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NCD 300.1 · version 2

NCD 300.1: Obsolete or Unreliable Diagnostic Tests

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: Medicare Coverage Database release of September 24, 2026 (effective September 20, 2026). Next CMS release: weekly (every Thursday) for the MCD; quarterly for lab NCD code lists.

Key facts for NCD 300.1

Benefit category
Diagnostic Tests (other)
Effective date
06/19/2006
Implemented 06/19/2006
Transmittal
Transmittal 48
Versions published
2
Manual chapter
300
NCD Manual (Pub. 100-03)

TL;DR

NCD 300.1 sets Medicare's national policy for obsolete or unreliable diagnostic tests under the benefit category "Diagnostic Tests (other)", effective 06/19/2006 and implemented 06/19/2006. Do not routinely pay for the following diagnostic tests because they are obsolete and have been replaced by more advanced procedures. The listed tests may be paid for only if the medical need for the procedure is satisfactorily justified by the physician who… It has been revised 1 time since publication and binds every Medicare Administrative Contractor nationally.

Indications and limitations of coverage

A. Diagnostic Tests

Do not routinely pay for the following diagnostic tests because they are obsolete and have been replaced by more advanced procedures. The listed tests may be paid for only if the medical need for the procedure is satisfactorily justified by the physician who performs it. When the services are subject to the Quality Improvement Organization (QIO) Review, the QIO is responsible for determining that satisfactory medical justification exists.

When the services are not subject to QIO review, the A/B Medicare Administrative Contractor is responsible for determining that satisfactory medical justification exists. This includes:

• Amylase, blood isoenzymes, electrophoretic,

• Chromium, blood,

• Guanase, blood,

• Zinc sulphate turbidity, blood,

• Skin test, cat scratch fever,

• Skin test, lymphopathia venereum,

• Circulation time, one test,

• Cephalin flocculation,

• Congo red, blood,

• Hormones, adrenocorticotropin quantitative animal tests,

• Hormones, adrenocorticotropin quantitative bioassay,

• Thymol turbidity, blood,

• Skin test, actinomycosis,

• Skin test, brucellosis,

• Skin test, psittacosis,

• Skin test, trichinosis,

• Calcium, feces, 24-hour quantitative,

• Starch, feces, screening,

• Chymotrypsin, duodenal contents,

• Gastric analysis, pepsin,

• Gastric analysis, tubeless,

• Calcium saturation clotting time,

• Capillary fragility test (Rumpel-Leede),

• Colloidal gold,

• Bendien's test for cancer and tuberculosis,

• Bolen's test for cancer,

• Rehfuss test for gastric acidity, and

• Serum seromucoid assay for cancer and other diseases.

B. Cardiovascular Tests

Do not pay for the following phonocardiography and vectorcardiography diagnostic tests because they have been determined to be outmoded and of little clinical value. They include:

• Phonocardiogram with or without ECG lead; with supervision during recording with interpretation and report (when equipment is supplied by the physician),

• Phonocardiogram; tracing only, without interpretation and report (e.g., when equipment is supplied by the hospital, clinic),

• Phonocardiogram; interpretation and report,

• Phonocardiogram with ECG lead, with indirect carotid artery and/or jugular vein tracing, and/or apex cardiogram; with interpretation and report,

• Phonocardiogram; without interpretation and report,

• Phonocardiogram; interpretation and report only,

• Intracardiac,

• Vectorcardiogram (VCG), with or without ECG; with interpretation and report,

• Vectorcardiogram; tracing only, without interpretation and report, and,

• Vectorcardiogram; interpretation and report only.

Text reproduced from the CMS Medicare Coverage Database record for NCD 300.1 version 2. View the original on cms.gov.

Revision history

03/2006 - Delete coding information. Effective/Implementation date: 06/19/2006. ( TN 48 ) (CR4278)

04/01/1997 - Excluded coverage of 10 phonocardiography and vectorcardiography diagnostic tests. Effective 1/1/1997. (TN 96)

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 300.1

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.

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Frequently asked questions — NCD 300.1

What does NCD 300.1 cover?

Do not routinely pay for the following diagnostic tests because they are obsolete and have been replaced by more advanced procedures. The listed tests may be paid for only if the medical need for the procedure is satisfactorily justified by the physician who performs it. When the services are subject to the Quality Improvement Organization (QIO) Review, the QIO is responsible for determining that satisfactory… The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.

When did NCD 300.1 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 300.1?

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.

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.