C4A.121 coverage policies: Medicare and commercial payers

133 active Medicare policies list C4A.121, 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.

Get free alerts for C4A.121

Free account. Policy pages stay open to everyone.

Medicare policies listing C4A.121

Showing 100 of 133

LCD · NORIDIAN-JE-L34233

Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34233

Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)

JF · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34411

Blepharoplasty, Eyelid Surgery, and Brow Lift

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34411

Blepharoplasty, Eyelid Surgery, and Brow Lift

JM · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33457

Cardiac Radionuclide Imaging

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33457

Cardiac Radionuclide Imaging

JM · Effective Oct 1, 2015

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 · PALMETTO-JJ-L33428

Cosmetic and Reconstructive Surgery

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33428

Commercial payer policies listing C4A.121

1 policy from 1 payer

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

Ambetter

Ambetter policies listing C4A.121, with the code’s status in each
Policy	Effective	Status of C4A.121
External Ocular PhotographyPayerPolicy · AMBETTER-CP-VP-43	Not recorded	Covered