How October Got Lighter and January Got Crowded
Seven days before its effective date, CMS pulled a national coverage determination out of the October coding update and parked it in an April 2027 change request. Seven of September's sixteen transmittals now land on January 4, Aetna's October bulletin is almost entirely about January 1, and the October outpatient and ASC rate files still are not posted.
Transmittal 13968 posted Thursday. Nine pages, roughly eight of them the boilerplate CMS bolts onto every quarterly coding update: the funding paragraph, the CAQH CORE remark codes, the standing note that ICD-9 translations were never one-to-one.
The paragraph that matters sits on the cover, above all of it.
"Transmittal 13910 issued August 14, 2026, is being rescinded and replaced by Transmittal 13968, dated September 24, 2026, to remove NCD 110.23 Stem Cell, by removing business requirements 14464.4 through 14464.4.1.1, as it will be added to an April 2027 CR."
Change Request 14464 is the October 2026 ICD-10 update for national coverage determinations. Effective October 1, implementation October 5.
Seven days out, CMS took a coverage determination out of it.
The Same Update, Now on Its Third Version
R13752OTN issued in May, got rescinded in August by R13910OTN, which dropped business requirement 14464.5 and NCD 250.4 actinic keratosis. Now R13910OTN is rescinded too, and stem cell transplantation follows actinic keratosis out the door.
Two NCDs gone from the October coding update across two revisions, the second with a week to spare. What survives is real work: the PET perfusion edits get an updatable parameter screen instead of a hardcoded tracer list in reason codes 32438 and 32440, and bone density codes 0554T through 0558T become payable for diagnostic indications.
If you bill stem cell transplant, the edits you were told in May and again in August to expect on October 1 are now a six-month wait, and the policy behind them never moved. The CR says so in as many words: "No policy is being changed as a result of these updates."
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