Non-covered Procedure Codes Over Age 60 ICD-10-PCS
The non-covered procedure codes over age 60 edit is a coverage check in Medicare’s claim-validation software, the Medicare Code Editor (MCE). It covers the 2 ICD-10-PCS procedure codes listed below. These lumbar disc replacement codes are denied as non-covered when the beneficiary is over age 60. For younger patients the edit does not apply.
Procedure Codes in This Edit 2 codes · 1 category
Questions About This Code Edit
What is the non-covered procedure codes over age 60 Medicare code edit?
The procedures shown below are identified as "Non-covered procedures" when the beneficiary is over age 60. The Medicare Code Editor flags any inpatient claim that triggers the check.
How many codes are on the non-covered procedure codes over age 60 list?
The FY 2026 list contains 2 codes, imported from the CMS Definitions of Medicare Code Edits v43.0.
What happens when a claim triggers this edit?
These lumbar disc replacement codes are denied as non-covered when the beneficiary is over age 60. For younger patients the edit does not apply.
Does this edit make the codes invalid?
No. Every code on this list is a valid code. The edit is about Medicare payment rules, not about whether the code exists or can be documented.
Other ICD-10-PCS Medicare Code Edits
Source: CMS Definitions of Medicare Code Edits v43.0, effective October 1, 2025 through September 30, 2026. Code lists are imported directly from the official manual. See also the ICD-10-CM diagnosis edits and the MS-DRG list.
