D13.0 coverage policies: Medicare and commercial payers

25 active Medicare policies list D13.0, 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 D13.0

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 · FIRST_COAST-L33583

Diagnostic and Therapeutic Esophagogastroduodenoscopy

J9 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33461

Implantable Infusion Pump

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33461

Implantable Infusion Pump

JM · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

LCD · NORIDIAN-JF-L37373

MRI and CT Scans of the Head and Neck

JF · Effective Oct 8, 2018

LCD · FIRST_COAST-L33933

Peripheral Nerve Blocks

J9 · Effective Oct 1, 2015

LCD · NGS-J6-L36850

Peripheral Nerve Blocks

J6 · Effective May 1, 2017

LCD · NGS-JK-L36850

Peripheral Nerve Blocks

JK · Effective May 1, 2017

Commercial payer policies listing D13.0

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 D13.0, with the code’s status in each
Policy	Effective	Status of D13.0
Virtual Gastrointestinal EndoscopyPayerPolicy · AETNA-CPB-0535	Jul 21, 2023	Covered

Anthem

Anthem policies listing D13.0, with the code’s status in each
Policy	Effective	Status of D13.0
Vitamin D TestingClinical Guideline · ANTHEM-CG-LAB-11	Oct 1, 2026	Covered