Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
15 active Medicare policies list D38.6, 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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J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J9 · Effective Oct 1, 2015
J6 · Effective May 1, 2017
JK · Effective May 1, 2017
National · Effective Oct 1, 2026
2 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of D38.6 |
|---|---|---|
| Concert Genetic Testing Oncology: Algorithmic Assays | Not recorded | Referenced |
| Policy | Effective | Status of D38.6 |
|---|---|---|
| Functional Endoscopic Sinus Surgery (FESS) | Jul 1, 2026 | Covered |
National · Effective Oct 1, 2026
J6 · Effective Apr 1, 2026
J6 · Effective Apr 1, 2026
National · Effective Oct 30, 2025
National · Effective Oct 1, 2026