Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 100.4
Not Otherwise Classified Clinical Laboratory Tests
100.4 - Not Otherwise Classified Clinical Laboratory Tests
(Rev. 1, 10-01-03)
The following codes for unlisted or not otherwise classified (NOC) clinical laboratory
tests are not subject to the NLA:
81099 87999
84999 88299
85999 89399
86999
The NOC codes shall suspend for review and the A/B MAC (B) shall determine a price
for them.