Every NCD in section 40
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.
| NCD | Title | Benefit category | Effective | Local policies | Contractor articles |
|---|---|---|---|---|---|
| 40.1 | Diabetes Outpatient Self-Management Training | Diabetes Outpatient Self-Management Training | 2001-02-27 | 1 | 2 |
| 40.2 | Home Blood Glucose Monitors | Durable Medical Equipment | 2006-06-19 | 4 | 2 |
| 40.3 | Closed-Loop Blood Glucose Control Device (CBGCD) | Inpatient Hospital Services | 1983-07-01 | — | 1 |
| 40.4 | Insulin Syringe | Incident to a physician's professional Service | longstanding | — | — |
| 40.5 | Treatment of Obesity | Incident to a physician's professional Service, Physicians' Services | 2013-09-24 | — | — |
| 40.7 | Outpatient Intravenous Insulin Treatment | Diagnostic Tests (other), Drugs and Biologicals, Physicians' Services | 2009-12-23 | — | — |
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 40 covers endocrine system and metabolism. Most of its NCDs fall under the Diabetes Outpatient Self-Management Training (1), Diagnostic Tests (other), Drugs and Biologicals, Physicians' Services (1), Durable Medical Equipment (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 1983-07-01 (NCD 40.3) to 2013-09-24 (NCD 40.5); 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 3 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
2 of the 6 NCDs in this section are cited by active Local Coverage Determinations, 5 citations in all; 3 have contractor billing articles (5 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.
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)
- 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)
- 190 Pathology and Laboratory (33)
- 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)
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.
Frequently asked questions
Which NCDs are in NCD Manual section 40?
Section 40, Endocrine System and Metabolism, holds 6 National Coverage Determinations in the current Medicare Coverage Database: 40.1 Diabetes Outpatient Self-Management Training; 40.2 Home Blood Glucose Monitors; 40.3 Closed-Loop Blood Glucose Control Device (CBGCD); 40.4 Insulin Syringe; 40.5 Treatment of Obesity; 40.7 Outpatient Intravenous Insulin Treatment.
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 (40 here), and the rest orders the policies inside it. Section 40 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 40 NCDs?
2 of the 6 NCDs are cited by at least one active Local Coverage Determination, and 3 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 2013-09-24 (NCD 40.5); 1 is a longstanding NCD 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.
- 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…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file article.csvSHA-256 5e95c4a8ac3664be…
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.