F33.3 coverage policies: Medicare and commercial payers

59 active Medicare policies list F33.3, 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 F33.3

LCD · NOVITAS-JH-L35006

Controlled Substance Monitoring and Drugs of Abuse Testing

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35006

Controlled Substance Monitoring and Drugs of Abuse Testing

JL · Effective Oct 1, 2015

LCD · CGS-J15-L38394

MolDX: Pharmacogenomics Testing

J15 · Effective Aug 3, 2020

LCD · NORIDIAN-JE-L38335

MolDX: Pharmacogenomics Testing

JE · Effective Aug 17, 2020

LCD · NORIDIAN-JF-L38335

MolDX: Pharmacogenomics Testing

JF · Effective Aug 17, 2020

LCD · PALMETTO-JJ-L38294

MolDX: Pharmacogenomics Testing

JJ · Effective Jul 26, 2020

LCD · PALMETTO-JM-L38294

MolDX: Pharmacogenomics Testing

JM · Effective Jul 26, 2020

LCD · WPS-J5-L38435

MolDX: Pharmacogenomics Testing

J5 · Effective Jul 26, 2020

LCD · WPS-J8-L38435

MolDX: Pharmacogenomics Testing

J8 · Effective Jul 26, 2020

LCD · NOVITAS-JH-L35049

Monitored Anesthesia Care

Commercial payer policies listing F33.3

2 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 F33.3, with the code’s status in each
Policy	Effective	Status of F33.3
Quantitative, Functional and Connectomic Analysis of Brain MRIPayerPolicy · AETNA-CPB-0739	Oct 4, 2023	Covered
Salivary TestsPayerPolicy · AETNA-CPB-0608	Aug 31, 2023	Covered