D37.5 coverage policies: Medicare and commercial payers

73 active Medicare policies list D37.5, 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 D37.5

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

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34415

CT of the Abdomen and Pelvis

JM · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34213

Diagnostic and Therapeutic Colonoscopy

Commercial payer policies listing D37.5

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 D37.5, with the code’s status in each
Policy	Effective	Status of D37.5
Genetic TestingPayerPolicy · AETNA-CPB-0140	Feb 27, 2024	Covered

Anthem

Anthem policies listing D37.5, with the code’s status in each
Policy	Effective	Status of D37.5
Transrectal UltrasonographyClinical Guideline · ANTHEM-CG-RAD-28	Apr 15, 2026	Covered