NCD Manual section 190: Pathology and Laboratory

Every NCD in section 190

What the section covers and how to read it

The NCD Manual groups national policies by body system or service type, and the section number is the first part of every NCD number in it. Section 190 covers pathology and laboratory. Most of its NCDs fall under the Diagnostic Laboratory Tests (28), Diagnostic Tests (other) (4), No Benefit Category (1) benefit categories, which decide whether Medicare can pay for the item at all before the NCD's clinical criteria are applied. Effective dates in the section run from 1978-08-01 (NCD 190.6) to 2023-07-31 (NCD 190.1); 1 NCD is longstanding policies for which CMS has not posted the effective date of the current version. A claim is judged against the version in force on the date of service, so the effective date and the revision history on each NCD page matter as much as the criteria.

Read an NCD in three layers. The item or service description says what the policy is about; the indications and limitations say when Medicare covers it, often with documentation, setting or frequency conditions; and the contractor articles say how the claim must be coded for the national criteria to be applied automatically. In this section 8 NCDs have such contractor articles, listed on each NCD page under "How MACs bill" with their covered ICD-10-CM codes. The laboratory NCDs here are different: CMS publishes their ICD-10-CM edit lists nationally every quarter, and every contractor applies the same list. Where a contractor has also written a Local Coverage Determination that cites the NCD, the LCD adds local documentation and coding detail but cannot narrow or widen the national coverage.

Local policies and contractor articles

9 of the 33 NCDs in this section are cited by active Local Coverage Determinations, 26 citations in all; 8 have contractor billing articles (18 articles across the Medicare Administrative Contractors). To see what applies to a claim, open the NCD, then the local policy and article of the contractor that processes it: the LCD list carries every active local policy, the LCD lookup guide explains which contractor covers which state, and the code-and-diagnosis checker tests one procedure code and one ICD-10-CM code against every article that applies in a state. A denial under an NCD returns CARC 50 with remark N386.

The most searched NCD in this section is NCD 190.21 Glycated Hemoglobin/Glycated Protein, at about 110 US Google searches a month for its number.

Other sections of the NCD Manual

Chapter 1 of the manual is published in four parts on cms.gov; every section with a current NCD has its own page here.

• 10 Anesthesia and Pain Management (6)
• 20 Cardiovascular System (49)
• 30 Complementary and Alternative Medicine (12)
• 40 Endocrine System and Metabolism (6)
• 50 Ear, Nose and Throat (ENT) (7)
• 70 Evaluation and Management of Patients - Office/hospital/home (6)
• 80 Eye (14)
• 90 Genetics (2)
• 100 Gastrointestinal System (13)
• 110 Hematology/Immunology/Oncology (23)
• 130 Mental Health (8)
• 140 Miscellaneous Surgical Procedures (8)
• 150 Musculoskeletal System (12)
• 160 Nervous System (23)
• 170 Nonphysician Practitioner Services (PT/OT/SLP/Audiologists/CRNA) (3)
• 180 Nutrition (2)
• 200 Pharmacology (3)
• 210 Prevention (16)
• 220 Radiology (30)
• 230 Renal and Genitourinary System - ESRD Services (19)
• 240 Respiratory System (12)
• 250 Skin (5)
• 260 Transplantation - Solid Organ Transplants (9)
• 270 Wound Treatment (6)
• 280 Medical and Surgical Supplies (14)
• 290 Nursing Services (2)
• 300 Diagnostic Tests Not Otherwise Classified (1)
• 310 Clinical Trials (1)

Frequently asked questions

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

• Medicare Coverage Database NCDs via the CMS Coverage API
  Version API snapshot 2026-09-27 · effective 2026-09-20 · file national-coverage-ncd.jsonSHA-256 a90fadfd264b9ef4…
• Medicare Coverage Database, current Billing and Coding Articles export
  Version MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…