Clinical Lab NCD 210.3 CRC Biomarker Screening Update — Implement by January 4, 2027
CMS Transmittal R13921NCD (CR 14581) updates NCD 210.3 non-invasive colorectal cancer biomarker screening coverage, effective January 4, 2027.
Action required by
January 4, 2027
Review the Action Required section below and ensure your team has completed all compliance steps before this date.
CMS Transmittal R13921NCD, Change Request (CR) 14581, updates National Coverage Determination (NCD) 210.3, Screening for Colorectal Cancer–Non-Invasive Biomarker Tests, with a systems implementation date of January 4, 2027. This is a Dynamic List Data Transmittal published under CMS Publication 100-03 (Medicare National Coverage Determinations Manual). Clinical laboratory billing teams must align claim submission practices with the updated NCD 210.3 parameters before the January 4, 2027 go-live date or risk denials on non-invasive CRC biomarker screening claims.
Regulatory Background
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Quick answers
Is the January 4, 2027 date the coverage effective date for NCD 210.3 changes, or only the claims system implementation date?
Per Transmittal R13921NCD, January 4, 2027 is designated as the Implementation Date — the date by which the Dynamic List data update must be active in Medicare claims processing systems. Whether this date also serves as the coverage effective date for policy purposes must be confirmed in the full CR 14581 transmittal text, which governs adjudication instructions to MACs.
Does a Dynamic List Data transmittal under Publication 100-03 require a new ABN process for newly non-covered non-invasive CRC biomarker tests?
If the CR 14581 Dynamic List update removes or restricts coverage for specific HCPCS codes or ICD-10-CM pairings under NCD 210.3, an Advance Beneficiary Notice of Noncoverage (ABN) is required before rendering a service that is now non-covered for a Medicare beneficiary who would otherwise expect coverage. The specific codes affected must be confirmed from the full transmittal text before updating ABN workflows.
Content summarized from publicly available federal publications including CMS, MAC contractors, and the Federal Register. CLV Intelligence is not affiliated with or endorsed by any government agency. This is not legal or medical advice.