G31.80 coverage policies: Medicare and commercial payers

23 active Medicare policies list G31.80, and 1 commercial payer policy lists 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 G31.80

LCD · PALMETTO-JJ-L39266

Cognitive Assessment and Care Plan Service

JJ · Effective Aug 28, 2022

LCD · PALMETTO-JM-L39266

Cognitive Assessment and Care Plan Service

JM · Effective Aug 28, 2022

LCD · PALMETTO-JJ-L34417

CT of the Head

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34417

CT of the Head

JM · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L37638

Health and Behavior Assessment/Intervention

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37638

Health and Behavior Assessment/Intervention

JM · Effective Jan 29, 2018

LCD · PALMETTO-JJ-L34424

Magnetic Resonance Angiography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34424

Magnetic Resonance Angiography

JM · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L35048

Nerve Conduction Studies and Electromyography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L35048

Nerve Conduction Studies and Electromyography

Commercial payer policies listing G31.80

1 policy from 1 payer

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

Cigna

Cigna policies listing G31.80, with the code’s status in each
Policy	Effective	Status of G31.80
Airway Clearance Devices in the Ambulatory SettingPayerPolicy · CIGNA-0069	Nov 9, 2025	Covered