D38.4 coverage policies: Medicare and commercial payers

41 active Medicare policies list D38.4, 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 D38.4

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 · NGS-J6-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

JK · 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

LCD · PALMETTO-JJ-L39237

Erythropoiesis Stimulating Agents

JJ · Effective Jul 24, 2022

LCD · PALMETTO-JM-L39237

Erythropoiesis Stimulating Agents

JM · Effective Jul 24, 2022

Commercial payer policies listing D38.4

1 policy from 1 payer

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

Ambetter

Ambetter policies listing D38.4, with the code’s status in each
Policy	Effective	Status of D38.4
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered