C94.40 coverage policies: Medicare and commercial payers

79 active Medicare policies list C94.40, 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.

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Medicare policies listing C94.40

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 · CGS-J15-L34356

Erythropoiesis Stimulating Agents (ESA)

J15 · Effective Oct 1, 2015

LCD · CGS-J15-L40386

Erythropoiesis Stimulating Agents (ESA)

J15

LCD · WPS-J5-L34633

Erythropoiesis Stimulating Agents (ESAs)

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34633

Erythropoiesis Stimulating Agents (ESAs)

J8 · Effective Oct 1, 2015

LCD · CGS-J15-L34037

Flow Cytometry

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L37606

Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases

J6 · Effective Aug 1, 2018

Commercial payer policies listing C94.40

1 policy from 1 payer

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

Aetna

Aetna policies listing C94.40, with the code’s status in each
Policy	Effective	Status of C94.40
Tumor MarkersPayerPolicy · AETNA-CPB-0352	Mar 5, 2024	Covered