C69.92 coverage policies: Medicare and commercial payers

117 active Medicare policies list C69.92, and 3 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.

Get free alerts for C69.92

Free account. Policy pages stay open to everyone.

Medicare policies listing C69.92

Showing 100 of 117

LCD · FIRST_COAST-L36767

Aortography and peripheral angiography

J9 · Effective Oct 31, 2016

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-L34417

CT of the Head

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34417

CT of the Head

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 · PALMETTO-JJ-L33461

Implantable Infusion Pump

Commercial payer policies listing C69.92

3 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 C69.92, with the code’s status in each
Policy	Effective	Status of C69.92
InfertilityPayerPolicy · AETNA-CPB-0327	Feb 15, 2024	Covered
Proton Beam, Neutron Beam, and Carbon Ion RadiotherapyPayerPolicy · AETNA-CPB-0270	Oct 3, 2023	Covered

Anthem

Anthem policies listing C69.92, with the code’s status in each
Policy	Effective	Status of C69.92
Fundus PhotographyClinical Guideline · ANTHEM-CG-MED-47	Apr 15, 2026	Covered