E09.42 coverage policies: Medicare and commercial payers

84 active Medicare policies list E09.42, and 3 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 E09.42

LCD · NGS-J6-L36236

Autonomic Function Testing

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L36236

Autonomic Function Testing

JK · Effective Oct 1, 2015

LCD · WPS-J5-L35490

Category III Codes

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L35490

Category III Codes

J8 · Effective Oct 1, 2015

LCD · CGS-J15-L38662

Implantable Continuous Glucose Monitors (I-CGM)

J15 · Effective Nov 2, 2020

LCD · FIRST_COAST-L38664

Implantable Continuous Glucose Monitors (I-CGM)

J9 · Effective Oct 11, 2020

LCD · NGS-J6-L38623

Implantable Continuous Glucose Monitors (I-CGM)

J6 · Effective Dec 1, 2020

LCD · NGS-JK-L38623

Implantable Continuous Glucose Monitors (I-CGM)

JK · Effective Dec 1, 2020

LCD · NORIDIAN-JE-L38657

Implantable Continuous Glucose Monitors (I-CGM)

JE · Effective Nov 2, 2020

LCD · NORIDIAN-JF-L38657

Implantable Continuous Glucose Monitors (I-CGM)

JF · Effective Nov 2, 2020

Commercial payer policies listing E09.42

3 policies from 1 payer

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

Aetna

Aetna policies listing E09.42, with the code’s status in each
Policy	Effective	Status of E09.42
Autonomic Testing / Sudomotor TestsPayerPolicy · AETNA-CPB-0485	Jul 13, 2023	Covered
Gastric Pacing / Electrical Stimulation and Gastroesophageal Per Oral Endoscopic MyotomyPayerPolicy · AETNA-CPB-0678	Sep 25, 2023	Covered
Orthopedic Casts, Braces and SplintsPayerPolicy · AETNA-CPB-0009	Mar 15, 2024	Covered