Key facts for NCD 20.11
- Benefit category
- Inpatient Hospital Services, Physicians' Services
- Effective date
- 10/29/1984
- Implemented 10/29/1984
- Transmittal
- n/a
- Versions published
- 1
- Manual chapter
- 20
- NCD Manual (Pub. 100-03)
TL;DR
NCD 20.11 sets Medicare's national policy for intraoperative ventricular mapping under the benefit category "Inpatient Hospital Services, Physicians' Services", effective 10/29/1984 and implemented 10/29/1984. The intraoperative ventricular mapping procedure is covered under Medicare only for the uses and medical conditions described below: It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
Intraoperative ventricular mapping is the technique of recording cardiac electrical activity directly from the heart. The recording sites are usually identified from an anatomical grid and may consist of epicardial, intramural, and endocardial sites. A probe with electrodes is used to explore these surfaces and generate a map that displays the sequence of electrical activation. This information is used by the surgeon to locate precisely the site of an operative intervention.
Indications and limitations of coverage
The intraoperative ventricular mapping procedure is covered under Medicare only for the uses and medical conditions described below:
• Localize accessory pathways associated with the Wolff-Parkinson-White (WPW) and other preexcitation syndromes;
• Map the sequence of atrial and ventricular activation for drug-resistant supraventricular tachycardias;
• Delineate the anatomical course of His bundle and/or bundle branches during corrective cardiac surgery for congenital heart diseases; and
• Direct the surgical treatment of patients with refractory ventricular tachyarrhythmias.
Text reproduced from the CMS Medicare Coverage Database record for NCD 20.11 version 1. View the original on cms.gov.
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 20.11
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 20.11
What does NCD 20.11 cover?
The intraoperative ventricular mapping procedure is covered under Medicare only for the uses and medical conditions described below: The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 20.11 take effect?
The current version (1) is effective 10/29/1984, implemented 10/29/1984. This is the only published version.
Does a Local Coverage Determination override NCD 20.11?
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.