Key facts for NCD 220.10
- Benefit category
- Diagnostic X-Ray Tests
- Effective date
- 11/06/1986
- Transmittal
- n/a
- Versions published
- 1
- Manual chapter
- 220
- NCD Manual (Pub. 100-03)
TL;DR
NCD 220.10 sets Medicare's national policy for portable hand-held x-ray instrument under the benefit category "Diagnostic X-Ray Tests", effective 11/06/1986. The use of the portable hand-held X-ray instrument as an imaging device is covered under Medicare. It should be reimbursed as part of the physician's professional service, and no additional charge should be allowed. It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
This low intensity X-ray imaging device is a light weight portable hand-held instrument using a low level isotope as its penetrating energy source. It can picture any part of the human anatomy that can be inserted in the space between the energy source and the viewing mechanism. The device can be useful in making an immediate diagnosis in the following settings: isolated areas, accident scenes, sports events and emergency rooms. It is also useful in the following instances where fluoroscopy would ordinarily be used: localization of foreign bodies, selected surgical procedures and the evaluation of premature or low birth weight infants.
Indications and limitations of coverage
The use of the portable hand-held X-ray instrument as an imaging device is covered under Medicare. It should be reimbursed as part of the physician's professional service, and no additional charge should be allowed.
Text reproduced from the CMS Medicare Coverage Database record for NCD 220.10 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 220.10
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 220.10
What does NCD 220.10 cover?
The use of the portable hand-held X-ray instrument as an imaging device is covered under Medicare. It should be reimbursed as part of the physician's professional service, and no additional charge should be allowed. The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 220.10 take effect?
The current version (1) is effective 11/06/1986. This is the only published version.
Does a Local Coverage Determination override NCD 220.10?
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.