C54.9 coverage policies: Medicare and commercial payers

113 active Medicare policies list C54.9, and 6 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 C54.9

Showing 100 of 113

LCD · NOVITAS-JH-L35396

Biomarkers for Oncology

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35396

Biomarkers for Oncology

JL · 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-L34415

CT of the Abdomen and Pelvis

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34415

CT of the Abdomen and Pelvis

JM · Effective Oct 1, 2015

LCD · NGS-J6-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

Commercial payer policies listing C54.9

6 policies from 1 payer

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

Aetna

Aetna policies listing C54.9, with the code’s status in each
Policy	Effective	Status of C54.9
CryoablationPayerPolicy · AETNA-CPB-0100	Dec 5, 2023	Covered
Endometrial Cancer Screening, Diagnosis, and PrognosisPayerPolicy · AETNA-CPB-0769	Oct 26, 2023	Covered
Fibroid TreatmentPayerPolicy · AETNA-CPB-0304	Feb 15, 2024	Covered
Intraoperative Radiation Therapy (IORT)PayerPolicy · AETNA-CPB-0721	Sep 22, 2023	Covered
Pharmacogenetic and Pharmacodynamic TestingPayerPolicy · AETNA-CPB-0715	Feb 27, 2024	Covered
Tumor MarkersPayerPolicy · AETNA-CPB-0352	Mar 5, 2024	Covered