Medicare Coverage with ICD-10 Diagnosis Codes


As of October 1, 2015 all medical claims must be submitted with ICD-10 instead of ICD-9 Diagnosis Codes.  Claims for services on or after that date will be subject to Medicare Coverage using the guidelines below.  


If you provide services for Medicare Beneficiaries, you know there are limitations in coverage.  Medicare only covers those lab tests it considers medically necessary for its beneficiaries.  Tests not ordered for these reasons must be accompanied by an Advance Beneficiary Notice (ABN) indicating the patient's willingness to accept financial responsibility for the charges.  Click on the test name below to find coverage limitations.