Appendix E - National Coverage Determinations Manual / NCD 406

Why This Topic Matters

National coverage determinations affect whether a service is payable under Medicare and how related laboratory or procedure claims are interpreted. This page helps readers identify the relevant CMS policy topic, the affected specialty area, and the general boundaries of the coverage discussion without relying on the premium text.

Article Sections

1. 20.25 Cardiac Catheterization Performed in Other Than a Hospital Setting

   A short policy item noting a coverage status change for a cardiac catheterization setting issue and its effective date information.

2. 190.28 Tumor Antigen by Immunoassay – CA 125

   The main policy section addressing CMS coverage guidance for CA 125 tumor marker testing, including the clinical contexts and limitations discussed in the manual entry.

3. Indications

   General circumstances under which CA 125 testing is discussed in the policy, including broad oncology-related uses and monitoring contexts.

4. Limitations

   The boundaries of the coverage discussion, including situations the policy says are not covered and the overall scope of use described by CMS.