E11.621 coverage policies: Medicare and commercial payers

87 active Medicare policies list E11.621, and 4 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 E11.621

LCD · NOVITAS-JH-L35022

Bariatric Surgical Management of Morbid Obesity

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35022

Bariatric Surgical Management of Morbid Obesity

JL · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34324

Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34324

Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography

JF · 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 · PALMETTO-JJ-L34419

Homocysteine Level, Serum

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34419

Homocysteine Level, Serum

JM · Effective Oct 1, 2015

LCD · CGS-J15-L38662

Implantable Continuous Glucose Monitors (I-CGM)

J15 · Effective Nov 2, 2020

LCD · FIRST_COAST-L38664

Commercial payer policies listing E11.621

4 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 E11.621, with the code’s status in each
Policy	Effective	Status of E11.621
Bio-Surgery: Medicinal Leech Therapy and Medical MaggotsPayerPolicy · AETNA-CPB-0556	Aug 10, 2023	Covered
Blood and Adipose Tissue Derived Products for Selected IndicationsPayerPolicy · AETNA-CPB-0784	Oct 26, 2023	Covered
IontophoresisPayerPolicy · AETNA-CPB-0229	Apr 26, 2023	Covered
Skin and Soft Tissue SubstitutesPayerPolicy · AETNA-CPB-0244	Feb 9, 2024	Covered