Key facts for NCD 240.2.2
- Benefit category
- Durable Medical Equipment
- Effective date
- 04/10/2023
- Implemented 04/10/2023
- Transmittal
- Transmittal 11892
- Versions published
- 3
- Manual chapter
- 240
- NCD Manual (Pub. 100-03)
TL;DR
NCD 240.2.2 sets Medicare's national policy for home oxygen use to treat cluster headache (ch) - retired under the benefit category "Durable Medical Equipment", effective 04/10/2023 and implemented 04/10/2023. 240.2.2 - Home Oxygen Use to Treat Cluster Headache (CH) (RETIRED) It has been revised 2 times since publication and binds every Medicare Administrative Contractor nationally.
Indications and limitations of coverage
240.2.2 - Home Oxygen Use to Treat Cluster Headache (CH) (RETIRED)
(Rev. 11892; Issued: 03-09-23; Effective: 04-10-23; Implementation: 04-10-23)
Effective September 27, 2021, the Centers for Medicare & Medicaid Services removed the national coverage determination (NCD) for home oxygen use to treat cluster headaches. In the absence of an NCD, coverage determinations will be made by the Medicare Administrative Contractors under section 1862(a)(1)(A) of the Social Security Act, as allowed and described in Chapter 1, Section 240.2 (Home Use of Oxygen), Subsection D, of Publication 100-03 of the NCD Manual.
Text reproduced from the CMS Medicare Coverage Database record for NCD 240.2.2 version 3. View the original on cms.gov.
Revision history
05/2022 - Transmittal 11263, dated February 10, 2022, are being rescinded and replaced by Transmittal 11429, dated, May 23, 2022 to extend the implementation date to January 3, 2023. All other information remains the same. ( TN 11429 ) (CR12607)
02/2022 - The purpose of the Change Request is to revise Section 240.2 and Section 240.2.2 of the National Coverage Determination (NCD) Manual (Pub. 100-03), Chapter 1, Part 4, and to inform the Medicare Administrative Contractors (MAC)s of the changes associated with these NCDs effective September 27, 2021. The Centers for Medicare & Medicaid Services finalized revisions to two separate, but medically related, NCDs for oxygen therapy and oxygen equipment in the home. Effective date: 09/27/2021 Implementation date: 06/14/2022. ( TN 11263 ) (CR12607)
01/2011 - After careful reconsideration, effective for claims with dates of service on and after January 4, 2011, Medicare will allow for coverage of home use of oxygen to treat Medicare beneficiaries diagnosed with CH when beneficiaries are enrolled in clinical studies that are approved by CMS for the purpose of gaining further evidence. Effective date: 01/04/2011. Implementation date: 02/15/2011. ( TN130 ) (CR7235)
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 240.2.2
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 240.2.2
What does NCD 240.2.2 cover?
240.2.2 - Home Oxygen Use to Treat Cluster Headache (CH) (RETIRED) The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 240.2.2 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 240.2.2?
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.