A05.1 coverage policies: Medicare and commercial payers

33 active Medicare policies list A05.1, and 1 commercial payer policy lists it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Medicare policies listing A05.1

LCD · NORIDIAN-JE-L34315

Electrocardiograms

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34315

Electrocardiograms

JF · Effective Oct 1, 2015

LCD · CGS-J15-L39038

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

J15 · Effective Apr 17, 2022

LCD · NORIDIAN-JE-L39001

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

JE · Effective Apr 17, 2022

LCD · NORIDIAN-JF-L39001

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

JF · Effective Apr 17, 2022

LCD · PALMETTO-JJ-L38988

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

JJ · Effective Apr 17, 2022

LCD · PALMETTO-JM-L38988

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

JM · Effective Apr 17, 2022

LCD · WPS-J5-L39044

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

J5 · Effective Apr 17, 2022

LCD · WPS-J8-L39044

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

Commercial payer policies listing A05.1

1 policy from 1 payer

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Cigna

Cigna policies listing A05.1, with the code’s status in each
Policy	Effective	Status of A05.1
Electrodiagnostic Testing (EMG/NCV)PayerPolicy · CIGNA-CPG129	Sep 15, 2026	Covered