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NCD Manual section 20: Cardiovascular System

Section 20 of the Medicare National Coverage Determinations Manual (Pub. 100-03, chapter 1, part 1) holds 49 National Coverage Determinations on cardiovascular system. Each binds every Medicare Administrative Contractor; this page lists them with their effective dates, the local policies that cite them and the contractor articles that turn them into claim edits.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: Medicare Coverage Database NCDs: API snapshot September 27, 2026 (effective September 20, 2026); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: weekly, every Thursday.

NCDs in the section
49
42 with a full reference page
Laboratory NCDs
0
Cited by local policies
14
45 LCD citations
With contractor articles
12
32 articles
Coverage analyses linked
64
Newest effective date
2025-10-28
NCD 20.40

Every NCD in section 20

Local policies counts the active LCDs that list the NCD as related; contractor articles counts the current Medicare Coverage Database articles that name it. NCDs with an indexed reference page are linked; the others are listed by number and title.

National Coverage Determinations in NCD Manual section 20, Cardiovascular System
NCDTitleBenefit categoryEffectiveLocal policiesContractor articles
20.1Vertebral Artery SurgeryInpatient Hospital Services, Physicians' Serviceslongstanding——
20.2Extracranial-Intracranial (EC-IC) Arterial Bypass SurgeryInpatient Hospital Services, Physicians' Services1991-03-27——
20.3Thoracic Duct Drainage (TDD) in Renal TransplantsInpatient Hospital Services, Physicians' Serviceslongstanding——
20.4Implantable Cardioverter Defibrillators (ICDs)Prosthetic Devices2023-07-3111
20.6Transmyocardial Revascularization (TMR)Inpatient Hospital Services, Physicians' Services1999-07-01——
20.7Percutaneous Transluminal Angioplasty (PTA)Inpatient Hospital Services, Physicians' Services2023-10-1184
20.8Cardiac PacemakersInpatient Hospital Services, Physicians' Services, Prosthetic Devices2013-08-132—
20.8.1Cardiac Pacemaker Evaluation ServicesDiagnostic Services in Outpatient Hospital, Diagnostic Tests (other)1984-10-011—
20.8.1.1Transtelephonic Monitoring of Cardiac PacemakersOutpatient Hospital Services Incident to a Physician's Service2003-10-031—
20.8.2Self-Contained Pacemaker MonitorsDurable Medical Equipmentlongstanding—2
20.8.3Single Chamber and Dual Chamber Permanent Cardiac PacemakersInpatient Hospital Services, Physicians' Services, Prosthetic Devices2013-08-1316
20.8.4Leadless PacemakersInpatient Hospital Services, Physicians' Services, Prosthetic Devices2017-01-18—1
20.9Artificial Hearts and Related Devices - RETIREDProsthetic Devices2023-04-10——
20.9.1Ventricular Assist DevicesInpatient Hospital Services, Prosthetic Devices2020-12-01—1
20.10Cardiac Rehabilitation Programs - RETIREDIncident to a physician's professional Service2023-04-1011
20.10.1Cardiac Rehabilitation Programs for Chronic Heart FailureCardiac Rehabilitation Programs2014-02-18——
20.11Intraoperative Ventricular MappingInpatient Hospital Services, Physicians' Services1984-10-29——
20.12Diagnostic Endocardial Electrical Stimulation (Pacing)Diagnostic Services in Outpatient Hospital, Diagnostic Tests (other), Physicians' Services1984-12-03——
20.13HIS Bundle StudyDiagnostic Tests (other)1984-12-03——
20.14PlethysmographyDiagnostic Tests (other)1980-11-15105
20.15Electrocardiographic ServicesDiagnostic Tests (other)2004-08-2665
20.16Cardiac Output Monitoring by Thoracic Electrical Bioimpedance (TEB)Diagnostic Tests (other)2006-11-24——
20.17Noninvasive Tests of Carotid FunctionDiagnostic Tests (other)1980-11-1552
20.18Carotid Body Resection/Carotid Body DenervationPhysicians' Serviceslongstanding——
20.19Ambulatory Blood Pressure MonitoringDiagnostic Tests (other)2019-07-02——
20.20External Counterpulsation (ECP) Therapy for Severe AnginaPhysicians' Services2006-03-201—
20.21Chelation Therapy for Treatment of AtherosclerosisIncident to a physician's professional Service, Physicians' Serviceslongstanding——
20.22Ethylenediamine-Tetra-Acetic (EDTA) Chelation Therapy for Treatment of AtherosclerosisPhysicians' Serviceslongstanding——
20.23Fabric Wrapping of Abdominal AneurysmsPhysicians' Serviceslongstanding——
20.24Displacement CardiographyDiagnostic Tests (other)1988-10-12——
20.25Cardiac Catheterization Performed in Other than a Hospital Setting - RETIREDDiagnostic Tests (other)2023-04-1011
20.26Partial VentriculectomyPhysicians' Services1997-04-15——
20.27Cardiointegram (CIG) as an Alternative to Stress Test or Thallium Stress TestDiagnostic Tests (other)longstanding——
20.28Therapeutic EmbolizationPhysicians' Services1978-12-15——
20.29Hyperbaric Oxygen TherapyIncident to a physician's professional Service, Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services2017-04-0353
20.30Microvolt T-Wave Alternans (MTWA)Diagnostic Tests (other)2015-01-13——
20.31Intensive Cardiac Rehabilitation (ICR) ProgramsIntensive Cardiac Rehabilitation Program2010-08-12——
20.31.1The Pritikin ProgramIntensive Cardiac Rehabilitation Program2010-08-12——
20.31.2Ornish Program for Reversing Heart DiseaseIntensive Cardiac Rehabilitation Program2010-08-12——
20.31.3Benson-Henry Institute Cardiac Wellness ProgramIntensive Cardiac Rehabilitation Program2014-05-06——
20.32Transcatheter Aortic Valve Replacement (TAVR)Inpatient Hospital Services, Physicians' Services2019-06-21——
20.33Transcatheter Edge-to-Edge Repair (TEER) for Mitral Valve RegurgitationInpatient Hospital Services, Physicians' Services2023-07-31——
20.34Percutaneous Left Atrial Appendage Closure (LAAC)Inpatient Hospital Services, Physicians' Services2016-02-08——
20.35Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)Incident to a physician's professional Service, Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services2017-05-252—
20.36Implantable Pulmonary Artery Pressure Sensors for Heart Failure ManagementInpatient Hospital Services, Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services2025-01-13——
20.37Transcatheter Tricuspid Valve Replacement (TTVR)Inpatient Hospital Services2025-03-19——
20.38Transcatheter Edge-to-Edge Repair for Tricuspid Valve Regurgitation (T-TEER)Inpatient Hospital Services, Physicians' Services2025-07-02——
20.39Cardiac Contractility Modulation (CCM) for Heart Failure (HF)Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services, Prosthetic Devices2025-10-28——
20.40Renal Denervation (RDN) for Uncontrolled HypertensionAmbulatory Surgical Center Facility Services, Incident to a physician's professional Service, Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services2025-10-28——

