E85.4 coverage policies: Medicare and commercial payers

75 active Medicare policies list E85.4, 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 E85.4

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-L35124

Autonomic Function Testing

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L35124

Autonomic Function Testing

J8 · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35395

Autonomic Function Tests

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35395

Autonomic Function Tests

JL · Effective Oct 1, 2015

LCD · CGS-J15-L33959

Cardiac Catheterization and Coronary Angiography

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L33557

Cardiac Catheterization and Coronary Angiography

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33557

Cardiac Catheterization and Coronary Angiography

JK · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33459

Computerized Axial Tomography (CT), Thorax

JJ · Effective Oct 1, 2015

Commercial payer policies listing E85.4

3 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 E85.4, with the code’s status in each
Policy	Effective	Status of E85.4
Laser Treatment for Psoriasis and Other Selected Skin ConditionsPayerPolicy · AETNA-CPB-0577	Aug 11, 2023	Covered
Pulsed Dye Laser TreatmentPayerPolicy · AETNA-CPB-0559	Aug 9, 2023	Covered

Ambetter

Ambetter policies listing E85.4, with the code’s status in each
Policy	Effective	Status of E85.4
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered