D01.1 coverage policies: Medicare and commercial payers

58 active Medicare policies list D01.1, and 2 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 D01.1

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 · WPS-J5-L34614

Colonoscopy and Sigmoidoscopy-Diagnostic

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34614

Colonoscopy and Sigmoidoscopy-Diagnostic

J8 · Effective Oct 1, 2015

LCD · CGS-J15-L34005

Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J15 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34454

Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34454

Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

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

Commercial payer policies listing D01.1

2 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 D01.1, with the code’s status in each
Policy	Effective	Status of D01.1
Tumor MarkersPayerPolicy · AETNA-CPB-0352	Mar 5, 2024	Covered

Anthem

Anthem policies listing D01.1, with the code’s status in each
Policy	Effective	Status of D01.1
Transrectal UltrasonographyClinical Guideline · ANTHEM-CG-RAD-28	Apr 15, 2026	Covered