D47.01 coverage policies: Medicare and commercial payers

53 active Medicare policies list D47.01, 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 D47.01

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

LCD · CGS-J15-L34356

Erythropoiesis Stimulating Agents (ESA)

J15 · Effective Oct 1, 2015

LCD · CGS-J15-L40386

Erythropoiesis Stimulating Agents (ESA)

J15

LCD · CGS-J15-L34037

Flow Cytometry

J15 · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34215

Lab: Flow Cytometry

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34215

Commercial payer policies listing D47.01

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 D47.01, with the code’s status in each
Policy	Effective	Status of D47.01
Flow Cytometry, Ektacytometry, DNA Ploidy, and S-phase FractionPayerPolicy · AETNA-CPB-0351	Jun 5, 2023	Covered

Cigna

Cigna policies listing D47.01, with the code’s status in each
Policy	Effective	Status of D47.01
Flow CytometryPayerPolicy · CIGNA-0538	Sep 15, 2026	Covered