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 20 covers cardiovascular system. Most of its NCDs fall under the Diagnostic Tests (other) (10), Inpatient Hospital Services, Physicians' Services (10), Physicians' Services (6) 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 1978-12-15 (NCD 20.28) to 2025-10-28 (NCD 20.40); 8 NCDs are 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 12 NCDs have such contractor articles, listed on each NCD page under "How MACs bill" with their covered ICD-10-CM codes. 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

14 of the 49 NCDs in this section are cited by active Local Coverage Determinations, 45 citations in all; 12 have contractor billing articles (32 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 20.4 Implantable Cardioverter Defibrillators (ICDs), at about 210 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.

Where QuickIntell fits in coverage checks

QuickAuth coordinates requirement checks, documentation, submission and status tracking for prior authorization with human review, so national and local coverage criteria are looked at before the service. QuickRCM picks up the claim and any coverage denial afterwards.

See QuickAuth for requirement checksSee QuickRCM for coverage denialsBook a meeting

Frequently asked questions

Which NCDs are in NCD Manual section 20?

Section 20, Cardiovascular System, holds 49 National Coverage Determinations in the current Medicare Coverage Database: 20.1 Vertebral Artery Surgery; 20.2 Extracranial-Intracranial (EC-IC) Arterial Bypass Surgery; 20.3 Thoracic Duct Drainage (TDD) in Renal Transplants; 20.4 Implantable Cardioverter Defibrillators (ICDs); 20.6 Transmyocardial Revascularization (TMR); 20.7 Percutaneous Transluminal Angioplasty (PTA); 20.8 Cardiac Pacemakers; 20.8.1 Cardiac Pacemaker Evaluation Services; and 41 more listed on this page.

How are NCD numbers assigned?

An NCD number is its place in chapter 1 of the NCD Manual: the part before the dot is the section (20 here), and the rest orders the policies inside it. Section 20 is in part 1 of the chapter. The number stays with the policy when CMS revises it; each revision gets a new version and transmittal instead.

Do Medicare contractors add local rules to section 20 NCDs?

14 of the 49 NCDs are cited by at least one active Local Coverage Determination, and 12 have contractor articles that implement them in the Medicare Coverage Database. A local policy may add documentation and coding detail but may not contradict the national determination.

How current is this list?

It is rebuilt from the CMS Coverage API NCD records and the weekly Medicare Coverage Database article export. The most recent effective date in the section is 2025-10-28 (NCD 20.40); 8 are longstanding NCDs whose current-version effective date CMS has not posted.

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.

Disclaimer

NCD titles, dates and counts are compiled from the CMS Coverage API and the Medicare Coverage Database export as an operational reference. Coverage depends on the full policy text, the claim and the contractor; verify against the current NCD on cms.gov. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.