Key facts for NCD 190.2
- Benefit category
- Diagnostic Laboratory Tests
- Effective date
- 06/19/2006
- Implemented 06/19/2006
- Transmittal
- Transmittal 48
- Versions published
- 2
- Manual chapter
- 190
- NCD Manual (Pub. 100-03)
TL;DR
NCD 190.2 sets Medicare's national policy for diagnostic pap smears under the benefit category "Diagnostic Laboratory Tests", effective 06/19/2006 and implemented 06/19/2006. A diagnostic pap smear and related medically necessary services are covered under Medicare Part B when ordered by a physician under one of the following conditions: It has been revised 1 time since publication and binds every Medicare Administrative Contractor nationally.
Indications and limitations of coverage
CIM 50-20, CIM 50-20.1
A diagnostic pap smear and related medically necessary services are covered under Medicare Part B when ordered by a physician under one of the following conditions:
• Previous cancer of the cervix, uterus, or vagina that has been or is presently being treated;
• Previous abnormal pap smear;
• Any abnormal findings of the vagina, cervix, uterus, ovaries, or adnexa;
• Any significant complaint by the patient referable to the female reproductive system; or
• Any signs or symptoms that might in the physician's judgment reasonably be related to a gynecologic disorder.
Screening Pap Smears and Pelvic Examinations for Early Detection of Cervical or Vaginal Cancer. (See section 210.2 .)
Text reproduced from the CMS Medicare Coverage Database record for NCD 190.2 version 2. View the original on cms.gov.
Revision history
03/2006 - Delete duplicate information and insert cross reference. Effective/Implementation date: 06/19/2006. ( TN 48 ) (CR4278)
07/1990 - Clarified section and title to differentiate its scope from and make it consistent with section on screening pap smears. Effective date NA. (TN 43)
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 190.2
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 190.2
What does NCD 190.2 cover?
A diagnostic pap smear and related medically necessary services are covered under Medicare Part B when ordered by a physician under one of the following conditions: The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 190.2 take effect?
The current version (2) is effective 06/19/2006, implemented 06/19/2006, published in transmittal 48. CMS lists 2 versions of this NCD.
Does a Local Coverage Determination override NCD 190.2?
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.