIRED) The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 180.2 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 180.2?
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.