C39.9 coverage policies: Medicare and commercial payers

79 active Medicare policies list C39.9, and 2 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 C39.9

LCD · PALMETTO-JJ-L33459

Computerized Axial Tomography (CT), Thorax

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33459

Computerized Axial Tomography (CT), Thorax

JM · Effective Oct 1, 2015

LCD · CGS-J15-L34356

Erythropoiesis Stimulating Agents (ESA)

J15 · Effective Oct 1, 2015

LCD · CGS-J15-L40386

Erythropoiesis Stimulating Agents (ESA)

J15

LCD · NGS-J6-L37810

Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms

J6 · Effective Apr 1, 2019

LCD · NGS-JK-L37810

Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms

JK · Effective Apr 1, 2019

LCD · NORIDIAN-JE-L34215

Lab: Flow Cytometry

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34215

Lab: Flow Cytometry

JF · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34513

Lab: Flow Cytometry

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34513

Lab: Flow Cytometry

Commercial payer policies listing C39.9

2 policies from 2 payers

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

Aetna

Aetna policies listing C39.9, with the code’s status in each
Policy	Effective	Status of C39.9
Strontium Chloride Sr-89PayerPolicy · AETNA-CPB-0361	Dec 15, 2023	Covered

Ambetter

Ambetter policies listing C39.9, with the code’s status in each
Policy	Effective	Status of C39.9
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered