Key facts for NCD 20.24
- Benefit category
- Diagnostic Tests (other)
- Effective date
- 10/12/1988
- Transmittal
- Transmittal 33
- Versions published
- 1
- Manual chapter
- 20
- NCD Manual (Pub. 100-03)
TL;DR
NCD 20.24 sets Medicare's national policy for displacement cardiography under the benefit category "Diagnostic Tests (other)", effective 10/12/1988. Cardiokymography is covered for services rendered on or after October 12, 1988. It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
Displacement cardiography, including cardiokymography and photokymography, is a noninvasive diagnostic test used in evaluating coronary artery disease.
Indications and limitations of coverage
A. Cardiokymography
Cardiokymography is covered for services rendered on or after October 12, 1988.
Cardiokymography is a covered service only when it is used as an adjunct to electrocardiographic stress testing in evaluating coronary artery disease and only when the following clinical indications are present:
• For male patients, atypical angina pectoris or nonischemic chest pain; or
• For female patients, angina, either typical or atypical.
B. Photokymography - Not Covered
Photokymography remains excluded from coverage.
Text reproduced from the CMS Medicare Coverage Database record for NCD 20.24 version 1. View the original on cms.gov.
Revision history
09/1988 - Cardiokymography covered for certain indications. Photokymography remained noncovered. Effective date 10/12/1988. (TN 33)
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 20.24
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 20.24
What does NCD 20.24 cover?
Cardiokymography is covered for services rendered on or after October 12, 1988. The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 20.24 take effect?
The current version (1) is effective 10/12/1988, published in transmittal 33. This is the only published version.
Does a Local Coverage Determination override NCD 20.24?
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.