D47.4 coverage policies: Medicare and commercial payers

55 active Medicare policies list D47.4, 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 D47.4

LCD · WPS-J5-L34633

Erythropoiesis Stimulating Agents (ESAs)

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34633

Erythropoiesis Stimulating Agents (ESAs)

J8 · Effective Oct 1, 2015

LCD · CGS-J15-L34037

Flow Cytometry

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L37606

Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases

J6 · Effective Aug 1, 2018

LCD · NGS-JK-L37606

Genomic Sequence Analysis Panels in the Treatment of Hematolymphoid Diseases

JK · Effective Aug 1, 2018

LCD · NORIDIAN-JE-L38972

MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

JE · Effective Aug 8, 2022

LCD · NORIDIAN-JF-L38972

MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

JF · Effective Aug 8, 2022

LCD · PALMETTO-JJ-L38966

MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

JJ · Effective Jul 3, 2022

LCD · PALMETTO-JM-L38966

MolDX: Lab-Developed Tests for Inherited Cancer Syndromes in Patients with Cancer

JM · Effective Jul 3, 2022

Commercial payer policies listing D47.4

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 D47.4, with the code’s status in each
Policy	Effective	Status of D47.4
Tumor MarkersPayerPolicy · AETNA-CPB-0352	Mar 5, 2024	Covered

Cigna

Cigna policies listing D47.4, with the code’s status in each
Policy	Effective	Status of D47.4
Flow CytometryPayerPolicy · CIGNA-0538	Sep 15, 2026	Covered