A52.15 coverage policies: Medicare and commercial payers

70 active Medicare policies list A52.15, and 4 commercial payer policies list 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 A52.15

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

LCD · NORIDIAN-JF-L37373

MRI and CT Scans of the Head and Neck

JF · Effective Oct 8, 2018

LCD · PALMETTO-JJ-L37642

Nerve Blocks and Electrostimulation for Peripheral Neuropathy

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37642

Nerve Blocks and Electrostimulation for Peripheral Neuropathy

JM · Effective Jan 29, 2018

LCD · CGS-J15-L35897

Nerve Conduction Studies and Electromyography

J15 · Effective Oct 1, 2015

LCD · FIRST_COAST-L34859

Nerve Conduction Studies and Electromyography

J9 · Effective Oct 1, 2015

LCD · NGS-J6-L35098

Nerve Conduction Studies and Electromyography

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L35098

Nerve Conduction Studies and Electromyography

JK · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L36524

Nerve Conduction Studies and Electromyography

JE · Effective Jun 1, 2016

LCD · NORIDIAN-JF-L36524

Commercial payer policies listing A52.15

4 policies from 3 payers

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

Ambetter

Ambetter policies listing A52.15, with the code’s status in each
Policy	Effective	Status of A52.15
Fundus PhotographyPayerPolicy · AMBETTER-CP-VP-29	Not recorded	Covered
Visual Field TestingPayerPolicy · AMBETTER-CP-VP-63	Not recorded	Covered

Anthem

Anthem policies listing A52.15, with the code’s status in each
Policy	Effective	Status of A52.15
Fundus PhotographyClinical Guideline · ANTHEM-CG-MED-47	Apr 15, 2026	Covered

Cigna

Cigna policies listing A52.15, with the code’s status in each
Policy	Effective	Status of A52.15
Autonomic Nerve Function Testing