C78.39 coverage policies: Medicare and commercial payers

93 active Medicare policies list C78.39, 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.

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Medicare policies listing C78.39

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-L40333

Erythropoiesis Stimulating Agents

LCD · NGS-J6-L40334

Erythropoiesis Stimulating Agents

J6 · Effective Jul 15, 2026

LCD · NGS-JK-L40333

Erythropoiesis Stimulating Agents

LCD · NGS-JK-L40334

Erythropoiesis Stimulating Agents

JK · Effective Jul 15, 2026

Commercial payer policies listing C78.39

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 C78.39, with the code’s status in each
Policy	Effective	Status of C78.39
External Ocular PhotographyPayerPolicy · AETNA-CPB-0734	Sep 22, 2023	Covered
VideostroboscopyPayerPolicy · AETNA-CPB-0305	Apr 28, 2023	Covered

Ambetter

Ambetter policies listing C78.39, with the code’s status in each
Policy	Effective	Status of C78.39
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered